Evaluation of the network of nutrition improvement program collaborators in a northern lowland district and preliminary recommendations for sustainable development of the network to year 2010

Dam Viet Cuong, Phan Hong Van and colleagues

Objectives

1.To investigate child anti-malnutrition activities at a locality.

2. To understand the status of nutrition collaborator network and its contribution to prevention of child malnutrition.

3. To make preliminary recommendations for sustainable development of a nutrition collaborator network to improve the effectiveness of its operation in child health care and protection.

Research site

This research was conducted in Tam Diep town (Ninh Binh province), a typical district that launched a comprehensive nutrition intervention.

Research methodology

1. Collect and analyse existing data

2. Qualitative research: group discussion and in-depth interview with stakeholders

3. Quantitative research: a semi-structured questionnaire used to interview randomly selected nutrition collaborators and 300 mothers with children age under 5 in three communes

Conclusions

1. Nutrition actitivies received interests and support from local authorities, health agencies, and mass organisations.

2. Anti-malnutrition activities brought about positive results. Annual child malnutrition rates decreased by 1,2 - 1,5 percentage points; local malnutrition rate currently stands at 18,9%, lower than that of provincial and national corresponding figures.

3. The nutrition collaborator network was fully developed. A public healthcare division was established at all levels that also acted as the steering committee for prevention of child malnutrition. Nutrition specialists were available at all town medical centers and commune health stations and nutrition collaborators were active in all villages.

4. All nutrition collaborators had at least a high school diploma, ages 40 - 50, and consisted of both men and women. The majority of them had at least 3 years of experience. 98% of these nutrition collaborators were village health workers who concurrently performed malnutrition prevention task.

5. Activities undertaken by the nutrition collaborator network was well known and highly appreciated by the community. A number of limitations persisted due to the following difficulties.

- Large coverage area and big number of households

- Excessive workload

- High prevelance of underweight amongchildren

- Lack of funding

- Low allowance for collaborators

- Holding many concurrent functions and tasks (to generate extra income) among male village health workers, resulting in little time left for nutrition work

- Lack of technical knowledge and communication skills

6. Despite of low compensation, all nutrition collaborators shown high enthusiasm and willingness to continue this task in the coming years.

Recommendations

1. Further support with operational funding and allowance for nutrition collaborators.

- Have official decisions regulating the sources of fundingand mechanism for monitoring and supervision of fund allocation and utilization.

- Mobilize funding sources from national and international organizations, mass organizations, and community.

- Increase monthly allowance for nutrition collaborators from the central and local budget.

- Integrate other activities into the nutrition program to raise funding butguarantee to meet work requirements for each program

2. Provide a scale to each nutrition collaborator

3. Improve and update knowledge for nutrition collaborators via

- Theoretical and practical training o­n an annual basis

- Provide books and technical reading

- Organize exchange trips for learning and sharing among locations

- Establish a hotline for advisory services

4. Provide health insurance cards for nutrition collaborators

5. Involve kindergarten teachers in the nutrition collaborators network

6. Extend the nutrition program in terms of its contents, activities, frequency and better outreach local authority and mass organizations.

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