INTRODUCTION:
In Puntland currently, breastfeeding counseling and promotion services to the pregnant and lactating mothers are integrated with Ante-natal care (ANC) services at health facility level with many gaps. Community-IYCF is more effective in addressing the gaps at facility level because target groups can be reached easily. In response to these challenges, Puntland Youth and Social Development Association (PSA) signed partnership agreement with UNICEF to deliver community based intervention on IYCN in collaboration with Ministry of Health in Bossaso town. The main strategies for delivering these IYCN services are through trained community health workers and peer support groups (mother to mother support groups) integrated with social mobilization and advocacy using different channels to reach the target audiences.
Based on the action plan in the program document (PD) signed between UNICEF and PSA, three days training course was organized and conducted for 10 Community Health Workers. The participants were selected from targeted sites in IDPs and host communities in Bossaso. The main training materials used for the training was the generic C-IYCF package developed by UNICEF and SPRING.
The content of the training:
The content focused on: Breastfeeding; complementary feeding; feeding sick/malnourished; infants and young children; and infant feeding in the context of HIV; as well as maternal nutrition.
- Objectives
- Explain why maternal, infant and young child nutrition practices matter.
- Demonstrate appropriate use of counseling skills-listening and learning; building confidence and giving support (practical help) and use the set of counseling cards.
- Use the Three-Step Counseling process (assess, analyze, and act) with a mother, father, or other caregiver.
- Describe recommended feeding practices through the first two years of life; demonstrate use of related possible counseling discussion points and technical material.
- Describe how to breastfeed most effectively.
- Identify ways to prevent and resolve common breastfeeding difficulties.
- Describe various aspects of appropriate complementary feeding during the period from 6 up to 24 months.
- Describe practices for feeding the sick child or recovering from illness.
- Facilitate action-oriented group sessions and mother-to-mother infant and young child feeding support groups.
- Describe basic information in infant feeding in the context of HIV.
- Counsel pregnant women and mothers on appropriate nutrition during pregnancy and breastfeeding.
Methodology:
Hand on practice with emphasis on effective use of the counseling cards. A variety of training methods was used including the use of counseling materials, visual aids, demonstrations, group discussions, and practice. Participants also act as resource persons for each other, and benefit from clinical and/or community practice, working directly with breastfeeding mothers, pregnant women, and caregivers who have young children.
Agenda for the training session
- Opening remark, self introduction, ground rules, expectations and objectives
- Why IYCF Matters
- Important of breastfeeding
- Recommended feeding practices through the first two years of life
- How to breastfeed most effectively (successful BF)
- How to counsel: Listening and learning
- Common breastfeeding difficulties
- How to counsel mother/father/ caregiver
- Complementary feeding for children from 6 months to 24 months
- Review of counseling cards on complementary feeding
- Feeding and care of the sick child
- Conducting support groups and scheduling home visits
- Conducting support groups and scheduling home visits
- Care for the woman during pregnancy and lactation
- Overview of HIV and infant feeding
- Clinical practice with mothers, listening and learning, assessing a breastfeed, giving support and positioning the baby
- Clinical practice: Taking an infant and young child feeding assessment
- Closing remarks
The training started on first day on time at 8:00 AM with a welcome note followed by participant introductions, registration and their expectations from the training.
The training ended on the third day at 3:30 PM with closing remarks from PSA Coordinator and the trainer, from the post training evaluation, the objectives of the training were met and achieved
Outcome:
CHWs learned new knowledge and skills for encouraging and supporting caregivers to adopt appropriate IYCF practices and behavior. We are expecting that CHWs will support caregivers during individual contacts and household visits by using the guidelines and counseling cards to encourage the caregivers, pregnant and lactating mothers. However, we need to arrange follow up with additional supervised practices at the participant’s worksite until competency is achieved.