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Compare between NIPP and IBSFP

This question was posted the Prevention and treatment of moderate acute malnutrition forum area and has 2 replies. You can also reply via email – be sure to leave the subject unchanged.

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Hamid Hussien

Nutrition Specialist Concern WW

Normal user

14 Jun 2013, 19:04

Nutrition impact positive practice and integrated blanket supplementary feeding program are two of success strategies implemented to reduce prevalence of malnutrition through vulnerable communities
what are differs between them and what is the appropriate strategy to use in refugees and displaced camps

Hatty Barthorp

Global Nut Advisor / GOAL

Normal user

17 Jun 2013, 12:06

Dear Hamid,
The NIPP (Nutrition Impact and Positive Practice) project and IBSFP are similar in that they are both pilots looking to improve the nutritional status of individuals with MAM and also tackle problematic IYCF and hygiene-sanitation practices, thus effecting a reduction in prevalence of acute MN. However, there are also fundamental and key differences.

To answer the first part of your questions, these include:
• NIPPs are designed around the concepts of sustainability and replicability, with three repeated core sessions; practical behaviour change sessions, micro-gardening and participatory cooking demonstrations. Where IBSFPs are reliant on the provision of food aid (daily ration of 100g Corn Soya Blend, 10g oil, 10g sugar and 5g salt*) to improve nutritional status , NIPPs use participatory cooking demonstrations whereby all ingredients for pre-tested high energy, micro-nutrient diverse recipes are provided collectively by the participants. Only locally available and accessible foods are used and recipes are designed and promoted for replication at home. Note: where there are SFPs running, NIPP circle participants are not prevented from accessing SFPs. However, initial results from Kutum, Darfur NIPPs show that in areas without SFP the number of HHs accessing 4 food groups, having established micro-gardens and with children 6-59mths with improved nutritional status (graduating with MUAC <12.5cm) has significantly increased. This has nothing to do with SFP, as food rations (as outlined above) are limited to cereal, oil & sugar, which only contribute to one IYCF food group, whereby we’d assume all HHs have some access to a staple ‘grains, roots, tubers’ prior to a food aid intervention.
• IBSFPs and NIPPs focus on IYCF and hygiene-sanitation, but NIPPs also focus on improving ‘nutrition insecurity’ through the initiation of micro-gardens aimed at improving diet diversity. Note: The type of garden – bag/keyhole/kitchen etc. is determined by land availability, resources and so on. A one-off starter seed pack is provided with only self-regenerating seeds, focussed on trying to address prominent micro-nutrient deficiencies.
• IBSFPs focus on infant and young child feeding, whereas NIPPs also focus on appropriate maternal nutrition during pregnancy and lactation, whereby it is hoped that this will help to improve and maintain maternal nutritional status and as per the 1000 days, reduce the prevalence of low birth weight (LBW) babies and improve milk ‘quality’ during the period of breastfeeding.
• IBSFPs use women’s clubs to promote optimal feeding and hygiene-sanitation practices, whereas in the NIPPs, there is parity between men and women. It is understood that the community and pre-identified ‘key gate-keepers to change’ play an integral role in enabling behaviour change to occur in a community. Thus the NIPPs use male circles, female circles (both running for the same duration) and a shorter community based circle to bring issues into the open within the target communities.
• IBSFPs target children U5 (‘improving IYCF practices and reducing the prevalence of wasting among children under five years’, WFP: Mukram, Kassala program), whereas NIPPs have a wider admission inclusion of high risk individuals; U5s, PLW, chronically ill and others.
• NIPPs have a greater focus on participatory practical sessions and positive reinforcement of both dominant males and females (this may also include mother-in-law figures) in the HH.
• Inclusions for NIPPs practical behaviour change sessions are based on formative research, including situational analyses, barrier analyses and the completion of designing for behaviour change frameworks. This ensures activities designed to tackle prioritised behaviours, are evidence based, tailored to the community and focused on their key determinants.
• I’m not sure what sort of follow-up IBSFPs use and it may vary from site to site, but NIPPs collect data on admission, upon graduation (usually ~12wks), then 2months, 6months and 12months post-graduation to asses longitudinal behaviour change and its sustainability.
• NIPPs are thought to have a more structured and in-built multi-sectoral approach, whereby nutrition security, care practices, environmental health and appropriate active health seeking practices are all actively promoted.
• As there is a worry that food hand-outs in sub-Saharan Africa have had a deleterious effect on the erosion of traditional coping strategies, if we can effect positive change without having to involve food hand-outs (which will only ever going to be a temporary measure) this is deemed to be a better solution.

To answer the second part of your question, ‘what is the appropriate strategy to use in refugees and displaced camps’. This is context specific. Any behaviour change focused project will need to invest in a significant amount of community engagement. The NIPP circles are based around there being positive deviant HHs within any community, they are also led on a volunteer basis through peer education/demonstration (to ensure sustainability and replicability), thus identification and motivation of willing volunteers also needs to be assessed and assured. The project would probably not be suitable for transitory populations, but they would be viable for consideration in any setting (refugee, IDP or host community), unless significant food insecurity is an identified issues, whereby this would need to be addressed as a priority.

* WFP: Impact of the Integrated Blanket Supplementary Feeding Programme (IBSFP) on Infant and Young Child Feeding (IYCF) Mukram Village, Kassala State

Hamid Hussien

Nutrition Specialist Concern WW

Normal user

17 Jun 2013, 19:08

Dear Hatty
thanks for provision information

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