Cmam integration and complementary models ce
- 1. Presenter: Dr. Sisay Sinamo (MD, MPH) Nutrition Advisor, East Africa Regional Office
- 2. Outline 1. Purpose of the presentation 2. Rational for Integration 3. Status of CMAM integration in Africa 4. MoH Integration: A case of Ethiopia 5. Aims of IYCF into CMAM ToT and planning workshop 6. Integrating IYCF into CMAM ToT 7. Integrating IYCF into CMAM planning workshop 8. Action plans 9. Roll-out and lesson
- 3. 1) Purpose of the presentation To share experiences in CMAM integration in MoH system and progress made to generate evidence on complementary models
- 4. 2) Rational for Integration Effective model for the rehabilitation malnourished children Operational - variety of settings (stable and emergency) More than 500,000 acutely malnourished children were rehabilitated Trained over 10,000 community health workers and 2000 health workers
- 5. 2) Rational for Integration CMAM integration into MoH system: 2008 Evidence on the project model effectiveness Demand for national level programming MoH readiness and ownership to take the lead: guideline and tools Complementary models: 2010 • CMAM provides timely and appropriate intervention to improve child survival • Lack of linkage between the ‘rehabilitative approach’ and preventive approaches • Partners collaboration to develop the tools and test model
- 6. 3) Status of CMAM Integration Currently almost all countries has CMAM guideline CMAM is considered as part of regular health service activity NGOs are called when the case load is high; except fragile state MoH is responsible for logistics transport and training NGOs minimal support to ensure the quality of the program
- 7. 3) MoH Integration: A Case of Ethiopia Strong national level Emergency Nutrition Coordination SAM Guideline approved in 2007 CMAM decentralization to the health post level in 2008 All food insecure districts has trained man power Health workers are responsible for case management and reporting Community volunteers conduct screening, referral and follow up
- 8. 4) Complementary Models Two complementary models are under operational research in Ethiopia: IYCF support into CMAM PD Hearth in the context of CMAM and ENA
- 9. 4.1) IYCF support into CMAM OR It is joint 2 years OR project between WV, SC US, ENN and Hawassa University The OR project is operational in two WV Ethiopia ADPs (one intervention and one control) The goal of the study is to test and document models of IYCF-CMAM integration. How best to integrate activities that support, promote and protect IYCF into CMAM programs The efficacy of integrating IYCF support into CMAM
- 10. 4.1) IYCF support into CMAM OR Phase 1: 6 months study design stakeholder consultations; ToT IYCF-CMAM integration baseline IYCF assessments; compilation and adaptation of IYCF- CMAM integration tools: Phase 2: 12 months Implementation Training at district/site level Testing of tools and job aids; wall chart, brief case and family folder Data collection through cohort follow-up; In-country mid-term review meeting Phase 3: 6 months Final IYCF assessment data analysis and review, In-country technical analysis and dissemination workshop, Publication: research results and lessons learned
- 11. 4.2) PD Hearth in Context of CMAM and ENA Is a joint 2 years OR project between WVE, WVK, WITH and EHNRI The overarching goal is to evaluate the effectiveness of: Target Groups: children 6 – 24 months the PD Hearth approach integrated into the context of the ENA & CMAM program on child growth and key child caring and feeding practices Comparing with children in the ENA intervention and the CMAM program only.
- 12. 4.2) PD Hearth in Context of CMAM and ENA Is a joint 2 years OR project between WVE, WVK, WITH and EHNRI The overarching goal is to evaluate the effectiveness of: Target Groups: children 6 – 24 months the PD Hearth approach integrated into the context of the ENA & CMAM program on child growth and key child caring and feeding practices Comparing with children in the ENA intervention and the CMAM program only.
- 13. Improvement of child growth Caregivers’ behavior change in ENA practices 4.2) PD Hearth in Context of CMAM and ENA Pathway to the reduction of malnutrition Counseling Learning by doing Caregivers’ behavior change in child feeding, caring and health seeking practices C o n t r o l I n t e r v e n t i o n
- 14. 4.2) PD Hearth in Context of CMAM and ENA
- 15. 5) Lesson Increased national and regional partnership opportunity and organizational visibility WV and partners staff equipped in key CMAM competencies and quality of program improved over the past years Provide opportunity to work with research institutes, universities in operational research
- 16. 6) Way forward Provide ongoing technical support CMAM projects & operational research projects Document the lessons Support the roll-out of project models and complementary models
- 17. Questions?