2009

CORE Group Nutrtion Working Group held a Positive Deviance/Hearth Technical Advisory Group (TAG) meeting in early 2009 in order to:
•    review implementation and results of PD/Hearth from recent experiences;
•    explore challenges and modifications in PD/Hearth implementation and make recommendations related to both essential elements and implications for scale; and
•    identify how PD/Hearth has been integrated into overall nutrition programs and with other approaches in order to make programmatic recommendations for the NPDA

The TAG Team reviewed PD/H experiences from the I-LIFE Title II consortium in Malawi, CCF / India’s PD/H work in West Bengal reaching over 14,000 malnourished children, SC Tajikistan’s integration of PD/H into a CSH program, government of Ethiopia PD/H program, PVO program in Bolivia, Indonesia PD/H Consortium final evaluation, Children’s Nutrition Program in Haiti, as well as specific experiences of TAG participants in other countries.
Presentations, detailed TAG notes and recommendations.

 

2008

In 2008, the Nutrition Working Group hosted two Technical Advisory Group (TAG) meetings to guide the development of a tool to improve the design of the nutrition component of Child Survival and Title II programs. The Nutrition Pathways Decision Tool has been extensively reviewed by members and partners and field-tested in Malawi with seven organizations as part of a multi-organization proposal for Title II programming.

The Nutrition Working Group also hosted several technical updates over the last year on topics including: recent advances in understanding the long term consequences of improving pre-school nutrition for human capital formation and economic productivity; a review of member program experiences to date in child nutrition, with a focus on exclusive breastfeeding to improve child nutrition; and building effective collaboration for improving breastfeeding practices.

Vision

The Nutrition Working Group underscores the critical role of nutrition in maternal and child survival and health through dissemination of state-of-the-art information and approaches essential for quality nutrition programming.

The Essential Nutrition Actions (ENA) Framework

The Essential Nutrition Actions (ENA) framework  an operational framework for managing the advocacy, planning and delivery of an integrated package of preventive nutrition actions encompassing infant and young child feeding (IYCF), micronutrients and women's nutrition. Using multiple contact points, it targets health services and behavior change communication support (BCC) to women and young children during the first 1,000 days of life - from conception through the first two years of life - when nutrient requirements are increased, the risks of undernutrition are great, and the consequences of deficiencies most likely to be irreversible. All these actions have been proven to improve nutritional status and reduce mortality.

The training component for the implementation of the ENA framework at both the health facility and community levels include 3 guides as follows:

1.The Booklet of Key ENA Messages (Word Version)/ French (Word) illustrates the key ENA messages and can be used by those implementing and supporting health, nutrition, and food security programs for improving nutrition practices among pregnant and lactating mothers and children under two.

2. ENA Health Worker Training Guide (Word Version)/ French (Word) equips health service providers with the technical, action-oriented nutrition knowledge and counseling skills needed to support pregnant women, mothers with children under two years of age, and other key family members to adopt optimal nutrition practices.

2b. ENA Health Worker Handouts (Word Version)/ French (Word)

3. ENA Community Volunteers Training Guide (Word Version)/ French (Word) equips semi-literate or illiterate Community Volunteers with the basic action-oriented nutrition knowledge and counseling skills needed to support pregnant women, mothers with children under two years and other key family members to adopt optimal nutrition practices

 

The Nutrition Program Design Assistant: A Tool for Program Planners (NPDA)

The NPDA helps program planning teams design the nutrition component of their programs and select the most appropriate community-based nutrition approaches for their specific geographic target areas.  The NPDA was created as a response to frustration that many nutrition programs, including well-implemented ones, don't achieve their intended results because of a key program design mistake: they use the wrong approach to address their context-specific nutrition problems. The NPDA provides much needed guidance on how to select an approach and compare and contrast approaches so that a team can determine which one(s) would best suit their programming needs.  The Reference Guide provides guidance on analyzing the nutrition situation, establishing objectives, and selecting a combination of approaches to suit the local nutrition situation and the program's resources and objectives.  The Workbook is a place to record data, decisions, and decision-making rationale.

Nutrition Program Design Assistant (NPDA) Reference Guide
NPDA Workbook
NPDA Workbook (Word Version)
NPDA Step 1 Data Tables
NPDA Guidance for Field Agenda
Nutrition Program Design Assistant Posters

NDPA Workshop

The workshop provided participants with experience using the tool and prepared them to use the tool for program planning in the field.  The following workshop materials can be used to support workshops or activities with the NPDA

NDPA Workshop Agenda (Feb 2011)
NDPA Workshop Syllabus (Feb 2011)
NDPA STEP 1 East Africa Data Set
NDPA STEP 1 West Africa Data Set
NDPA STEP 3 East Africa Charts
NDPA STEP 3 West Africa Charts

Tools & Resources

• NPDA Tool Promotion Flyer
• Nutrition Works: Measuring, Understanding, and Improving Nutrition Status (2001)
• Findings and Lessons Learned: An In-Depth Assessment of Large Scale Implementation of PD/Hearth in Indonesia (2009)
• 2006 Nutrition Technical Reference Materials
• The Status of Programs and Research to Improve Complementary Feeding - Judiann McNulty
• Positive Deviance / Hearth
• Maternal Nutrition During Pregnancy and Lactation: Dietary Guide
• CORE Diffusion Product: The Integration of Vitamin A Supplementation Into Community-Directed Treatment with Ivermectin: A Practical Guide for Africa (HKI)

Meetings & Reports

• Fat in the Critical 1000 Days: Ensuring Adequacy of Essential Dietary Fats for Mothers and Children in Low and Middle Income Countries (April 7, 2011)
• PD/Hearth Technical Advisory Group (TAG) Meeting Report (February 6, 2009)
• MOST Powerpoint: Implications Of Research Findings For Programs To Reduce Micronutrient Deficiencies
• Community-based Therapeutic Care (CTC): Managing Severe Acute Malnutrition in Emergencies and Development

Useful Links

• 1,000 Days
• A2Z: The USAID Micronutrient and Child Blindness Project
• Alive & Thrive
• Food and Nutrition Technical Assistance (FANTA)
• General Nutrition Information
• Global Breastfeeding
• KPC Module 2: Breastfeeding and Infant/Child Nutrition (January 2005 Update)
• LINKAGES Project
• MOST: The USAID Micronutrient Project
• PROFILES
• Program Assessment Guide (PAG)
• Scaling Up Nutrition: A Framework for Action
• Sharing U.S. Technology to Aid in the Improvement of Nutrition (SUSTAIN) Project

Past Highlights