Submitted to U-landshjelp fra Folk til Folk, Norge DAPP DOWA NUTRITION PROJECT PPROJECT REPORT JANUARY TO DECEMBER 2014
The Project activities DAPP Malawi implemented the Support to Scaling Up Nutrition project with funding from Department (in short: DAPP Dowa Nutrition Project) with the main donor being International Development (DfID) through Clinton Health Access Initiative (CHAI) in 3 Traditional Authorities of Dowa District in the central region of Malawi for the period of 7 months from December 2013 to July 2014. The District has an estimated human population of about 500,000 people faced with nutritional problems, particularly amongst pregnant and lactating mothers and their infants (under 2 years old) and this has led to stunting amongst children and maternal anemia. Contributing factors to malnutrition in Dowa include low household incomes, poor child feeding and care practices, inadequate education and lack nutritional knowledge, poor food processing and utilization, and diseases such as diarrhea and worms infestation. A combination of malnutrition and anaemia in a child leads to stunting that can not be corrected by treatment, and thus must be prevented through interventions that promote healthy growth in the young child such as adequate nutrition of the mother prior to pregnancy, during pregnancy, and for the child during the first 24 months of life, also referred to as the 1,000 Special Days Window of Opportunity. It is against this background that DAPP Malawi embarked on a six months project in order to work in Dowa District to reduce the problems of malnutrition. The project also identified HIV positive patients and linked them to care and treatment. The project phased out in May 2014 and had an extension to the month of June 2014. The project targeted 500 households which were trained in energy saving cooking technologies; distribution of Likuni Phala (Maize Porridge) to 2,000 malnourished infants and under five children, malnourished children in 30 Community Based Child Care Centres (CBCC), and 98 groups of People Living with HIV and AIDS (PLWHAs); and providing training in exclusive breast feeding, nutrition and health education, and backyard gardening. The project targeted and reached out to a total of 20,000 households (indirect beneficiaries) in six months. The development objective that this project will contributes to is the reduction of malnutrition in pregnant and lactating women, infants, children under 5 and people living with HIV and AIDS in Malawi, whilst the immediate objective of the project has been, Enhancing and scaling up infants, children, pregnant and lactating women and PLWHA nutrition service delivery at community level in Dowa District. The project had the following expected outcomes: 50 % of children under 5 years receiving minimum package of community nutrition services 50 % of children between 0-6 months on exclusive breast feeding 50 % of children 6-24 months receiving complementary and supplementary feeding 50 % pregnant mothers attending antenatal clinics during first trimester 50 % of pregnant and lactating women eat six food groups DAPP-Malawi shared the lessons learnt and experiences generated with its stakeholders through District Councils, Area Development Committees (ADC), Village Development Committee (VDC) Meetings and workshops, and district levels. The project further published the lessons learnt and experience generated through its reports that shall be posted on DAPP Malawi webpage :www.dapp-malawi.org
The Project activities 114 Village Development Committees (VDCs) were oriented in the 3 Traditional Authorities against the planned 98. 775 out of the planned 779 villages were oriented on the programme by Field Officers with the help of the village heads. The reduction in the number of villages was contributed by the fact that the 4 villages were not recognized as registered villages by the District Office as such they were combined with the rest of the villages. 43 Front-line staff (24 project staff, 9 Community Development Assistants and 10 Agriculture Extension Development Officers) were trained in new guidelines called Community based Management of Acute malnutrition (CMAM) for screening the malnourished infants and under 5 children. The trainings were conducted in two phases which were facilitated by the district CMAM trainer of trainers. All Health Surveillance Assistants and health staff in the district were trained by Clinton Health Access Initiative (CHAI) as partners. 303 Passionates were trained in growth monitoring. 114 group village headman level campaigns were done with all stakeholders invited to attend. The invitation was extended to the other working partners in the area with an idea of sharing best practices with them so that if they would like to adopt the practices for the benefit of developing the area, they may do so. 2000 undernourished under 5 children, infants, pregnant and lactating women and mothers and guardians with under 5 children were identified through door to door visitations and village meetings. Passionates (community Volunteers) would screen children together with the Health Surveillance Assistant (HAS) of the particular village and admit the eligible beneficiaries into the Supplementary Feeding Programme (SFP). 114 breast feeding and cooking demonstrations for pregnant and lactating mothers and mother and guardians with under 5 children were conducted at group level and also during distributions at the health centre. 91,085 tons of supplementary feeding Likuni Phala (Maize porridge) were procured and distributed to households with malnourished infants and under 5 children. Each beneficiary was allocated 5kg of SFP per fortnight. 24,237 tons of supplementary feeding Likuni Phala ((Maize porridge) were procured and distributed to Community Based Care Centres (CBCCs). 2,300 packets of 10g vegetable seeds procured and distributed to beneficiaries that led to the establishment of 2194 gardens in the three Traditional Authorities. 2003 People Living With HIV and AIDS (PLWHAs) were identified and were educated on improved nutrition through meetings in support groups. 87,355 tons of supplementary feeding Likuni Phala (Maize porridge) was procured and distributed to households with PLWHAs. 9925 households with pregnant and lactating women and mothers and guardians with children under 5 years were mobilised and educated on effects of climate change and global warming and the need for energy saving cooking technologies. These households in response adopted and constructed 9925 firewood saving stoves. At the village level 114 energy saving cooking stoves demonstrations were done and the stoves were mounted. The idea was that all the villages should adopt the use of these stoves and also how to construct them.
The Project in Numbers DAPP Dowa Nutrition Planned Activities 2014 Planned Activities January to December Achieved January to December 2014 Variances District and sub-district level structures (District Councils, ADCs VDCs and Villages) oriented on the nutrition project 2 2 2 0 Nutrition and Health Care Groups (NHCGs) groups at village established/strengthen Education and nutrition support to households with malnourished under 5 children, infants, and pregnant and lactating women provided Education and nutrition support to PLWHAs groups provided Energy saving cooking technologies implemented in households 779 779 775-4 2000 2000 2000 0 2003 2003 2003 0 9925 9925 9925 0 Number of tons of supplementary food procured and distributed to households with malnourished infants and under 5 children. Number of tons of supplementary food procured and distributed to Community Based Care Centre s (CBCCs). To Conduct campaigns and cooking demonstration to sensitize community on improved nutrition 87,375 87,375 91,085 + 3,710 21,237 21,237 24,237 +3000 114 114 114 0 Training of Community Volunteers( Passionates) 300 300 303 +3 Comments Although the duration of seven months of the project was too short to measure nutritional impacts such as reduced stunting in children, the impact of the Support to Scaling Up Nutrition Project in Dowa district was evidenced through the targets that have been reached and by the high demand of nutrition and climate change interventions in the three TAs in Dowa District The project registered high improvements in the nutrition status of infants, under five children, PLWHAs, and pregnant and lactating mothers after they had received Likuni Phala (maize porridge) and nutrition education. There was also high adoption of making and using energy saving cooking stoves, backyard gardening, food processing and preservation, and general hygiene and sanitation by households in the three Traditional Authorities.
The effects During the 7 months of the project period (January to end July) the following effects were achivevd. High improvements in the nutrition status of infants, under five children, People Living With HIV and AIDS, pregnant and lactating mothers after they had received Likuni Phala and nutrition education. Aquisition of new knowledge on making energy saving stoves as evidenced by high adoption on the usage of energy saving cooking stoves in the households reached with global warming and climate change lessons. High adoption of new knowledge on making backyard gardens and consumption of 6 nutritious food groups from the villages in the three Traditional Authorities. Improved knowledge and adoption of food processing and preservation techniques. Improved knowledge, adoption and adaptation to the general hygiene and sanitation at household level in each of the three Traditional Authorities. With support from the project, improved confidence in the Passionates to carry out their work and consistently report to the Health Centres through the Health Surveillance Assistants Strengthened collaboration existing between the community and the Health Centres and Clinics as more volunteers were trained by the Project Strengthened collaboration as evidenced by the commitment of the other working partners to take over the activities, ensuring sustainability of the activities we implemented. These include the District Nutritionist, Health Surveillance Assistants, Department of Agriculture, Social Welfare, District Community Development Office, Education and Forestry, Passionates, and health and nutrition committees.
Project in pictures DFID /CHAI visiting a CBCC garden. A volunteer is making a presentation on how they are benefitting from the garden - both for consumption and income generating - selling and how they will continue with the activities in one of the garden farms. During campaigns local food stuffs were exhibited to teach the community how to make balanced meals from the six food groups. Women were able to explain what nutrients are in each.
Project in pictures The project trained community volunteers who carried out infants and Under 5 Children Screening during growth monitoring using different tools. The undermalnourished received supplementary feeds from the Community Based Child Day Care Centres whilst others received packs of the same at the Clinic. Review Meetings with volunteers have been conducted to consolidate and share plans and reports.
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