Implementing an Integrated Nutrition Programme - Health Systems ...

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Resources The vegetable garden is situated in the grounds of the Kakamas hospital. The ground is provided free of charge, but the project pays for water. Two of the project committee members are from Kakamas Secondary School and the school is used for the project committee’s monthly meetings. Activities The project aims to achieve the following goals: • Production of vegetables (for use by TB patients). • Provision of nutrition education for TB patients and their families. • Monitoring and evaluation of TB patient’s nutritional status. The garden is now producing vegetables, although it is not yet able to supply all TB patients with a regular supply of fresh vegetables. Other activities include holding weekly soup kitchen where the nutritional status of patients is monitored and nutrition education given. More funding has been received for training of community members in food processing techniques – it is hoped that the garden will be able to generate income in the future. Intersectoral links As outlined above, this project can be regarded as a joint project between SANTA and the health services. The Welfare Department is also involved, but communication between the two departments is not always very good. The Kakamas Local Authority has been supportive of the project. Co-operation between the various government departments has been sub-optiamal. For example, the project approached the Department of Agriculture to assist with analysis of the soil. The samples were taken, but were subsequently lost and the project received no feedback. They would have had to pay for repeat samples to be taken. Involvement in the district Kakamas has an extremely high incidence of TB. The district has identified TB as a priority health issue and has developed plans to tackle the problem. There is close co-operation between SANTA and the health services (both the local clinic and at district level). It is hoped that this project will help to strengthen this co-operation. Interaction with health facilities TB patients on treatment at the clinic will be referred to the project. Patients’ nutritional status will be monitored at the clinic on a regular basis. 2.2 Grootdrink Community Nutrition Surveillance Project History From nutrition surveillance data it was found that a high percentage of preschool children were underweight for age in the Grootdrink community. A meeting was held with the Local 34
Development Forum (LDF) and the UNICEF conceptual framework was used to determine causes of the high incidence of malnutrition. The health committee of the LDF became involved and a community based nutrition surveillance programme was started. Organisational Structure The health committee identified a number of volunteer workers who took responsibility for nutrition surveillance and education in the community. Resources A local church hall is used for the monthly weighing sessions that are organised by the volunteer workers. Activities • Training in basic nutrition topics for volunteer workers (done by health educator). • Monthly weighing and record keeping of preschool children. • Referral of children to the clinic when necessary. • Educating mothers who bring their children for monthly weighing. Target Groups Preschool children and their parents. Interaction with health facilities Children are referred from the community-based nutrition surveillance project to the clinic when food supplementation is necessary. Future plans Funds have been allocated to the community for establishment of a community bakery. 3 Primary School Nutrition Programme 3.1 Organisation and management As in other provinces, the PSNP accounts for the largest portion of expenditure on nutrition at district level. In the Northern Cape, the PSNP is jointly managed by the Departments of Health (Nutrition sub-directorate) and Education (Educational Support Systems). Particular attention has been given to reaching farm and rural schools. With decentralisation of the programme, the health department has taken on most of the responsibility for management and administration of the scheme. The relationship between the health and education departments at district level is variable. Initially within Lower Orange, the health department left the running of the PSNP to the education department. More recently a teacher has been seconded from the Education Department to the Nutrition Programme for a period of three years. 35
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 and 18: Breastfeeding and weaning practices
Page 19 and 20: Chapter Two: Management of the INP
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: 1.9 Parasite control There are no p
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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