Implementing an Integrated Nutrition Programme - Health Systems ...

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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. 40
Integrating Nutritional Surveillance with the District Health Information System Although nutritional surveillance is an important component of a district INP, it is important that it does not distract nutrition and PHC workers from service delivery and development. A district health information system is currently being developed in order to ensure that information is available for planning and decision-making. Nutritional surveillance should form part of this system. It is therefore important that there is good communication and coordination between the two systems. 41
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 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: Chapter Five: Factors which facilit
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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