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Evaluation of National Nutrition Programs

This question was posted the Management of wasting/acute malnutrition forum area and has 4 replies.

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DIEUDONNE BIKORIMANA

Normal user

15 Mar 2023, 05:39

Good morning,

If in a country, the malnutrition rate remains high (5 to 9% of acute malnutrition) and the chronic malnutrition rate is more than 50% among children under 5 years old, isn't this a good reason to evaluate the national program to understand what is not working ?

If such studies are available, please share them with me.

Thank you

ILLA Abel

Nutritionniste, ANS

Normal user

15 Mar 2023, 12:26

Plusieurs raisons peuvent motiver une évaluation des programmes de prise en charge de la malnutrition aigue. Généralement l'évaluation est obligatoire quelque soit la situation nutritionnelle si un programme est en cours.

Concernant les seuils des différents types de malnutritions, des termes spéciaux existent et qui nous permettent d'apprecier la situation en fonction des types de malnutrition

Seuils Malnutrition Aiguë

Seuils Malnutrition Chronique (retard de croissance)

Seuils Insufisance pondérale 

Appréciation

Situation

< 5 %

< 20 %

< 10 %

Faible

Acceptable

5 à 9 %

20 à 29 %

10 à 19 %

Modérée

Précaire

10 à 14 %

30 à 39 %

20 à 29 %

Elevée

Sérieuse

15% et +

40% et +

30% et +

Très élevée

Critique

 Voici un exemple d'évaluation de programme PCIMA: https://www.bing.com/ck/a?!&&p=67801ed3f6bfa6d2JmltdHM9MTY3ODgzODQwMCZpZ3VpZD0zMjIzNDExZS02OWI1LTY4NTgtMmMyZC01MGM0NjhhNzY5ZTUmaW5zaWQ9NTE1Mw&ptn=3&hsh=3&fclid=3223411e-69b5-6858-2c2d-50c468a769e5&psq=evaluation+PCIMA+burkina&u=a1aHR0cHM6Ly9ldmFsdWF0aW9ucmVwb3J0cy51bmljZWYub3JnL0dldERvY3VtZW50P2ZpbGVJRD0xNjQyMQ&ntb=1

Merci

ILLA Abel

Nutritionniste, ANS

Normal user

15 Mar 2023, 12:37

There are several reasons why an evaluation of acute malnutrition management programs may be required. Generally, evaluation is mandatory whatever the nutritional situation if a program is underway.
Concerning the thresholds of the different types of malnutrition, special terms exist for the assessment (qualification) of the nutritional situation

Seuils Malnutrition Aiguë (émaciation)

Seuils Malnutrition Chronique (retard de croissance)

Seuils Insuffisance Pondérale

Appréciation

Situation

< 5 %

< 20 %

< 10 %

Faible

Acceptable

5 à 9 %

20 à 29 %

10 à 19 %

Modérée

Précaire

10 à 14 %

30 à 39 %

20 à 29 %

Elevée

Sérieuse

15% et +

40% et +

30% et +

Très élevée

Critique

Kévin Debonheur

Normal user

3 Feb 2024, 08:57

In addition to the previous answers, I think that the care program alone is not enough to respond to nutritional crises.

We must rethink the vision by implementing integrated strategies involving food safety specialists (agroveterinary, etc.)

Marie-France Lalancette

Nutrition sans Frontieres

Normal user

3 Feb 2024, 17:06

What doesn't work is that the mass protocol approach chronicizes malnutrition. We need a preventive approach based on early and individualized intervention. We must strengthen local nutritionists and give them the same tools to intervene and do their work as nutritionists in more fortunate countries. As a nutritionist who worked in Canada for 25 years, I worked with malnourished children. At the beginning there were still a lot of them. With the implementation of models based on prevention which are now funded by the government, the problem has become rather rare. We need commitment at all levels, but above all working together to prove to these decision-makers that it works when we put professionals in the right place with the right tools. It took a dedicated nutritionist dedicated to maternal nutrition for 40 years before the program gained recognition. It is thanks to her that today in Canada this service is funded. Nothing will fall from the sky but if everyone worked in the same direction, the strategies are there, you just need to adapt them to each country or community. Nutrition sans Frontières believes in this and acts in this direction. Prevention through intervention by nutritionists, one family at a time, works. At least 4 or 5 follow-up interventions are needed to ensure that malnutrition does not return.

Nutrition Sans Frontières trains nutritionists with the same tools and approaches to which nutritionists in wealthy countries usually have access, through its action research currently underway (RE-ACT project) which aims to test this approach with 500 mother dyads. -child to resolve malnutrition from an individualized approach. This is not Chinese, we cannot prevent malnutrition by giving supplements or foodstuffs. You have to give the fishing rod, not the fish. OR at least when we give the fish, let's take the opportunity to give the fishing rod at the same time.

Yes, in the name of children who are the adults of tomorrow, we must rethink everything. Africa has everything it needs to solve its nutrition problem, provided that nutrition becomes a priority and that we stop infantilizing professionals by giving them small upper arm circumference cuffs and boxes of supplements while thinking that it will be enough. This is not the job of a nutritionist...Professionals can learn to really educate their populations, they are no less intelligent than our Canadian professionals...

I admit to dedicating my life to this cause, as the founder of this organization. I believe in the power of nutritionists. Anyone who wants to really change things is invited to mobilize with us to influence practices.

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