Training of Trainers Workshop: Positive Deviance and Hearth

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6. Children’s hand washing and snack distribution • Personal hygiene • Wash between fingers • When? • Clean water • Puppet show • Proportionate distribution • Have to wash hands before you can get snack 7. Mother feeding child • Eye to eye contact • Be patient • Sing songs and show kids • Clean hands, plate, food • Active feeding • Age wise feeding • Managing the child who doesn’t want to eat 8. Key Messages • Diarrhea ORT • Deworming • Pneumonia • ARI • Variety of food • Breast feeding • Micronutrients • Eat food with calorie and protein content • Types of food • Make child sit on lap – physical • Tell a story • Observation of child while eating • Proper feeding (i.e. amounts) • Supplement not a substitute • Hygiene and sanitation • Safe drinking water • Frequency of feeding • Don’t worry be happy • Continue at home • Place of health services • Birth spacing 9. Clean up • Hygiene • Clean up the utensils • Keep your home clean • Proper disposal of food • Germs contaminate next days food • Cover food and water • Cleaning will keep flies off • Proper storage of food 10. Decide menu and contribution next day • Food groups • Variety • Color of foods (food groups, variety) • Age related requirements of nutrients • Good choices for snack foods • Reason for selecting the food 36
… Hearth panel discussion (re placed by small group discussion on PD applications) The large group brainstormed on how they might apply PD to their program. There were four small groups which tackled: Reproductive Health Group: STDs for adolescents, anemia prevention, TB Program Group, and Street children group. This was an opportunity to start thinking out loud with others to help determine how the methodology could look like in their programs at home. It was a peer counseling session. † Home visits Why? Encourage and support behavior change Monitor impact of program Who? Health community Health volunteers How? Based on perceived needs of caregiver Tailored to the caregiver Time selection (fixed time or surprise?) Inquire about receptivity Document success stories Do not criticize When? 1 time in 18 days several times 1 time for general visit, several times if at risk or sick For whom? Malnourished children Hearth participants Observe Give positive feedback Record what was observed, good behaviors can be documented in a poster Before and after pictures Game: My nanny is so funny she keeps doing this and this and this… First participant makes a motion and all say “My nanny is so funny she keeps doing this and this…” then she picks another participant to add another motion to that motion. That participant then makes both motions together and comes to the center and then chooses another participant to add another motion and come to the middle and so on. ‡ Step 8: Repeat Hearth as needed Ideas for graduation criteria (this should be decided with community): 1. Nutritional status After child has reached normal or if severely malnourished child has improved to become a moderately malnourished child etc. 2. Weight gain If child gains at least 400 grams and is growth as fast or faster than international standard median If a child is not gaining weight: • Could be underlying illness -- Refer to health center • If they use the Hearth meal as a substitute • Quality of hearth menu is inadequate • Attendance 37
Page 1 and 2: Training of Trainers Workshop on: P
Page 3 and 4: TABLE OF CONTENTS Foreword A. Intro
Page 5 and 6: A. Introduction: The Hearth Nutriti
Page 7 and 8: C. Workshop Goals and Objectives Ov
Page 9 and 10: 45m) H & J STEP 4: Conducting the P
Page 11 and 12: Speakers: 1. Ramesh Singh, Director
Page 13 and 14: ü Understand PD process ü Integra
Page 15 and 16: Manjushree, SPCO: Last 5 years doin
Page 17 and 18: 1993 Experimental use of PD approac
Page 19 and 20: ethnic Tharus, who are considered a
Page 21 and 22: Strengths ü Identifying change age
Page 23 and 24: *Hearth is not to be sustained. Mot
Page 25 and 26: # in poor households # in wealthier
Page 27 and 28: Tea break Warm-up: Observation game
Page 29 and 30: PDI General Information: PD • Lar
Page 31 and 32: • No father input in care giving
Page 33 and 34: Refer to Attachment H for a copy of
Page 35: At each step in the Hearth protocol
Page 39 and 40: Spectrum of Emphasis: Rehabilitatio
Page 41 and 42: „ Monitoring and Evaluation see p
Page 43 and 44: Innovations/bright ideas accumulate
Page 45 and 46: K. Epilogue: This workshop is just
Page 47 and 48: Attachment B: PD/Hearth TOT Worksho
Page 49 and 50: Sr. No. Description of Events 1. Ai
Page 51 and 52: Attachment D: Materials List Welcom
Page 53 and 54: Findings of PD/Hearth Studies and C
Page 55 and 56: Summary Report: High Impact PVO Chi
Page 57 and 58: Child Survival was able to make con
Page 59 and 60: Attachment E. List of Evening Discu
Page 61 and 62: Attachment G: Field Plan for Wednes
Page 63 and 64: Attachment H: Results of Market Sur
Page 65 and 66: Cucumbers 90 2.5 0.4 13 0.6 7 0 Pum
Page 67 and 68: Sr. NO. 1. 2. 3. 4. 5. 6. 7. 8. 9.
Page 69 and 70: Sr. NO. 24. 25. 26. 27. 28. 29. 30.
Page 71 and 72: Attachment K: Final Evaluation Resu
Page 73 and 74: • Shorter training (1) • Not lo
Page 75 and 76: Attachment L: PRESS RELEASE 4 th De
Page 77 and 78: Hearth trainers identify positive d

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