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INFANT AND YOUNG CHILD FEEDING

Overview of the Community Infant and Young Child Feeding (IYCF)

The Community IYCF Counseling Package is a generic resource designed to equip community workers (CWs), other community workers, or primary health care staff to support mothers, fathers, and other caregivers to optimally feed their infants and young children. The training component of the package is intended to prepare CWs with technical knowledge on the recommended breastfeeding and complementary feeding practices for children from 0 up to 24 months, enhance their counseling, problem solving and reaching-an-agreement (negotiation) skills, and prepare them to effectively use the related counseling tools and job aids.

In the Community IYCF the terms 0 up to 6 months, 6 up to9 months, 9 up to 12 months, and 12 up to 24 months are used when discussing infant and young child age groups.

Training Methodology

The ultimate goal of Community IYCF Counselling Training is to change the behaviour of both the CWs (the learning Participants) and the mothers and caregivers that they counsel. Hands-on practice is the focus of the training, with emphasis on counselling skills and the effective use of the Counselling Cards and Take-home Brochures. The competency-based participatory training approach used in the key principles of behavior change communication (BCC) with a focus on the promotion of small doable actions, and recognition of the widely acknowledged theory that adults learn best by reflecting on their own personal experiences. :(Principles of Adult Learning). The approach uses the experiential learning cycle method and prepares Participants for hands-on performance of skills. The course employs a variety of training methods, including the use of counselling materials, visual aids, demonstrations, group discussion, case studies, role plays, and practice. Training Methodologies: Advantages, Limitations and Tips for Improvement). Participants also act as resource persons for each other, and benefit from clinical and/or community practice, working directly with breastfeeding mothers, pregnant women, and mothers/fathers/ caregivers who have young children. Suggested Training Exercises, Review Energisers (group and team building) and Daily Evaluations, Cutouts for ‗Happy Faces‘for daily evaluations).

The training is based on proven participatory learning approaches, which include:

  • Use of motivational techniques
  • Use of the experiential learning cycle
  • Problem-centred approach to training
  • Mastery and performance of one set of skills and knowledge at a time
  • Reconciliation of new learning with the reality of current work situation and job description
  • Supervised practice of new skills followed by practice with mothers and caregivers, to provide Participants with the confidence that they can perform correctly once they leave the training
  • Carefully thought out supervisory or follow up mechanisms to help counsellors maintain and improve their performance over time. .

Post Training Follow-Up

The desired output of Community IYCF Counselling Package is the effective and continuing application of new skills and knowledge resulting in improved performance of both the CHW and those who receive their counselling and follow-up. Participant mastery of new knowledge can be measured immediately through the pre/post tests that are built into the training.

To assess and support the ability of Participant/CWs to appropriately apply the knowledge and counselling skills gained in training to the post-training work in the community, the training Facilitators (who may or may not be programme Supervisors) should observe and evaluate Participants at their work place as soon as feasible following the completion of training, within at least 3 months after training. Ideally, Facilitators/Supervisors should provide on-the-job support or mentoring and assist with problem-solving in work situations that include i) a counselling interaction with a mother/father/caregiver and child in a community or home setting, ii) during group education (action oriented groups), and iii) during support group facilitation. Post-training follow-up will allow a Facilitator/Supervisor/Mentor to determine the need for reinforcement of specific Participant‘s knowledge and skills through additional or refresher training or ongoing supportive supervision.

Ongoing follow-up through a formalized system of supervision/mentoring will allow Supervisors/Mentors or Programme Managers to monitor CHW retention or erosion of knowledge and the development of skills over time; to focus ongoing supportive supervision and problem-solving to meet the needs of individual CWs ; and to determine the need and timing for on-the-job training or other refresher training. Where supervision/mentoring of individual CWs is not possible, peer discussion and mentoring among a group of CWs might be considered.

Objectives of  IYCF

The purpose of an IYCF support group is to share personal experiences on IYCF practices. Poor child feeding during the first 2 years of life harms growth and brain development. An infant aged 6 up to 9 months needs to eat at least 3 times a day in addition to breastfeeding.  A pregnant woman needs to eat 1 more meal per day than usual. At 4 months, infants need water and other drinks in addition to breast milk. Just telling a mother how to feed her child is an effective way of changing her infant feeding practices.  A woman who is malnourished can still produce enough good quality breast milk for her baby. The more milk a baby removes from the breast, the more breast milk the mother makes. The mother of a sick child should wait until her child is healthy before giving him/her solid foods. At about six months, the first food a baby takes should have the consistency of breast milk so that the young baby can swallow it easily. During the first six months, a baby living in a hot climate needs water in addition to breast milk. A young child (aged 6 up to 24 months) should not be given animal foods such as eggs and meat . A newborn baby should always be given colostrum.

An HIV-infected mother should never breastfeed . Men play an important role in how infants and young children are fed.

THE ROLE OF OUTREACH COMMUNITY DURBAR IN CENTRAL GONJA DISTRICT OF NORTHERN REGION AND THE BOLGATANGA MUNICIPALITY UPPER WEST REGION OF GHANA

Aidez Small Project International (ASPI) is an NGO that is devoted to making lives better by educating and improving the health and livelihood of people across the country and beyond. With our total commitment to improving a healthy lifestyle, economic growth, and poverty eradication simultaneously, we offer integrated services in health, finance, and human right. We have been in existence since June 2003, operating mainly in the Volta and Greater Accra Regions of Ghana. We have undertaken various social and economic intervention projects including the education and prevention of malaria, HIV/AIDS prevention, Tuberculosis, and reproductive health programmes in various communities in the country. ASPI also gives out microloans to groups and individuals, small and medium enterprises among others under its microfinance scheme. A lot of people and communities are benefiting from our help, and so far the testimonies have been great.

Recently, ASPI (lead consultants) and its partners UNWFP together with Ghana Health Service organized durbars in six (6) communities. Three (3) communities (Buipe, Yapei and Kusawgu) in Central Gonja District of the Northern Region and three (3) communities(Dagweo, Zuarungu and Sumbrungu) in Bolgatanga Municipality in Upper West Region of Ghana. This was part of concerted efforts toward reducing preponderance of stunting in the district.

Stunting is a chronic form of malnutrition which reflects failure to reach linear growth potential as a result of sub-optimal health and/or nutritional deficits. In resource poor settings stunting among infants and young children (6-23 months) co-exists with micronutrient deficiencies. Together, stunting and micronutrient deficiencies cause reduction in attainment of individual child potential with attendant reduction in national development potential.

The last DHS survey conducted in 2008 showed severity of stunting in this area, though nationally, the cases of stunting is seen to be in a decline.

As part of the entire campaign to reduce the levels of stunting, ASPI with the support of Ghana Health Service brought together people from Buipe, Yapei and Kusawgu in the Central Gonja district of Northern Region as well as Dagweo, Zuarungu and Sumbrungu in Bolgatanga Municipality of Upper West Region to help increase their awareness of their present situation. To ensure the success of this campaign ASPI brought together resource persons such as District Director of Health, Nutritionist (DNO), CHO’s, WFP representatives, cultural and Drama group who helped in facilitation of the durbar sessions in Central Gonja district of Northern Region. Also, in attendance were the community leaders and Imams who helped in ensuring the success of the rally.

Likewise On the 22nd, 23rd, and 24th days of November 2016 in Bolgatanga Municipality of Upper West Region, to ensure the success of this campaign the agenda entailed participation of key donor supporters (WFP), Ghana Health Service officials, Farm Radio International’s reps, and elders of the communities to assist and observe how the audience would benefit the durbar. Notable persons present includes Grace Akolba a District Nutritionist with Ghana Health Service, she did awesomely well handling the role of a District Facilitator. Also In attendance was a World Food Project – Program Officer in person of Amata. Amata was present as a Regional Event Observer. Allisa was also in attendance as a National Event Monitor for World Food Project.

Each session started with an arrival of dignitaries and stakeholders, followed by a prayer and cultural troops who took to the floor with a colorful display in WFP’s branded Polo shirts. During dancing sessions some community members joined the cultural dance group. After the introduction of dignitaries and the objectives of the durbar stated and explained. Also, leadership of the community and on whose authority the gathering was sanctioned were acknowledged.

These were followed by a brief presentation on WFP LoFAIN project, highlighting the status of the district with regards to stunting and negative effects on households and community members.

The Drama group then took to the floor and performed a script-crafted base on the principles of community infant and young child feeding (C_IYCF). Community members were enthused by the presentation and were occasionally seen to be laughing and cheerful.

After the drama display, the District Nutrition Officer (DNO) firmed up the issues that arose during the drama display and urge mothers to take the lessons learnt seriously. The DNO further spoke about the local available nutritious food for improving the health status of their families especially the 25 earmarked food by WFP for consumption. Also, the Grow Nut product was also promoted and mothers who were registered to receive the Grow Nut for children urged to feed their children with it as prescribed.

At the Bolgatanga Municipality of Upper West Region, each durbar session lasted between 4 – 5hours with not less than 150 target beneficiaries in attendance. The events were climaxed with questions and answers sessions, followed by another round of cultural display and ended with a closing remarks and vote of thanks.