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INTEGRATED PILOT PROJECT
“ 6 month contact point "
An integrated approach for child survival
REPÚBLICA DE MOÇAMBIQUE Ministério da Saúde
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High micronutrient deficiency (VAD
69% Iron Def. 75%); and poor
nutritional practices
• 69% of children under five have
Anemia. ( DHS 2011)
• Children 6-23 months are at risk of
malnutrition. Only 13% receiving
adequate complementary food (DHS
2011).
BACKGROUND
48%
44%
43%
40%
41%
42%
43%
44%
45%
46%
47%
48%
49%
Malnutrition in Mozambique
2003 2008 2011
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• 58,9 children under 5 years are
anemic in Gaza province (2011
DHS);
• According to the MICS 2008,
44.9% of children 0-5 months
received exclusive breastfeeding.
BACKGROUND – GAZA PROVINCE
34%
27%
0%
5%
10%
15%
20%
25%
30%
35%
40%
Malnutrition in Gaza province
2008 2011
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Background
• Since 2008, in order to increase the coverage of interventions for child survival, MoH initiated with HKI a bi-annual CHW to ensure the distribution of vitamin A capsules, de-worming and routine vaccinations;
• In addition to CHW, VAS also happens as part of the routine health service delivery which takes place both in the health facility and through mobile brigades;
• Routine VAS is part of the district annual planning and is organized by the district level authorities
Contributions Cost of CHW
Pro Saúde 45.027.178,71 Mts
UNICEF 38.000.160,17 Mts
OMS 5.608.782.27 Mts
Remanescente da 1ª Fase 11.968.872,37 Mts
Total cost 2014 : 115.210.445,62 MT
US $ 3.840.348,19
Total cost 2015: 79,887,131.54 MT
US$1.775.269,59
Contributions Cost of CHW
ProSaúde 50.880.132,32
UNICEF 28,879,922.22
HKI 127.076,60
Total 79,887,131.54
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P ILOT EXP ER IENC E ON INTEGR ATION OF MN P, VA S , IY C F TO TH E 6 MO N TH C O N TA C T
P O IN T O F C H ILD R EN 6 - 2 3 MO N TH S .
• 36 Health Facilities
• Duration: 12 Months
Gaza Province
District : Mandlakazi e
Chibuto
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OBJECTIVE 1: Increase coverage of vitamin a supplementation from current
level according to the pecs, 82% to 95%
• Involve the community leaders, community health workers, community
voluntaries, and community based organizations, as diffusers of key messages for
promote Vitamin A supplementation at 6 month
Promote vitamin A capsules in the community through CHW
Increase number of advanced mobile brigades to reach the area of hard access;
Support community leaders to register all the child under 5
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OBJECTIVE 2: achieve at least 50% of children 6 -23month
receiving twice year MNP
Support health workers training on MNP and its integration into health routine activities for child;
Avaliar a viabilidade da promoção e distribuição dos MNP´s no ponto de contacto ao 6º mês, integrando também
actividades de promoção da alimentação infantil e da 1ª dose de suplementação com Vitamina A;
Evaluate the feasibility of MNP promotion and distribution at 6 month contact point and integrate it in the IYCF
and VAS activities;
Criar de demanda de mercado dos MNP, para impulsionar a sua sustentabilidade.
Create market demand on MNP.
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OBJECTIVE 3 : Inc rease l eve l o f knowledge and prac t i ces on IYCF among mothers and ca reg ivers o f ch i ld ren 6 to 23 months .
Involve community-based organizations ( mothers and fathers groups, Health Committee, co-
management committees, religious organizations) on promoting adequate practices of IYCF
and hygiene;
Create district coordination platforms( NGOs and local government, private sectors,
churches) to support and coordinate the nutrition activates;
Promover massivamente a Alimentação Infantil através meios de difusão massiva existentes e
acessíveis na comunidade, como por exemplo as radio comunitárias,
Disseminate key message IYCF and hygiene through community radio and churches,
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OBJECTIVE 4: increase 6 month contact point of child, from 27%( pecs) to 50% by 2016
Involve the OBC in particular mother father support groups, on promotion and sensitization about importance of
6 month contact point;
Test introduction of 6 month contact point as a component of vaccination calendar and routines.
Use the project result and lessons learned on integrated intervention approach to support scaling up at national
level;
Estabelecer um Sistema de Registo das Crianças menores de 6 meses nas unidades sanitárias
Establish a system for registration of children under 6 months at health facilities
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PROMOTION AT HF
H. F
acility
Group lecture Demonstration Interpersonal counselling
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COMMUNITY STRATEGY FOR PROMOTION OF 6 MONTH CONTACT POINT
G MP
APES
FBO
Community mobilization : Radio, Lectures, home Visit, Homilies
VAS
MNP
FP
Vacination
Nutritional Surveillance
Counselling in nutrition/hygiene
6 Meses
ACS
L C
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PROJECT RESULT ONE YEAR
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PEOPLE TRAINED/INVOLVED IN PROJECT IMPLEMENTATION
Peoples Number
Community leaders 68
Members of mothers and fathers groups 370
Comunity health workers 50
Health workers 52
Journalist from community radios 2
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117% 109%
97%
107% 112%
104%
110%
98% 108%
109%
98% 100% 99% 98%
0%
20%
40%
60%
80%
100%
120%
140%
2012 2013-1ª ronda 2013-2ª ronda 2014 - 1ª ronda 2014 - 2ª ronda 2015 - 1ª ronda 2015 - 2ª ronda
Tend of VAS coverage - CHW 2012-2015
Mandlakazi Chibuto
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110%
107%
92%
104%
108%
102%
110%
94%
103%
99%
95% 95% 94%
95%
80%
85%
90%
95%
100%
105%
110%
115%
2012 2013-1ª ronda 2013-2ª ronda 2014 - 1ª ronda 2014 - 2ª ronda 2015 - 1ª ronda 2015 - 2ª ronda
Trend of deoworming - Mebendazol - CHW 2012-2015
Mandlakazi Chibuto
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0
50
100
150
200
250
300
350
400
Julho Agosto Setembro Out Nov Dez Jan Fev Março
Children Supplemented at 6 Month Jun/15 – Mar/2016
Chibuto Mandlakazi
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2704
2062
1895
1411
70%
68%
CHIBUTO MANDLAKAZI
Relationship between children completed 6 months Vs supplemented at 6 month
(Jun/15-Mar/16)
Crianças que completam 6 meses de idade no mês Crinaças receberam Vitamina A pontualmente ao 6 mês %
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27 27
68 70
0
10
20
30
40
50
60
70
80
Mandlakazi Chibuto
Comparison of VAS coverage at 6 month before and after the HKI
intervention
PECS 2013/14 Rotina 2015
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0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
Meta jun Jul Ago Set Out Nov Dez Jan Fev Mar
13935
19098
Cumulative children registration 0-23 months for distribution MNP
Jun/15 – March 16
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CONCLUSIONS
• Community involvement and participation can be a support to improve routine adherence on VAS
activities
• Community child registration creates more involvement and accountability of community leaders on
child protection, health and nutrition;
• District nutrition platform can be a means of action coordination and create more of Government
involvement and support for nutrition
• Integrated interventions based on 6 month contact point is a good opportunity for the health and
nutrition of children and mother;
• Child registration at HF function as well as a reminder promote 6 month contact point;
• MNP can be attractive to the mothers take their children to HF.
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RECOMMENDATIONS
• Adoption of a strategy for community involvement and participation in the nutrition and health promotion community
(registration, mothers and father support groups, community mobilization, SMS, Community Radio);
• Strengthening and scaling up the 6 month contact point promotion at HF and community level as a nutrition strategy for
child 6-23 months;
• Explore more, the importance of district nutrition platform for improve coordination;
• Improve technical capacity of health workers on integrated strategy based on 6 month contact point;
• Use the advanced mobile brigades to reach hard-to-reach children.
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OBRIGADA MERCI
THANKS