Last week the local Ministry of Health’s Nutrition Team officiated a CHW (Community Health Worker) training on IYCF. Training materials were developed in conjunction with Path, University Research Co., LLC, and UNICEF.
Here is an account by one of our most astute Field Officers, Paul Mogosi. This will be the last Healthcare training Paul will participate as he is moving to the Training Team to learn how to facilitate Nuru’s newest curricula. He will be greatly missed, but will undoubtedly continue to help improve his community’s health-based decision making when possible.
During the training the CHW’s learned thier expectations like how to how to use new knowledge in IYCF while explaining to the community and how to change behaviors. The CHWs will do a very good job during household visits by using general counseling guidelines learned in training, mostly for mothers who are breastfeeding. They were trained to use open questions, rather than closed, to find out the information they need. Here are some examples of both.
Closed:
CHW: Good morning. I am Esther Kebaki. a IYCF counselor. Is your baby, Cha Cha, well?
Mother: Yes, thank you.
This will not let the CHW know about the child to inform the rest of the visit.
Open:
CHW: Good morning, Bhoke. I am Esther Kebaki, a IYCF counselor. How is Cha Cha? Can you please tell me about his health?
Mother: He is well, but is always hungry.
This will make the CHW know more about the baby. Then the CHW can ask questions like, “why do you think he is hungry? What do you usually feed him? Can I provide some advice?”
The CHW’s will have a chance to show the mothers the advantages and benefits of exclusive breastfeeding for the first 6 months of life. This education and demonstration can help build immunity and reduce illnesses like pneumonia, diarrhea and malnutrition.
They will teach why families should not give the infant water or herbs immediately after birth, and that newborn babies should be given breast milk within 30 minutes in order to provide special protection from illnesses.
CHWs will also teach mothers about proper attachment and position of their baby during breastfeeding. Proper attachment will reduce the common breast conditions like cracked nipples and Candida (thrush), boils, and plugged ducts.
Along with exclusive breastfeeding, they will introduce new immunizations called Pcv10, which is given after 6 weeks of birth and is given three times. Thus reducing the number of children who are dying from pneumonia.
CHWs learned about the needs of children after 6 months including giving a balanced diet of 3 types of food: Protein (body building food,) vitamins (protective foods,) and carbohydrates (energy giving food.) During home visits they will give examples of each group and explain how much and how often to feed young children from 6-24 months. This will include critical nutrition supplements for children in our community because we have problems like eyesight, night blindness, diarrhea, anemia and brain damage. The CHWs will give advice on the use of vitamin A, Zinc, Iron, folic acid, and iodine in order to reduce the risk of deadly disease and long-term health problems. Our health goal is to prevent and mitigate diseases therefore household counseling will greatly help the community.
CHWs had a follow up review session this Wednesday, and they showed impressive knowledge retention. They were reminded about the various determinants for nutrition related behaviors and were equipped with a food pyramid and checklist of topics to cover. They will also introduce Moringa Leaf Powder as a nutritional supplement, which we expect will have an extremely positive impact on malnutrition rates over the next year.
Nutritional value of Moringa Leaf Powder:
- 7 times the Vitamin C of oranges
- 4 times the Vitamin A of carrots
- 4 times the Calcium of milk
- 3 times the Potassium of bananas
- 2 times the Protein of yogurt
- Leaves contain all of the essential amino acids (proteins)
- Leaves contains antioxidants
We are still eager to learn about home visit methodology. This week we are specifically interested in tools for nutrition specific visits. We would appreciate any information you may have!