ACCURO FIDUCIARY
CHILD NUTRITION PROGRAM NEPAL 2020
Children helped directly: 1500
Number of people helped indirectly: 16000
Malnutrition is a serious problem in Nepal. It is a major threat to the health of infants, adolescent girls and pregnant & lactating mothers. Malnutrition is the direct result of an inadequate diet and or infection and takes various forms (acute malnutrition, chronic malnutrition or stunting and micro-nutrient deficiencies).
Nutritional anaemia remains a public health issue among women, adolescents and children. Forty-one percent of women of reproductive age and 46% of pregnant women are anaemic. About 68% (National Demographic Health Survey [NDHS], 2016) of children aged 6-23 months are anaemic while the prevalence of that among adolescent women (15-19) has been increased from 38.5% in 2011 to 43.6% in 2016 (NDHS).
Bihadi Rural Municipality - Our Proposed Working Area.
BIHADI RURAL MUNICIPALITY - AREA OF PROGRAM FOCUS
After the political restructuring, there are 753 local governments in Nepal and the Bihadi Rural Municipality in Parbat Districts is one of them. The Municipality is not covered by any existing nutrition programs and therefore remains a high risk area for malnutrition.
Only 30% of the population have access to water from public tap and 70% need to manage the water from other sources.
It is common practice to give birth at home and and only a small minority of pregnant women visit health centres for delivery. The data also shows that the pneumonia (very common in malnourished children) cases are higher in Bihadi Rural Municipality than any other municipalities of the district; there are 309 cases of pneumonia in children under the age of 5. Acute Respiratory Infection incident cases are also high at 1052 children under the age of 5.
Besides this, the pregnant women are also taking less iron tablets, the data shows only 29% of pregnant women received the tablets and visited Antenatal Care (ANC) clinic 4 times.
Based on the situation of Bihadi Rural Municipality, it is necessary to implement the nutrition program to pregnant women and children under age 5 to reduce the child mortality and maternal mortality rate. This program contributes to increase the health services delivery as well as reduce the malnutrition situation among children.
OBJECTIVES
To reduce protein-energy malnutrition in children under 5 years of age.
To reduce the prevalence of anaemia among adolescent girls, women and children
To reduce the infestation of intestinal worms among children and pregnant women
To promote good dietary habits to improve the nutritional status of all people
To prevent and control infectious diseases to improve nutritional status and reduce child mortality
A Standard Kitchen For The Area
Primary Target Group:
Children under age 5
Mothers
Pregnant Women
Secondary Target Group:
Child Club members
Female Community Health Volunteers
District level stakeholder,
Teachers, Parent Teachers Association, School Management Committee
Provincial level parliamentarians and CSOs
STRATEGIES
Outreach Education
Kanallan hires two health professional for project areas to create awareness on nutrition. As well as this they will share information on Health & Hygiene to change the behaviour of the target population on food habits as well as regular health check ups of pregnant women and encourage utilising birthing centres for delivery. The health professionals will also educate on vaccines and make villages aware of vaccine centres. They will also be responsible for educating new mothers on early stage nutrition and child health.
Community Mobilisation
The Nepal government has been mobilising the female community health volunteers (FCHV) and this program will integrate with our the nutrition program and disseminate the message on nutrition to pregnant women and child (under age 5) mothers. Kanallan will coordinate with FCHV to identify the malnourished children and make referrals to the Nutrition Rehabilitation Center which is running under district hospital.
Coordination and Linkages
Kanallan will coordinate with municipality, district health office, district hospital for bridging the nutrition program as well as make links to refer malnourished children for their treatment. Kanallan will coordinate with the district health office and organise jointly the creation of a district level health camp.
ACTIVITIES
Need Assessment
Kanallan has visited the project areas and run the assessment, coordinated and linked with municipality and district level stakeholders. The assessment identified the poor situation of child nutrition of Bihadi Rural Municipality and established a working relationship for this program with the local community.
Coordination and Approval
Kanallan will submit the project proposal to the social welfare council and respective municipality and take their approval before the program implementation.
Some proposed members village advisory committee
Advisory Committee Formation
Kanallan will form an advisory committee with 18 members; 3 members from each ward (mothers group, ward representatives and FCHV)of the six wards of Behadi Rural Municipality. The advisory committee will review the regular progress, create an enabling environment for program implementation. The advisory committee will organise regular monthly meetings.
IEC (Information, education and communication) Materials Development and Distribution
Kanallan will develop the different IEC materials related on Nutrition and distribute the IEC materials based on target population. The IEC materials contribute to disseminate the message on nutrition at community level.
Media Mobilisation
Kanallan will mobilise media for mass reach of target population as well as also disseminate the best practices and behaviour change message through media. The role model will invite and disseminate his/her experiences on nutrition.
ToT (Training of Trainers) on Nutrition
Kanallan will organise the ToT on Nutrition to project staff, FCHV and key stakeholders in project areas and mobilise them to raise the awareness on Nutrition
Health Camps
Kanallan will organise the three health camps in coordination with the District Health Office and respective ward office. During the health camp, Kanallan will mobilise the trained health profession who will provide the necessary medicine to patients.
Village Housing
Behaviour Change Communication on food habit
Kanallan will mobilise the two health staff to provide the education and information on nutrition as well as provide the information on local food habit. They visit the primary and secondary target groups and provide correct information on nutrition. During the project period, staff will meet 600 people from primary and secondary group. During the program implementation staff will organise the 6 interaction programs at ward level.
Interaction with Stakeholders
Kanallan will organise regular interaction meetings with stakeholders and share information on the project objectives, strategies and activities.
Advocacy Meeting with Provincial Stakeholder
Kanallan will organise one advocacy meeting at Gandaki Province to create an enabling environment to increase the government budget on child and health. This meeting also sensitises the stakeholder to allocate more budget on children and health.
Interaction with School Management/ Teachers/Child Club Members
Kanallan will reach 30 schools and run courses on nutrition and how school management & teachers can contribute to promote the nutrition program and change the food habits of school children.
Mid-day Meal Program
Kanallan will select one school from each ward for Mid-day meal program. In total, there will be six schools that will implement the Mid-day meal program as pilot and monitor the outcome. In Mid-day meal, Kanallan will promote the local food and products for making good food habits among children.
Emergency Support
Kanallan also manages the emergency fund for children in urgent need. Some children may be referred to/from other districts health clinics and may need some financial support.
An example of nutrition advice board that we will use in the villages
Monitoring and Evaluation
Kanallan will run quarterly monitoring at project areas as well as arranging visits from the social welfare council to ensure the quality and outcome of program.
Staffing
Kanallan will hire part time staff for Kathmandu office i.e. Program Manager-KTM and Finance Staff. Besides this, Kanallan will hire one project coordinator and two health staff at field level.
PROJECT MANAGEMENT
Decentralisation Mechanism: Under this Mechanism, the Program Manager will be the responsible person for the project’s overall activities, and the authority for individual day to day running of the program and its activities will be decentralised to the District/Provincial Coordinator. There will be a central core team and the District/Provincial Coordinator will be responsible for mobilising field staff and implementing the program according to the operational plan and Monitoring Plan.
Reporting Mechanism: Under this mechanism District/Provincial Coordinator and Admin/Finance Officer are responsible for preparing report on activities on a monthly basis and will be responsible to submit report to Program Manager. This reporting system includes program reporting & financial reporting. After processing all requirements, the Program Coordinator will forward to donor agency in quarterly basis.
CONTROLLING
For the project implementation, the program will monitor in two parts as given below
1. Program
2. Financial
For the program part, the different tools and formats that we are using in existing projects for qualitative and quantitative data will be applied to this project too. In this project, the following tools and formats will be used for regular monitoring
1. Progress Indicator form
2. Planning Matrix
3. Operational map
4. Participatory Review and Reflection Process
5. Social Audit
The project team will monitor regular activities through its central as well as field based management team. For this purpose, the Program unit will be initially responsible to monitor all program activities. District/Provincial Coordinator will manage regular and periodic field site visit. Besides this, central office team will be responsible for monitoring of the project activities accordingly.
The monitoring processes will be based on qualitative and quantitative data, designed monitoring plan, work-plan and operational/social maps of project, to ensure that not only data but most importantly, the impact of the activity on the target group, is monitored. Besides this, there will be regular meetings with project team to review the achievements against the work-plan and develop the strategies to fulfil the underachieve activities.
For the Financial part, financial internal review and external audit system will manage monitoring and controlling of the financial management system, as is current practice of organisation in other programs. Accordingly under the financial policies of the organisation, the project will maintain all its accounting transactions through the following mechanism which is also applied in current projects.
1. Control Ledger Sheet
2. Trail Balance
3. Bank Reconciliation
4. Fund Status
5. Debtors & Creditors Sheet
6. Budget Vs. Expenditure
Project team will be responsible for preparing monthly financial report and narrative report, which will be submitted to funding agency on a quarterly basis.