The Iringa Nutrition Programme
the iringa region in Southern Tanzania has a population of approximately 1.200.000 the majority being smallholders in 620 villages. 168 of which were included in the original programme. the number of underweight children declined from 50 percent in 1984 to 37 percent in 1988 and 35 percent in 1990. Severe malnutrition declined from 6 percent in 1984 to 2 percent in 1988 and 1,4 percent in 1990. what brought about this sharp improvement in the nutrition status of children?
the iringa project was supported and initiated by WHO and UNICEF. However, these agencies did not produce a “blueprint”for the project in New York, Geneva or dar-es-Salaam. Instead the strategy involved people from the national to the village level who reviewed the causes of malnutrition in a cyclical process of assessment, Analysist and action. They discussed the reasons for high mortality rates in a conceptual framework which included:
1. basic causes such as the availability of resources and the political/economic structure.
2. Underlying causes such as household food security, child care practices and the state of health services and
3. immediate causes, the interrelationship between malnutrition and disease.
the process involved a great deal of advocacy and awareness creation at all levels, including village campaign, mass media such as newsletters and films, training programmes and the involvement of cultural and youth groups. A number of mobilizing agents were identified including important allies in the Party and Government, local government, village committees and village health workers. It also involved extensive monitoring systems, the most important being the weighing of children and use or growth cards by the village themselves. Finally, the programme included the strengthening of critical services such as immunization, diarrhea and malaria control, and the care and feeding of children.
It is evident forum the above that this programme through its extensive process of analysis and social mobilization, went much beyond what world normally be understood as a nutrition programme. It is an important achievement for accelerating overall development in Tanzania.
To a large extent, social mobilization for EPI and other programme has begun such a transformation in the health a nutrition sector iin many countries around the world. Of cour programme must be strengthened and sustained. Where Epi has been built on the existing health care system such as Bangladesh the task will be easier. Where a parallel delivered system has been built, systematic integration is probably necessary for long-term sustainability. Much more effort will be need to achieves this. In many countries, however, social mobilization for health and nutrition goals has set the stage for achieving the goals of other programmes such as environmental sanitation are based education.
on the other hand, in the push for acceleration in Bangladesh and other countries, some important lessons of social marketing experiences were missed. The most important channel of communication the health worker, was not identified and through strengthened soon enough. The early and methodical application of some social marketing research method would have helped to avoid this problem. Social mobilization, therefore, just like social marketing, does not represent a complete model for development communication. The science side of communication is sometimes missed in the efforts to decentralize control and push for programme acceleration. It is worthwhile exploring further the model of communication given on page 137 which includes all there element: advocacy, social mobilization, and programme communication. the latter should include the planning and research activities of social marketing. the possibilities concerning this model are further explored in the next and final chapter of this book.
the iringa project was supported and initiated by WHO and UNICEF. However, these agencies did not produce a “blueprint”for the project in New York, Geneva or dar-es-Salaam. Instead the strategy involved people from the national to the village level who reviewed the causes of malnutrition in a cyclical process of assessment, Analysist and action. They discussed the reasons for high mortality rates in a conceptual framework which included:
1. basic causes such as the availability of resources and the political/economic structure.
2. Underlying causes such as household food security, child care practices and the state of health services and
3. immediate causes, the interrelationship between malnutrition and disease.
the process involved a great deal of advocacy and awareness creation at all levels, including village campaign, mass media such as newsletters and films, training programmes and the involvement of cultural and youth groups. A number of mobilizing agents were identified including important allies in the Party and Government, local government, village committees and village health workers. It also involved extensive monitoring systems, the most important being the weighing of children and use or growth cards by the village themselves. Finally, the programme included the strengthening of critical services such as immunization, diarrhea and malaria control, and the care and feeding of children.
It is evident forum the above that this programme through its extensive process of analysis and social mobilization, went much beyond what world normally be understood as a nutrition programme. It is an important achievement for accelerating overall development in Tanzania.
To a large extent, social mobilization for EPI and other programme has begun such a transformation in the health a nutrition sector iin many countries around the world. Of cour programme must be strengthened and sustained. Where Epi has been built on the existing health care system such as Bangladesh the task will be easier. Where a parallel delivered system has been built, systematic integration is probably necessary for long-term sustainability. Much more effort will be need to achieves this. In many countries, however, social mobilization for health and nutrition goals has set the stage for achieving the goals of other programmes such as environmental sanitation are based education.
on the other hand, in the push for acceleration in Bangladesh and other countries, some important lessons of social marketing experiences were missed. The most important channel of communication the health worker, was not identified and through strengthened soon enough. The early and methodical application of some social marketing research method would have helped to avoid this problem. Social mobilization, therefore, just like social marketing, does not represent a complete model for development communication. The science side of communication is sometimes missed in the efforts to decentralize control and push for programme acceleration. It is worthwhile exploring further the model of communication given on page 137 which includes all there element: advocacy, social mobilization, and programme communication. the latter should include the planning and research activities of social marketing. the possibilities concerning this model are further explored in the next and final chapter of this book.
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The Iringa Nutrition Programme
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