Implementing an Integrated Nutrition Programme - Health Systems ...

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lack of food (as opposed to poor access to health and other basic services combined with poor feeding practices) remains a problem. • Although the levels of Vitamin A deficiency is lower than in most parts of the country, levels are still unacceptably high. Levels of anaemia are also high. • Low birth weight rates are extremely high. This contributes to the high perinatal mortality in the district. 18
Chapter Two: Management of the INP 1 The role of the Provincial Office The provincial Nutrition Sub-directorate falls under the Provincial Programme and Support Directorate. Management of nutrition services in the province was traditionally extremely centralised with all planning and budgeting being done in the provincial office. Following implementation of the District Health System, management of the INP has been decentralised to the districts. Attempts were made to ensure that the decentralisation process occurred in a planned and logical way. As a first step in this process, the respective roles of the provincial and district offices were defined as follows: PROVINCIAL FUNCTIONS Determine policy; standards, norms and identify indicators Monitor, evaluate and manage information on programmes (e.g. PSNP, PEM-scheme and CBNP) to make decisions regarding the budget, staff allocation etc. Conduct research and development. Initiative, develop and co-ordinate training programmes according to needs of personnel. Provide a comprehensive advisory service e.g. budgets. DISTRICT FUNCTIONS Implement policies according to the needs of the district. Develop operational objectives and plans to achieve set indicators. Process and summarise data to make an input to provincial office regarding nutrition surveillance PEM-scheme (monitoring tool). Monitor and evaluate CBNP according to suggested work programme. Submit quarterly progress reports on CBNP to Provincial office. Monitor and improve reliability of nutritional data collected. Initiate surveys by indicating which areas need to be investigated. Participate in surveys. Identify training needs of personnel and PHC workers in district. Train personnel and PHC workers in order to implement policies; gather information and monitor programmes and do nutrition education. Plan district budget according to planned activities. Countercheck monthly expenditure of programmes. Manage decentralised budgets of Nutrition Programmes. 19
Page 1 and 2: Implementing an Integrated Nutritio
Page 3 and 4: Framework for District INP Situatio
Page 5 and 6: List of Tables Table 1: Admissions
Page 7 and 8: Table 1: Admissions to Gordonia Hos
Page 9 and 10: Department of Health survey The Nat
Page 11 and 12: serum ferritin levels below 12ug/l
Page 13 and 14: 15% 1% 11% 1% Tap in house Tapwater
Page 15 and 16: On average socio-economic condition
Page 17: Breastfeeding and weaning practices
Page 21 and 22: Step 3: Orientation on programme pl
Page 23 and 24: Five key performance areas were ide
Page 25 and 26: Transport The district has a pool o
Page 27 and 28: nurses) attended an eighty hour cou
Page 29 and 30: In theory every preschool child who
Page 31 and 32: • The mothers of children on the
Page 33 and 34: 1.9 Parasite control There are no p
Page 35 and 36: Development Forum (LDF) and the UNI
Page 37 and 38: Other concerns raised included that
Page 39 and 40: Chapter Five: Factors which facilit
Page 41 and 42: Integrating Nutritional Surveillanc
Page 43 and 44: APPENDIX A: RESULTS OF DEPARTMENT O
Page 45 and 46: 1. Implementation of the policy 2.
Page 47 and 48: APPENDIX C: DISTRICT NUTRTION PLAN
Page 49 and 50: 3. Monitoring and Evaluation Implem
Page 51 and 52: 5. Community Development + Intersec
Page 53 and 54: APPENDIX D: SCHOOLS PARTICIPATING I
Page 55 and 56: APPENDIX E: PROJECTS FUNDED BY ALLE

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