1. Cambodia: Wells Project
Project Description: This project drilled deep-bore community waters wells in 15 villages in the Svay Rieng and Pursat provinces of Cambodia. In addition, the program provided health, hygiene, and sanitation education to hundreds of villagers.
Long-Term Success: By ensuring access to safe drinking water and basic hygiene education, this project reduces child mortality, illness, and school absences due to water-borne disease. The program additionally reduces the amount of time villagers spend fetching water, freeing up valuable time for things like studying and livelihood activities.
Short-Term Success: Provides immediate access to a daily supply of safe drinking water for 1,700 people.
2. Niger: Micronutrient Supplementation
Project Description: Buddhist Global Relief (BGR) partnered with Helen Keller International (HKI) to pilot a micronutrient nutrition program in the Zinder Region of Niger that trained village-based Growth Monitoring Teams to provide children 6 to 36 months of age, pregnant women and deworming medication (Mebendazole). The project was piloted in 10 villages located in the southern Tanout and northern Matameye health districts. The project aimed to build the capacity of health facilities, workers and volunteers, as well as the general population, in order to improve health and nutritional outcomes through community-based supplementation of micronutrients and anti-parasitic medication.
Long-term Success: This pilot project demonstrated that trained community teams can successfully distribute micronutrients and anti-parasitic medications to children under 36 months of age through associating distribution with monthly growth monitoring sessions. Although it was not possible to ensure sustainability during the life of the project because of current issues with the Ministry of Health’s reimbursement system for essential medicines, it should be possible to do so once the reimbursement system is functional again or the government has found another solution for ensuring the availability of essential medicines in health facilities.
Short-term Success: A total of 60 community Growth Monitoring Team members were trained on micronutrient distribution, community education techniques to be used when providing micronutrients to women and children, and how to track distribution data. A total of 30 community micronutrient distributions occurred over the course of this project, where one distribution occurred per village each month over a period of three months (December 2009-February 2010). The project reached 1,096 children between the ages of 6-36 months of age and 202 nursing women with vitamin A capsules. In addition, 1,068 children ages 6-36 months, 641 pregnant women and 109 lactating women were reached with iron supplementation. Finally, 1,072 children between the ages of 6-36 months and 553 pregnant women were treated with Mebendazole (deworming medication).
Success Monitored By: A HKI field agent and a nurse from the nearest health center supervised each of the 30 community micronutrient distribution sessions in order to ensure that distributions were properly implemented and that data was accurately and properly collected.
Program Success Examples: The program targets of reaching at least 90% of the population for each beneficiary group were not only met but exceeded. Through the integration of micronutrient and anti-parasitic medication distributions into community growth screening sessions, the project was able to reach children at the appropriate age at high percentages with vitamin A, iron, and de-worming supplements. Moreover, the project was also able to provide needed supplements to pregnant and lactating mothers who accompanied their children to growth screenings.
3. Program: Mali: National Nutrition Weeks
Children and Youth (infants - 19 years.)
Program Description: Buddhist Global Relief (BGR) partnered with Helen Keller International (HKI) to reduce maternal and child mortality in Mali. The specific objectives of this project were to: 1) support the Government of Mali (GoM) to implement National Nutrition Weeks (NNWs), including the distribution of vitamin A and albendazole (to combat intestinal worms) in the Douentza district of Mopti; 2) improve vitamin A status of children (6 to 59 months) and post-partum women through vitamin A supplementation (VAS); and 3) raise awareness about VAS, exclusive breastfeeding, complementary feeding, iodized salt consumption, and malaria prevention.
Program Long-Term Success: NNWs are being institutionalized in Mali, but until the Regional Health Directorates are in a position to mobilize their own resources for these activities, donor and partner assistance will continue to be needed in order to ensure the success of these critically important activities.
Program Short-Term Success: Official results from the regional health center for the NNW indicate that the coverage rate for vitamin A distribution in Douentza was 100% for children between 6 and 11 months and 94% for children between 12 and 59 months. A total of 4,461 children between 6 and 11 months, 34,849 children between the ages of 12 and 59 months, and 1,278 post-partum women received vitamin A capsules. A total of 7,437 children between the ages of 12 and 23 months, 27,539 children between the ages of 24 and 59 months, and 1,281 post-partum women received albendazole deworming medication. In addition, social mobilization activities to raise awareness and encourage participation in the NNW activities took place at the regional and district health centers. Public service announcements also were broadcast through community radio stations.
Program Success Monitored by: A total of 721 community health workers were trained to monitor NWW activities and to ensure high quality service delivery.
Program Success Examples: The aim of the project was to achieve a coverage rate of 80%, which is the goal established by the World Health Organization. This average was exceeded in Douentza for all targeted children between the ages 6 to 59 months.
4. Program: Niger: Food Crisis Response
Poor/Economically Disadvantaged, Indigent, General
Program Description: Buddhist Global Relief (BGR) partnered with Helen Keller International (HKI) to address the devastating food crisis in Niger, which was triggered by a lack of rainfall in 2009 that negatively impacted crops and livestock. The project expanded to severely affected areas Community-based Management of Acute Malnutrition (CMAM) activities, a holistic approach to building the capacity and skills of existing health and community structures to provide care, thus minimizing the time that women and children need to spend away from home in malnutrition treatment centers.
Program Long-Term Success: With support from Buddhist Global Relief and other partners, HKI responded in a significant way to the nutritional crisis experienced in Niger in 2010, including supporting health facilities with training, supervision, materials and equipment and logistics. BGR’s support made it possible to increase the number of health facilities providing CMAM services and these facilities will continue to assist malnourished children and women into the future.
Program Short-Term Success: This project made it possible for 14 health posts in Zinder Region to start providing CMAM services that had not been able to do so earlier because staff had not been trained to implement the program. In November 2010, 28 health workers staffing the 14 health posts were trained in Niger’s national protocol for acute malnutrition management; the Essential Nutrition Actions (ENA, a framework for promoting optimal infant and young child feeding practices), and managing nutrition rehabilitation supplies. Once the workers were trained, the 14 health posts began offering CMAM services, making treatment readily accessible to mothers and children who had previously been required to travel long distances to reach assistance. In addition, project funds contributed to the purchase of both Plumpy’nut and medicines, making a critical difference in addressing the needs of the population. Government partners expressed particular appreciation for the Plumpy’nut and medications provided by HKI this year since maintaining an adequate supply was even more challenging than usual.
Program Success Monitored by: Project activities were constantly observed by monitoring field agents and other HKI staff in collaboration with health districts and the Regional Offices of the Ministry of Health through formative supervision, monthly monitoring visits, and weekly and quarterly data collection and transmission.
Program Success Examples: As described above, HKI expanded the number of health facilities providing CMAM services in the target regions in 2010, bringing the total number of facilities and communities supported for CMAM to 217. Through these centers, 40,402 children and 9,689 pregnant or nursing women suffering from moderate acute malnutrition received rations, and 8,838 children were treated for severe acute malnutrition.
5.Program: Niger: Breastfeeding in Diffa
Children and Youth (infants - 19 years.)
Program Description: Buddhist Global Relief (BGR) partnered with Helen Keller International (HKI) to reduce malnutrition, morbidity and mortality of children under two years of age in 18 villages in Niger’s Diffa Region through the promotion of breastfeeding, which can make a profound difference in the nutritional status and survival of children under 24 months of age, averting as much as 13 percent of child deaths. The project specifically worked to improve breastfeeding practices through two strategies: 1) Creation of Breastfeeding Support Groups at the community level; and 2) Training of health center nurses in optimal breastfeeding, including the management of breastfeeding problems, and in techniques for supporting correct practices and negotiating with mothers to adopt these practices.
Program Short-Term Success: HKI provided training or refresher training for 18 health agents on optimal breastfeeding and infant and young child feeding. HKI helped form 19 Breastfeeding Support Groups and provided training to 38 members (two from each group) on technical knowledge related to breastfeeding and infant and young child breastfeeding and on counseling techniques to encourage adoption of these behaviors. Each group received visual materials for use in community education activities and also notebooks for recordkeeping. The 19 Breastfeeding Groups held a total of 526 education sessions, which included the participation of 10,150 women and 2,394 men. Topics covered in these sessions include exclusive breastfeeding, frequency of breastfeeding, complementary foods, diet diversity, malnutrition, personal hygiene, and nutrition for pregnant and nursing women.
Program Success Monitored by: HKI field agents and government health agents visited the Breastfeeding Support Groups regularly to make sure that they were functioning well and also collected information concerning the number of pregnant women in the area, the number of mothers who breastfed within the first hour of their infant’s birth, the number of women practicing exclusive breastfeeding until their child reached six months of age, the number of groups able to correctly describe exclusive breastfeeding, and the number of education sessions organized the first two months after training.
Program Success Examples: The following individual story of a project participant illustrates how the project promoted optimal breastfeeding practices: Fatima has a family with four children and lives in the Diffa region of Niger a fragile and vulnerable environment with some of the highest mortality rates for children in the world. A village health worker trained by HKI taught Fatima about the importance of exclusively breastfeeding her daughter for 6 months rather than introducing water, goat or camel milk to her daughter’s diet, as she had with her other children. At three months, her daughter is chubby, robust and full of life in contrast to her siblings, who were constantly sick as infants. Fatima’s positive experience inspired her to become a peer counselor in her community, and she is now involved with persuading other mothers to try exclusive breastfeeding.
6.Program: Côte d’Ivoire: Infant and Young Child Feeding Practices
Category: Food, Agriculture & Nutrition, General/Other
Children and Youth (infants - 19 years.)
Program Description: Program Description: Buddhist Global Relief (BGR) partnered with Helen Keller International (HKI) to implement a project aimed at strengthening nutritional education for at-risk populations in Côte d’Ivoire by working with women’s support groups and associations to improve feeding practices of infants and young children through the Essential Nutrition Actions (ENA) framework. The stated project goal was to contribute to the improvement of infant and young feeding practices, including increasing breastfeeding for children under 6 months and consumption of fortified complementary foods among vulnerable children between the ages of 6 and 24 months, thereby reducing childhood malnutrition and vitamin and micronutrient deficiencies.
Program Long-Term Success: This project positively contributed in Côte d’Ivoire to the promotion of ENA, a framework for promoting optimal infant and young child feeding practices that is recognized as a priority action in the fight against childhood malnutrition. To ensure long-term impact, the project was oriented from the start to strengthening the capacity of key project partners through training, the provision of communication and education materials, and formative supervision of activities including follow-up of specific cases. Considering the high rate of malnutrition among children under 5 in Côte d’Ivoire, interventions like this project should be scaled up in order to increase impact and to ensure the permanent reduction of child malnutrition (including high rates of stunting, a key marker of malnutrition) across the country.
Program Short-Term Success: A total of 123 members of the 8 women’s support groups were trained under the supervision of HKI; these women carried out 511 individual negotiation sessions – through home visits and individual counseling, as well as group sensitizations – for behavior change through the promotion of ENA in their neighborhoods. In addition, 15 members of partnering community-based organizations (IBFAN-CI and MIBEF) were trained on promotion of ENAs so that they can continue to ensure future training and formative supervisions beyond the life of this project. A total of 600 ENA leaflets, 10 sets of flash cards (8 flash cards each), and 80 posters were distributed.
Program Success Monitored by: HKI measured the effectiveness of the project’s training sessions through pre- and post-training tests in order to evaluate changes in knowledge. For the pre-test, trainees had an average mark of 12.2/20 (mark values between 6 and 18); after the training, the average mark was 15.5/20, with mark values between 12 and 20. This shows that trainees assimilated most of the information provided to them. In addition, the provision of communication and nutrition education materials to the support group members and volunteers will allow support groups to continue negotiation, sensitization and nutritional education activities in the community beyond the 511 mothers who already benefited from this intervention.
Program Success Examples: The following individual story of a project participant (a mother 27 years of age) illustrates how the project promoted positive changes in infant and child feeding practices despite misperceptions: “I gave birth with a C-section, and my mother was telling me that I would have not been able to breastfeed on account of the operation wounds and blood lost, which is what is traditionally believed in my culture. She said I would be obliged to feed my child with a nursing bottle. Thanks to the health center visit and discussion with the members of MIBEF, they convinced me and my mother as well that I could and should in fact breastfeed as the operation would have not affected my health. They taught me how to hold my baby and breastfeed him, and one of them regularly pays me a visit to support my nursing and provide me with advice on the best nutrition options for my baby and for me as well.”