Implementation of Micronutrient Supplementations in Community-Based Nutrition Program in Ethiopia after Integrated Refresher Training (IRT)
Masresha Tessema *
Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia.
Aregash Samuel Hafebo
Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia and Wageningen University, Wageningen, The Netherlands.
Tesfaye Hailu
Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia.
Desalegn Kuche
Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia.
Aweke Kebede
Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia.
Tsehai Assefa
Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia.
*Author to whom correspondence should be addressed.
Abstract
Objectives: Community-Based Nutrition (CBN) is important component of National Nutrition Program, designed to build upon the Health Extension Program packages to improve nutritional status of under-five children, pregnant and lactating women. Therefore, this study was conducted to assess CBN program implementation after IRT.
Methods: The study was conducted from October to November, 2012 in four agrarian regions. Institutional based cross-sectional study with both qualitative and quantitative data collection approach at 56 kebeles were used.
Results: Some of the Health Extension Workers (HEWs) were not delivering GMP in a quality way as they were trained on IRT. For HEWs it was difficult to follow the procedure of GMP service properly. The gap in skill was higher in the new CBN woredas. Task shifting from VCHWs to HDAs didn't occur in most kebeles of Amhara region. In most regions it was observed that supportive supervision and review meetings are offered but it is not regular and consistent. It was observed that some new programs contradict with CBN service like new community health management information system. Based on the information gathered, all health post of study areas were conducting Community Health Day services for micronutrient supplementations in every three months regularly except very few.
Conclusions: Factors which affect the implementation of CBN are: lack of training for both HEWs and HDAs, work load for HEWs. Training should be given as it helps to improve competencies/refresh the already trained and trainees those who didn't get it. Strengthening the CBN service can be achieved by increasing the manpower.