Wednesday, July 24, 2013

Training Village Health Care Teams to Identify Cases of Malnutrition in Rukungiri District

On June 20th and June 27th the IECM outreach team including our nurses, volunteers, and Nutrition Fellow helped to train 113 VHTs in Ruhinda sub-county. The trainings include education on signs of malnutrition, screening children for malnutrition, and best nutritional practices.

As a follow-up to training, VHTs went out into the community and screened children making referrals for Child’s Days held on July 6th and July 13th. 184 children were screened, eleven children were admitted to our outpatient treatment program, and four patients were admitted to our inpatient treatment program. Each subsequent visit to our Ruhinda outreach site has increased the volume of children being screened and continued to train VHTs.

It is amazing to see the dedication and hard work our VHTs put in to protect the health of their community members. VHTs are supported by the Ministry of Health in Uganda, but extensive training in malnutrition prevention is not part of their initial five day training program.

IECM has worked with VHTs in communities that receive malnutrition prevention and treatment services from our outreach site. VHTs have been an integral part of our program by helping to identify children deep within the community that are severely and moderately malnourished. The impact that our trained VHTs have holds promising potential for Bikurungu and Murama sub-counties, two of our seven outreach sites that still need VHT training.

Friday, July 12, 2013

Essential Nutrition Actions

Nyakibale Hospital is home to the Karoli Lwanga School of Nursing and Midwifery. The nursing and midwife students are assigned to work as interns on each ward as part of their education. When students are assigned to the pediatric ward, they are taught how to follow the IECM protocol by IECM program coordinators and GHI interns. These training sessions are valuable, imparting the students with the knowledge of how to care for malnourished patients. Unfortunately, due to time constraints the training is limited to the clinical aspect of treating malnutrition and does not cover in-depth nutritional messaging such as proper feeding practices for young children or how to incorporate important vitamins and minerals into the diet such as iron and vitamin A. In the last weeks, IECM has had the opportunity to fill this gap by holding classroom sessions with nursing and midwife students. The purpose of the sessions was to teach students appropriate nutritional messaging in addition to the counseling skills necessary to effectively communicate the messages to caregivers.
The nutrition education session was led by Esther, a nutrition Fellow, and Alex one of the current student interns. The topic was Essential Nutrition Actions (ENA), nutrition interventions developed by the WHO which target the first 1,000 days of life. Proper nutrition during the first thousand days of life from conception to the child’s second birthday is crucial for normal physical and mental growth and development. Esther and Alex used PowerPoint slides to first teach the 7 ENA’s, often pausing to answer questions from the audience and to use the white board to list foods that include certain nutrients. Some of the topics were familiar to students such as exclusive breastfeeding for infants 0-6months, while other topics needed more attention such as control of iodine deficiency disorders.

After the ENAs were covered, the students were divided into seven groups and each one was assigned one of the essential nutrition actions. Each student group made a poster with instructions to mothers and fathers describing what they can do to help their families receive the proper nutrients. A representative from each group presented their poster to the class. The students were challenged to communicate the nutrition messages in a way that caregivers could understand. This exercise in role play was important since certain words that we use in the English language to explain nutrition are not directly translatable into Runyankore, the local language in Rukungiri. For example, when explaining the importance of iron in preventing anemia, the student-presenter had to clearly define anemia without using words such as “red blood cells” or “hemoglobin”.  

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