Menu ENN Search

Training and workshop to integrate IYCF in CMAM

Summary of report1

Training/workshop participants

Between 23 and 31 August 2010, World Vision International (WVI) and the Emergency Nutrition Network (ENN) held a six day training of trainers (TOT) and two day companion planning workshop in Ethiopia on integration of infant and young child feeding (IYCF) activities into community based management of acute malnutrition (CMAM) programmes. The training took place in Shone ADP2 and the workshop in Hawassa Region.

The aim of the TOT workshop was to strengthen the technical capacity of World Vision country, regional and headquarters (HQ) staff. The aim of the companion workshop was to contribute to WV's strategic planning to integrate IYCF support into its CMAM programmes at country, regional and global level. The companion workshop paid particular consideration to locating integration within the Ethiopian Governments policies and programmatic guidance.

ENN consultants from Nutrition Policy and Practice (NPP) led the training, supported by the ENN and WVI headquarter- Nutrition Centre of Expertise (NCOE) technical staff.

Fourteen WV programme staff from Sierra Leone, Zimbabwe, Zambia, Ethiopia, Rwanda, Kenya and Uganda participated in the TOT. They were joined by staff from regional and global NCOE who support Eastern and Southern Africa, and WV support office staff from Canada and the US. An additional five participants participated in the two day planning workshop from WV regional offices, the Sudan Ministry of Health (MoH), and Concern Worldwide.

Five day TOT

The five day TOT used the 'Integration of IYCF Support in CMAM'3 training materials as the technical content. It was a competency based 'hands-on' training built around adult learning principles. The approach used the experiential learning cycle (a learning cycle of experience, reflecting, thinking and acting), employing a variety of training methods. Two days of practice sessions (Days 4 and 5) took place in health facilities within a half-hour's drive of the Shone ADP.

The end of training evaluation was positive. Participants highlighted sessions on behaviour change, counselling skills, forming action and support groups, the 'adult learning' approach to the workshop facilitation, and the practical sessions as especially helpful. Recommendations for future TOT were more practical field sessions, more preparation for field sessions to include orientation of managers of CMAM programmes, and more practical application of HIV and infant feeding recommendations. Competency ratings (self assessment) increased significantly pre and post training.

Two day planning workshop

The specific objectives of the two day companion workshop were to share cross country/agency experiences on IYCF and CMAM, develop WV action plans to rollout the 'Integration of IYCF Support into CMAM Programming' training material, define operational research questions and explore WV monitoring and evaluation (M&E) around IYCF in CMAM. The 2 day planning benefitted from the presence of Ethiopian university staff to consider Ethiopia-specific recommendations.

Appreciative Inquiry (AI) methodology4 was used to explore how IYCF can best be integrated into existing CMAM programmes through working groups. Integration was considered for key contact points in community mobilisation, Outpatient Therapeutic Programme (OTP), Supplementary Feeding Programme (SFP), Stabilisation Centre (SC), and other community services. Integration was also considered for national level pre-service and in-service training, and by international agencies and local partners.

Opportunities

Participants envisaged good synergy and many benefits of IYCF integration in CMAM including improved acute and longer term nutrition and developmental outcomes for children, reduced relapse amongst treated children, and strengthened community component of CMAM programming and continuity of care. There were many suggestions for integration at contact points. Specific to Ethiopia (detailed in the report) priority actions suggested to enable IYCF in CMAM in Ethiopia included training community volunteers on implementation of action-oriented group sessions and support groups, revitalising the Health Education Talks at OTP with action-oriented group sessions and support groups and, researching breastfeeding counselling feasibility at a designated OTP follow up visit. Additional areas identified for action included advocacy for IYCF integration with the existing NNTWG (National Nutrition Technical Working Group) in Ethiopia, development of refresher training (in-service), and embedding IYCF into CMAM in pre-service training.

Participants considered baseline IYCF information was needed to inform integrated activities and may involve surveys of Knowledge, Attitude, Practice (KAP), KAPB (behaviour), KPC (coverage) and community led assessments, ideally prior to setup.

A brief session on M&E discussed the benefits of disaggregating programme age data in programmes and the potential to include IYCF process indicators in the WV CMAM database. Participants considered a simplified measurement approach of IYCF assessment may be more realistic for programmes; a simplified methodology should be consistent over time and the results not compared to those obtained using globally- agreed indicators and measurement guidance.

Action plans were developed for six countries (Ethiopia, Kenya, Rwanda, Sierra Leone, Uganda and Zimbabwe), the Africa region, two training contexts (SNNP Sudan and Hawassa University, Ethiopia), and for WV Support Offices and Global Health Offices. Training of community based staff featured strongly in plans, in addition to policy/strategy updates at country level, engaging in operational research, and documentation of best practice and lessons learned to inform programming.

At an agency level, opportunities for strengthening technical capacity identified were WV country office assistance through WV-NCOE/Regional Office, development of institutional capacity in Hawassa University, developing linkages with UNICEF, and undertaking operational research.

Constraints

Throughout both the training and workshop, participants identified many constraints to integrating IYCF in CMAM. The lack of a defined operational model for integrated programming limited scale up of integration in action plans. Key operational research needs identified were around impact on nutritional and programme outcomes, effect on IYCF integration on programming caseload, feasibility of integration at key contact points, how to monitor and evaluate programming within the existing CMAM framework and cost-benefit analysis.

Given the gaps in operational guidance, the importance of capturing experiences on integration to inform programming and the need for collaboration and partnership were highlighted. Participants suggested it may benefit to learn by small scale integration, e.g. integrate in one geographic area, or focus on strengthening IYCF with one key contact point.

Conclusions

The facilitators concluded that to move forward on IYCF in CMAM at a national level, it is essential to identify key government and agency partners, as well as seek to locate interventions within national strategies and priorities. In future research, the operational model (or models) for consideration should comprise a multi-component intervention including interpersonal IYCF counselling and negotiation, action-oriented group education, peer support and targeted, context specific messaging.

As a next step, an initiative that looked to address more closely the integration of IYCF in CMAM in the Ethiopian context could draw on Ethiopia's considerable lessons to date from both OTP scale up and IYCF programming. Such an initiative(s) should include experience documentation, operational research and rapid dissemination of lessons learned.

For more information, contact: Sarah Carr, World Vision Canada, email: sarah_carr@worldvision.ca

Show footnotes

1WORLD VISION International-ENN. Collaborative project to enable Integration of IYCF Support into CMAM Programming at Agency and National Levels. Ethiopia. 23- 31 August, 2010. Final Report. 25 September 2010

2Area Development Programme (World Vision)

3Developed by the ENN in collaboration with the partnership Nutrition Policy and Practice Group (NPP) in 2008, funded by the GNC. Available in English and French at: http://www.ennonline.net/resources/722

4This comprised four 'D's: discovery (whtat are the benefits of implementing IYCF and CMAM), dream (what do we expect to acheive through integration of IYCF in CMAM), design (how to integrate IYCF into CMAM contact points) and delivery (action plan development).

5This comprised four 'D's: discovery (whtat are the benefits of implementing IYCF and CMAM), dream (what do we expect to acheive through integration of IYCF in CMAM), design (how to integrate IYCF into CMAM contact points) and delivery (action plan development).

More like this

FEX: Planned study on feasibility and efficacy of IYCF in CMAM integration in Ethiopia

Dr Ferew, MOH Advisor, Government of Ethiopia, addressing the consultation on Day 1 The Alive and Thrive Project1 is supporting a two-year, field-based study on the...

FEX: World Vision

Name World Vision Website www.worldvision.ca Address 1 World Drive, Mississauga, Ontario L5T 2Y4 Director The President of World Vision Canada is Dave Toycen Dr. Carolyn...

FEX: Building national capacity in HIV and Nutrition

By Kate Sadler Kate Sadler is a nutritionist and senior researcher with a focus on nutrition in emergencies at the Feinstein International Centre. She worked previously with...

en-net: Sr. Policy Advisor, Maternal & Child Nutrition

Senior Policy Advisor, Maternal & Child Nutrition (MCN) Nutrition Centre of Expertise, Global Health Center Full Time Temporary, 18 Months World Vision is a Christian...

FEX: Transforming awareness and training into effective CMAM Performance

By Maureen Gallagher and Armelle Sacher Maureen Gallagher is the Senior Nutrition & Health Advisor ACF USA based in New York. She has worked for the last 10 years in nutrition...

en-net: SMART SURVEY CONSULTANT-NEEDED FOR Integrated Emergency Nutrition and WASH Response in SW Angola

Project Summary
The proposed Emergency Nutrition and WASH Response (ENWR) aims to contribute towards humanitarian lifesaving that focuses primarily on children U5. The...

FEX: Infant and Young Child Feeding in Emergencies (IYCF-E) –Toolkit for implementation

By Britni Burkhardsmeier (Programme Coordinator, Save the Children USA), Nicki Connell (Emergency Nutrition Advisor, Save the Children USA) and Sarah Butler (Emergency...

FEX: World Vision programme for severe acute malnutrition in SNNPR

By Dr. Sisay Sinamo and Dr. Gedion Tefera Dr Sisay Sinamo is Coordinator for the Health and Nutrition Coordination Unit with World Vision Ethiopia. A medical graduate from...

FEX: Regional IFE workshop in Bali

Summary of meeting1 One hundred and twelve participants from 16 countries and special territories, together with regional and international representatives of United Nations...

FEX: Treatment of severe acute malnutrition through the Integrated Child Development Scheme in Jharkand State, India

By Grana Pu Selvi and Colleen Emary Grana Pu Selvi has postgraduate qualifications in food and nutrition and international public health. She has been working with World...

FEX: Integrating OTP into routine health services CONCERN’s experiences

By Emily Mates Emily Mates is a public health professional with a focus in nutrition. She recently left Concern Worldwide, Ethiopia where she worked for many years in...

FEX: Integration of IYCF into CMAM – new training content

A training content 'Integration of IYCF (infant and young child feeding) support into CMAM (community based managment of acute malnutrition)' is now available. The materials...

en-net: Short term consultant for IYCF-workshop

Job Title: Lead Organizer: Infant and Young Child Feeding workshop Aim of consultancy To take the lead in organizing a 5 day workshop on IYCF and...

FEX: Treatment of malnutrition in Lebanon: Institutionalisation with the Ministry of Public Health – steps and lessons learned

By Linda Shaker-Berbari, Pressila Derjany Khoueiry and Dima Ousta Linda Shaker Berbari works with International Orthodox Christian Charities (IOCC) as Regional Technical...

FEX: Tech RRT CMAM Adviser: Experiences from Nigeria and Yemen

By Simon Kiarie Karanja Simon Karanja is a nutritionist with over ten years' experience in nutrition in emergencies, holding various positions in NGOs, UNICEF and the Global...

FEX: IYCF in Zimbabwe

By Fistum Assefa Fitsum Assefa is currently working as UNICEF Nutrition Manger, in Zimbabwe. Zimbabwe has a high prevalence of stunting (32%) and low prevalence of...

FEX: Report on WFP Training Workshop in Sudan

By Theresa Loro, WFP Sudan Group work presentation Theresa Loro is a Senior Nutritionist working with WFP Sudan and has been based in Khartoum since 2004 as a National...

FEX: Guidelines and free on-line modules to support multi-sectoral programming for nutrition and resilience

Guidelines and a free online module have been developed by the Food and Agricultural Organisation (FAO) to assist professionals involved in emergency, resilience and...

FEX: Update on Minimum Reporting Package (MRP) trainings in London and Nairobi

By Emily Mates, Nutrition Advisor, MRP, Save the Children UK The ‘Minimum Reporting Package’ (MRP) has been developed to support standardised data collection for emergency...

FEX: From the editor

Rabia, seven months, with her mother at an OTP Aim and structure of this special issue This Field Exchange special issue on ‘Lessons for the scale up of Community-based...

Close

Reference this page

Training and workshop to integrate IYCF in CMAM. Field Exchange 40, February 2011. p81. www.ennonline.net/fex/40/training