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Integration of maternal child health and nutrition interventions in development

programs: Experiences and Best practices

03 February 2015Benjamin Aisya

M&E Learning Manager

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Presentation Outline

• Description of Community Connector • Integration in Community Connector• CC Experience: Family Life Schools

• What is FLS?• Why FLS?• CC FLS approach

• Best practices

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..a quote…

…acceleration of progress in nutrition will require effective, large-scale nutrition-sensitive programmes that address key underlying determinants of nutrition and enhance the coverage and effectiveness of nutrition-specific interventions

Ruel M.T, Alderman H (2013), Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? The Lancet, Volume 382, Issue 9891, Pages 536–551

• a five-year community-based Project, 15 districts in Uganda

• integrates nutrition and agriculture interventions

• is funded under Feed the Future initiative

• FHI360 is prime partner in a consortium of eight partners (two are Universities)

• designed to support the Uganda Nutrition Action Plan & Agriculture Sector Plan

• designed against the Collaborating, Learning and Adapting approach

IR 1: Improved nutritional status

of women and children

IR2: Improved livelihoods of

vulnerable populations

Poverty reduced among vulnerable households

USAID/Community Connector …

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CC: Framework for integration

Nutritional status

WASH and health environment

Diet diversification and quality

Household food access

Child care aspects

Nutrient value crops

Market value agriculture

produce

Household disposable incomes

Interaction with markets

Household savings and

credit access

Gend

er Is

sues

and

Con

cern

sBehavior Change Com

munication

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CC experience: Infusing group activities

Financial literacy

WASH

Gender

VSLA

Grants forEnterprise

All the CC groups receive these services

Agriculture Enterprises

Business development

Self financed &administered

Enterprise selection

Community group dialogues (Gender, Family Planning, nutrition, livelihoods and [Social]

Behaviour Change Communication)

Nutrition & food

security

Start End

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Family Life School: What is it?

An approach to disseminate multi-sectoral interventions [evidence-based nutrition interventions integrated with agriculture and livelihoods] to a targeted group of parents, primarily mothers, during the first 1000 days of the child’s life.

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Family Life School: What is it?

Cohorts of learners register in FLS depending on the stage within the 1,000 days:

• when they are pregnant--mama class;

• when the baby is between 0 and 6 months of age- Baby class; and

• when the baby is between 6 and 24 months of age--family class.

Learners graduate from one level to the other.

• Supports 1,200 FLS across 15 districts

• FLS have reached over 11,000 women

• Collaborating with 180 health workers and 300 community health teams (volunteers)

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Why Family Life Schools?

• Improve targeting in a bid to strengthen nutrition knowledge and practice

• Use [same] conditions to stimulate participation

• Optimize women's time, available health workers

Then Now

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Family Life Schools: CC approach

5. Encourage members to save money weekly or monthly

4. Create a nutrition learning site where FLS members are taught to grow nutrient rich fruits and vegetables for family use.

3. Hold classes for FLS members at least monthly, depending on stage in the 1000 days

2. Hold community outreach events for health and nutrition services three times a year.

1. Mobilize pregnant and postpartum women [and their partners] to join FLS

6. Hold periodic dialogues/meetings to discuss gender equity and family planning topics.

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Milly Odongo, 24 years old, is married to Brian Odongo. They have two

children aged 4 years, and 5 months.

“Each time I returned home, my husband would ask me what I learnt. I was happy to explain to him. There was a session were husbands [and men] were invited.

My husband, Brian had not accompanied me for Antenatal care during my first pregnancy but after attending FLS, he did come with me for two of the visits. For me, the most significant change I got from the Mama Class was my husband’s support.

He became concerned about the amount of work I was doing. He wanted me to take rests in the afternoon.”, Milly narrates her experience

We learned together how to hold and place the baby on the breast. It was fun for all of us even for the other men who attended. Milly is still breastfeeding and not giving the baby any other foods. The baby doesn’t fall sick as often and he is healthy”, Brian interjects.

Case story: of change

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FLS: Best Practices

• Use local structures, networks and systems to implement initiatives such as FLS; CC uses health workers and community health teams.

• Advocate for the policy framework to favor/incorporate what is already working; Aspects of FLS considered for the Maternal Infant and Young child road map

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…a quote…

…to eliminate stunting in the longer term, these [nutrition-specific] interventions should be supplemented by improvements in the

underlying determinants of undernutrition, such as poverty, poor education, disease

burden, and lack of women's empowerment.

Zulfiqar A Bhutta, Tahmeed Ahmed, Robert E Black, Simon Cousens, Kathryn Dewey, Elsa Giugliani, Batool A Haider, Betty Kirkwood,Saul S Morris, H P S Sachdev, Meera Shekar (2008), What works? Interventions for maternal and child undernutrition and survival? The Lancet, Volume 371, Issue 9610, Pages 417–440

Ahsante Sana (Thank you)

This presentation is made possible by the generous

support of the American people through the support of the United States Agency for

International Development (USAID) to FHI 360 contract #

AID-617-C-12-00001.

The contents are the responsibility of FHI 360 and do not necessarily

reflect the views of USAID or the United States Government.

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