Nutrition Impact & Positive Nutrition Impact & Positive Practice (NIPP) Project Practice (NIPP) Project

GOAL GOAL

Spring 2014 Global Health Practitioner ConferenceDate: 5th – 9th May 2014

Presentation Prepared By: Hatty Barthorp, GOAL Global Nutrition Advisor hbarthorp@goal.ie

Presentation Presented By: Geraldine McCrossan, GOAL Global Health Advisor

Why we chose to create a new approach?

Offers an alternative to food hand outs for community based MAM treatment and prevention in non-emergency settings

Supports: The treatment of mild or moderate MN in the

community

Prevents future episodes of acute MN

To reduce the prevalence and thus burden of chronic MN

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Rationale: Other Approaches not addressing the underlying causes of MN

ØTSFP: Treat MAM - impact on the prevalence of SAM & associated mortality

ØBSFP: Prevent MAM - impact on the prevalence of SAM & associated mortality, and partial role in reducing MAM

ØSignificant issues around plausibility & sustainability of SFPs in chronic or cyclical emergencies

How do NIPPs attempt to achieve their outcomes?

By using a grass-roots based approach, tackling a multi-sectoral package of underlying behavioural causes of acute & chronic MN, through changing community norms and targeting infants, children, PLW &/or CI.

Despite having a nutrition focus, NIPPs have been designed to be sensitive to pre-identified health, hygiene-sanitation and nutrition security causes of MN, in addition to addressing problematic care and feeding practices.

Objective: To achieve positive and sustained Behaviour Change through a holistic approach

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Structure of the project“Macro-circles” are comprised of a female circle, a male circle & a community circle

The focus is around replicable, peer-led education and practical demonstrations, in attempts to support positive behaviour change in communities where inappropriate behaviours are known to contribute to MN.

As knowledge does not necessarily translate into action, sessions use: participatory methods, positive reinforcement and repetition.

The circles focus on 3 main components which are repeated during each session:1. Behaviour Change Communication & Counselling 2. Micro-gardening 3. Cooking demonstrations

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How do we maximise outcomes?Formative research -household analyses, understanding of barriers and market assessments Specific activities designed based on findings.

Note: different messages & activities can be promoted in different settings, dependent on causes identified.

How do we monitor whether it’s working?

a) LQAS to assess chronic and acute MN - indication of the ‘impact’

b) Longitudinal data collection– indication of ‘outcomes’ 8

Activities Incorporated

Construction of fuel efficient stoves & Cooking demonstrations after market assessment

Fuel-efficient stove building Cooking demonstration items, South Sudan999

Kassala State, Sudan

Use of Food Flash Cards to teach participants about food groups, diet diversity and help design their own recipes

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Micro-gardening (eating produce at home)

The garden at the HH of a NIPP circle beneficiary in Baliet County, South Sudan

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Produce from the Micro-garden

Harvesting tomatoes/ eggplant in Ulang County, South Sudan

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Participatory, activities on food processing, preservation & storage

Food preservation in Garbia, Sudan

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Construction of basic hygiene-sanitation hard-ware to address related causes of MN

Tippy taps for hand washing, South Sudan

Household latrines

Drying rack

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Where is GOAL implementing NIPPsGeographic coverage of the intervention at present:

South Sudan (4 field sites) – Baliet & Ulang in Upper Nile State, Twic in Warrup State and Abyei Administrative Area, all sites direct oversight by GOAL

Sudan (3 field sites) – Kutum in N.Darfur, oversight by GOAL, Kassala in East Sudan, oversight by local partner WOD and Mayo in Khartoum, oversight by local partner ALMANAR

Zimbabwe 3 districts – Hurungwe, Makoni and Nyanga districts, all direct oversight by GOAL

Malawi in the process of transitioning from PD Hearth to full NIPP approach in two districts, Balaka and Nsanje

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Why do we think it works?

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Results Admission data from 130 circle cyclesGraduation data from 59 circle cycles

From Sudan & SS we have been able to show:Ø79.7% (419 cases) of children/PLW admitted

graduated ØFollow- up on-going

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To give an idea of scalability: DFID Roll-out plan for Zimbabwe

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MoH, local CBOs or national NGOs could run the project. As M&E can be downscaled and operational costs are purposefully kept to a minimum.

• Volunteer incentives are limited to non-expensive means •• The only hand out to participants – is a starter seed pack:

everything else is sourced by the participants locally.

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Thinking long-term:

2020

Acknowledgements

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