The Tamilnadu Integrated Nutrition Project (TINP)
The project, carried out by the Government to Tamilnadu, covered 40 percent of the State’s rural population and involved 9.000 Community Nutrition Centre stafled by one Community Nutrition Worker (CNW) each. They were supervised by 900 Community Nutrition supervisors (CNS) and all were trained by 173 Community Nutrition Instructresses (CNI) at the Block (district) level. The target group was children, age 6 months to 3 years, a post-exclusive breastfeeding age group that is not otherwise enrolled in the State’s child feeding programmes. The main components included :
1) monthly weighing and growth charting
2) short-term supplementary feeding for the malnourished
3) Intensive counseling
4) Deworming and closes of vitamin A
5) provision of iron folic acid tablets to all pregnant women and
6) education on home-based management of diarrhoea
Babies whose growth was faltering were given a supplement but as soon as they reached normal growth levels the supplements was taken away. In spite of what might be regarded as a disincentive for progress, an independent evaluation revealed a decline in children enrolled in supplementary feeding from 40 to 25 percent during the project period and a 55.5 percent reduction in severe malnutrition during the first 72 months, 24 percent over the next 38 months, 35 percent over the following 38 months.
Communication materials produced to support worker-client interaction were not well used. the supplementary feeding provided a drawing card for reaching the malnourished in the community and a procces of intensive contact and counseling followed, supported by mother’s and children’s clubs.
The lessons learned on the training side were:
1. Selection on WNWs from the community with a criteria that they be good communicators.
2. Intensive training of well-educated CNIs who then developed and continually adjusted their own training syllabi for the local need of CNSs and CNWs
3. Training carried out at block headquarters (non-residential and similar in setting to nutrition centres)
4. Follow-up supervision by those involved in training
5. Great emphasis placed on interpersonal communication skills of CNWs during training and follow-up supervision by CNSs
6. Only 10 CNWs to each Cns, allowing for intensive supervision and monitoring.
another successful nutrition programme is the Iringa Nutrition Programme in Tanzania (see panel on page 142). although the contribution of malnutrition to child mortality was the starting point, this programme benefited from a very thorough process of problem identification with the involvement of villagers, district and national-level officials. As the programme evolved a broad-based process of social mobilization took place, leading to a large number of the development activities with the participation of local people. The iringa Nutrition Programme is perhaps one of the best examples where villages-level communities have become involved in social mobilization process through full participation in programme analysis. In setting and adjusting programme goals and strategies and in programme implementation. in fact, the best elements of the Iringa Nutrition Programme have been replicated in other areas of Tanzania, covering an area three times the size of the original programme at less than half the cost per child.
The Iringa experiences has become the back-bone of Tanzania’s child survival and development programme. However, it remains to be seen if a programme such as this, which involves a high degree of long-term participatory analysis and action, can be widely replicated in other areas of Africa and the developing world with which do not have the social structures of Tanzania, a country with 25 years of experiences in grass-roots socialism. in the final chapter the Iringa approach is discussed in more detail in the context of conclusions I have arrived in my thinking about social mobilization and community participation.
conclusion
it has been said that, social mobilization brings about the – internalization of programme objectives by the people, thus ensuring the creation of consumer demand, availability of human, material and financial resources, and multisectoral inputs. When all social group aspire to the attainment of a nation objective which transcends political barriers, means are found solution are developed and innovations become commonplace.
1) monthly weighing and growth charting
2) short-term supplementary feeding for the malnourished
3) Intensive counseling
4) Deworming and closes of vitamin A
5) provision of iron folic acid tablets to all pregnant women and
6) education on home-based management of diarrhoea
Babies whose growth was faltering were given a supplement but as soon as they reached normal growth levels the supplements was taken away. In spite of what might be regarded as a disincentive for progress, an independent evaluation revealed a decline in children enrolled in supplementary feeding from 40 to 25 percent during the project period and a 55.5 percent reduction in severe malnutrition during the first 72 months, 24 percent over the next 38 months, 35 percent over the following 38 months.
Communication materials produced to support worker-client interaction were not well used. the supplementary feeding provided a drawing card for reaching the malnourished in the community and a procces of intensive contact and counseling followed, supported by mother’s and children’s clubs.
The lessons learned on the training side were:
1. Selection on WNWs from the community with a criteria that they be good communicators.
2. Intensive training of well-educated CNIs who then developed and continually adjusted their own training syllabi for the local need of CNSs and CNWs
3. Training carried out at block headquarters (non-residential and similar in setting to nutrition centres)
4. Follow-up supervision by those involved in training
5. Great emphasis placed on interpersonal communication skills of CNWs during training and follow-up supervision by CNSs
6. Only 10 CNWs to each Cns, allowing for intensive supervision and monitoring.
another successful nutrition programme is the Iringa Nutrition Programme in Tanzania (see panel on page 142). although the contribution of malnutrition to child mortality was the starting point, this programme benefited from a very thorough process of problem identification with the involvement of villagers, district and national-level officials. As the programme evolved a broad-based process of social mobilization took place, leading to a large number of the development activities with the participation of local people. The iringa Nutrition Programme is perhaps one of the best examples where villages-level communities have become involved in social mobilization process through full participation in programme analysis. In setting and adjusting programme goals and strategies and in programme implementation. in fact, the best elements of the Iringa Nutrition Programme have been replicated in other areas of Tanzania, covering an area three times the size of the original programme at less than half the cost per child.
The Iringa experiences has become the back-bone of Tanzania’s child survival and development programme. However, it remains to be seen if a programme such as this, which involves a high degree of long-term participatory analysis and action, can be widely replicated in other areas of Africa and the developing world with which do not have the social structures of Tanzania, a country with 25 years of experiences in grass-roots socialism. in the final chapter the Iringa approach is discussed in more detail in the context of conclusions I have arrived in my thinking about social mobilization and community participation.
conclusion
it has been said that, social mobilization brings about the – internalization of programme objectives by the people, thus ensuring the creation of consumer demand, availability of human, material and financial resources, and multisectoral inputs. When all social group aspire to the attainment of a nation objective which transcends political barriers, means are found solution are developed and innovations become commonplace.
Postingan
0 komentar:
Posting Komentar