Implementing an Integrated Nutrition Programme - Health Systems ...

District level
• Limited human resources – it is difficult for the nutritionist and nutrition advisors to cover
such a large area.
• Limited financial resources – the budget is decreasing.
• The systems for monitoring quality of service provided (e.g. quality of growth
monitoring, implementation of the PSNP) are poorly developed.
• The links between health and other sectors are poor.
Facility level
• Staff at facility level do not all regard nutrition as a priority.
• Little is known regarding the quality of the service provided.
Community level
• Few community-based organisations or initiatives exist.
• Nutrition workers do not always have the time and skills necessary to initiate and sustain
community-based projects.
Conclusion and recommendations
Overall the Integrated Nutrition Programme in Lower Orange can be regarded as a well-run
and managed programme. Most of the components of a District Integrated Nutrition
Programme are in place. Efforts can therefore focus on consolidating and improving the
quality of existing services.
Emphasis on improving the quality of care
More emphasis should be placed on monitoring and improving the quality of services,
provided particularly at facility level. Because most service are provided by PHC nurses this
needs to be done in collaboration with the PHC co-ordinator. The district staff are wellaware
of the need for more intensive evaluation and monitoring of their services, but may
need support in developing systems and methods for supervision and evaluation.
Strengthening Intersectoral Collaboration
The Nutrition Programme is well-established and is in a good position to play an important
role in improving collaboration between various sectors in the district. Opportunities for
intersectoral collaboration and partnerships with other government departments and
community organisations should be explored.
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