iycf support in emergencies mother-to-mother support groups in the dadaab refugee camps
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IYCF Support in Emergencies Mother-to-Mother Support Groups in the Dadaab Refugee Camps. TOPS FSN Network Regional Knowledge Sharing Meeting Washington, DC: November 2012 Mary Lung’aho for CARE, UNHCR and Partners. Partners in IYCF Support in Dadaab. UNHCR UNICEF CARE GTZ IRC NCCK. - PowerPoint PPT PresentationTRANSCRIPT
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IYCF Support in IYCF Support in EmergenciesEmergencies
Mother-to-Mother Support Mother-to-Mother Support GroupsGroups
in the Dadaab Refugee Campsin the Dadaab Refugee Camps
IYCF Support in IYCF Support in EmergenciesEmergencies
Mother-to-Mother Support Mother-to-Mother Support GroupsGroups
in the Dadaab Refugee Campsin the Dadaab Refugee CampsTOPS FSN Network Regional Knowledge Sharing
MeetingWashington, DC: November 2012
Mary Lung’aho for CARE, UNHCR and Partners
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Partners in IYCF Support in Partners in IYCF Support in DadaabDadaab
• UNHCR• UNICEF• CARE• GTZ• IRC• NCCK
• IMC• ACF• SAVE UK• MSF• KRCS
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Emergency Contexts: Population on Emergency Contexts: Population on Move Move
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Emergency Contexts: Congested Emergency Contexts: Congested SettingsSettings
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Emergency Contexts: Disrupted Emergency Contexts: Disrupted Families Families
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Emergency Contexts: Defensible Emergency Contexts: Defensible Living SpaceLiving Space
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Emergency Contexts: Organized Emergency Contexts: Organized CampsCamps
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Dadaab Refugee CampsDadaab Refugee Camps
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Creating a System of IYCF Creating a System of IYCF SupportSupport
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MtMSG ObjectivesMtMSG Objectives
Share experiences Ask questions and exchange
information Examine values and attitudes, discover
patterns of behavior Encourage women and communities to
identify and solve their own problems Make better decisions about feeding and
care of their children Provide SUPPORT for each other Build self-confidence
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Camp-level Support StructureCamp-level Support Structure
Health Post
Health Post
Dadaab IYCF Team UNHCR—CARE—GTZ—NCCK
AAH—Save UK
Hagadera Hospital Ifo Hospital Dagahaley Hospital
Health Post
IYCF Coordinating Team:
IYCF Health Post Team
IYCF Community Workers
Health Post Staff ANC consultant Under five consultant HIS staff EPI staff SFP and OTP staff
UNHCR Nutritionist CARE IYCF Supervisor GTZ Nutrition Coordinator NCCK
Community Workers CHWs- Community Health Workers TBAs- Traditional Birth Attendants CDWs- Community Dev Workers RHMs- Repro. Health Motivators CPWs- Children Protection Workers
Community Volunteers-IYCF Counselors
Mother-to-Mother Support Groups
Secondary Targets Men’s support groups School clubs Youth groups etc.
IYCF Officer. Maternity staff Pediatric staff Under five
consultant HIS staff SC staff PMTCT etc.
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Capacity-Building: Knowledge & Capacity-Building: Knowledge & SkillsSkills
• Training materials for Community Workers in Dadaab based on competencies outlined in: WHO counselling courses IFE Core Group Modules 1 & 2: for
health and nutrition workers in emergency situations, including:
Assessment of infant feedingPractical help with breastfeeding
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13
Experiential Learning Cycle: SkillsExperiential Learning Cycle: Skills
Supervised field practice and feedback
Discuss skill
Demonstrate
Practise in classroom
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Capacity-Building: IYCF Support Capacity-Building: IYCF Support ActivitiesActivitiesWith:• Field Practice• Supportive supervision/mentoring• Referral• Routine programme monitoring • Periodic refresher training• Exchange visits• Quarterly meetings: share
experiences, discuss ‘cases’ (‘peer’ mentoring)
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Field PracticeField Practice
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Counselling Cards that can be used in Counselling Cards that can be used in MtMSGMtMSG
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Impact ???Impact ???
• Much of the impact is often assumed• Impact evaluation usually not possible:
often no population level baseline or endline in emergencies
• Thus: heavy reliance on monitoring data
• But: lack of agreement on routine monitoring indicatorsQ: Possible to adapt or build upon
indicator categories suggested for development programming?
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IYCF Routine Programme IYCF Routine Programme MonitoringMonitoringQ1: How much did we do?
• Implementation of activities:# Training events# / % MtMSG facilitators trained# / % MtMSGs active# / % MtMSG facilitators mentored
# Communications activities (videos, drama, IEC materials)
Monitoring records (pictorial)
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Activities: MtMSG Facilitator Activities: MtMSG Facilitator TrainingTraining
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Activities: MtMSG MeetingsActivities: MtMSG Meetings
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Activities: Video Presentations Activities: Video Presentations (Messaging(Messaging))
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Activities: Pictorial Activities: Pictorial ‘record-keeping’/monitoring‘record-keeping’/monitoring
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IYCF Routine Programme IYCF Routine Programme MonitoringMonitoring
Q2: How well did we do it?• Coverage: geographic/spatial coverage
(MtMSGs per camp, health post, block)• Coverage: participation of target
population (in MtMSGs)
• Quality: % MtMSG facilitators who meet quality benchmarks
• Quality: caregiver knowledge and attitudes
• Quality: client satisfaction
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Coverage: Camps Blocks showing Coverage: Camps Blocks showing MtMSGsMtMSGs
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Quality: Supportive Quality: Supportive Supervision/MentoringSupervision/Mentoring
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IYCF Programme ResultsIYCF Programme Results
Q3 (RESULTS - survey): Is anyone better off?• IYCF Practices (WHO indicators)• Health & nutritional status
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Exclusive Breastfeeding & Population Exclusive Breastfeeding & Population GrowthGrowth
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Results: Exclusive Results: Exclusive BreastfeedingBreastfeeding
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
2005 2006 2007 2008 2009
Exclusive BF Dadaab 2005-2009
Percent EBF Dag Hag Ifo
Projected EBF Rate from Baseline
IYCF Program
Start
Influx of New Refugees
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0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
45.0%
50.0%
2005 2006 2007 2008 2009
Global Acute Malnutrition Dadaab 2005-2009
Percent GAM Dag Hag Ifo
Global Acute Malnutrition Global Acute Malnutrition (GAM)(GAM)
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Issues: IncentivesIssues: Incentives
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Men’s InvolvementMen’s Involvement
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Creating ExcitementCreating Excitement
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Charismatic LeadershipCharismatic Leadership
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THANK YOU!THANK YOU!