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Protection, Promotion and Support of Healthy Maternal, Infant and Young Child Feeding
The Essential Nutrition Actions (ENAs) Approach
Service Quality Self Assessment Tools - Facility Based
Ante-Natal Contact
Performance self-assessment tool for use by Key Stakeholders at key contact points - The following Essential Nutrition Actions (ENAs) are recommended:
| Recommended ENAs at Ante-Natal Contact. Key stakeholders: health workers, supporting staff, VHT |
Rating* |
Discuss and identify key gaps in provision and utilization of ENAs at Ante-Natal Contact.
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| Maternal Iron Deficiency Anaemia (IDA) control: |
1. Malaria prevention and control:
- All pregnant women receive 2 Doses of IPT:
- First dose = 3 tablets SP once during the 4th to 6th months of pregnancy.
- Second dose: 3 tablets SP once during the 7th to 9th months of pregnancy.
- All pregnant women are counselled on how to use the ITN.
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Total 1: ….. |
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2. Iron/Folic Acid or multiple micronutrient supplementation:
- All pregnant women receive 30 Iron/Folic Acid tablets a month for six months (180 tablets in total).
- All pregnant women are counselled on side effects, compliance and safety of IFA supplements.
- All pregnant women are counselled on importance of adhering with daily intake of one tablet of Iron/Folic Acid for six months.
- All pregnant women are screened for pallor on every visit.
- Pregnant women with pallor receive Iron/Folic Acid supplementation according to protocol.
NOTE: Supplementation can continue also after delivery if the six months are not completed during pregnancy. |
Total 2: ….. |
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| 3. De-worming: All pregnant women receive one Mebendazole 500 mg two times during pregnancy at the same time as SP. |
Total 3: ….. |
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| Maternal nutrition improvement: |
All pregnant women are counselled on:
- Increased energy intake through one additional meal a day.
- How to improve variety (cereal/starchy roots plus animal foods/legumes/nuts plus fruit/vegetable).
- Reduced workload (or at least having resting moments).
- Daily use of iodized salt for all family members.
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Total 4: ….. |
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| Preparation for exclusive breastfeeding: |
All pregnant women are counselled on:
- Initiation of breastfeeding within 60 minutes.
- Importance of colostrums or 'First Milk".
- Feeding only breast milk, no water or other liquids/foods for the first six months.
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Total 5: ….. |
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| Infant feeding options for HIV+ pregnant women: |
- All pregnant women are encouraged to have an HIV test
- All HIV+ pregnant women are counselled in private to make informed infant feeding choices based on the AFASS criteria (Acceptable, Feasible, Affordable, Sustainable and Safe).
- All HIV+ pregnant women who choose replacement feeding are encouraged to have the food ready ready/available at the time and place of delivery
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Total 6: ..... |
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| OVERALL SCORE (TOTAL 1 + 2 + 3 + 4 + 5 + 6): |
..... |
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Rating: 0 = insufficient; 1 = fair; 2 = good; 3 = very good; 4 = excellent
16 December, 2017
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