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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
Delivery and Immediate Post-partum
Performance self-assessment tool for use by Key Stakeholders at key contact points - The following Essential Nutrition Actions (ENAs) are recommended:
Recommended ENAs at Delivery and immediate post-partum contact.
Key stakeholders: midwifes/health workers at health facilities and trained birth attendants for home delivery.
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Rating* |
Discuss and identify key gaps in provision and utilization of ENAs at Delivery and Immediate Post Partum Contact. |
| Exclusive breastfeeding: |
All mothers are assisted / advised to:
- Give unrestricted skin-to-skin contact immediately after delivery.
- Initiate breast-feeding within 60 minutes.
- Give the colostrums or 'First Milk' to the baby
- Empty one breast before switching baby to other breast.
- Feed only breast milk - no water, glucose, or other fluids like tea and soda.
- Breastfeed frequently and on-demand, day and night (at least 8 times).
NOTE: Service provider observes a breastfeed session to assess "positioning and attachment" and counsels/supports. |
Total 1 …. |
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| Infant feeding for HIV+ mothers, who opt to use breast-milk substitute: |
- All HIV positive mothers, who opt to use breast-milk substitutes, are supported to initiate the chosen option.
- Privacy is ensured in the use of breast-milk substitute to prevent 'spillover' effects into the wider community.
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Total 2 ….. |
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| Maternal and Infant Vitamin and Mineral Deficiencies control: |
1. Maternal Iron Deficiency Anaemia (IDA) control:
- Service provider ensures mothers who did not take Iron/Folic Acid supplementation for six months have enough supplies to last to the next visit.
2. Infant Iron Deficiency Anaemia (IDA) control:
- Cord clamping of all new born children delayed for two minutes at least.
- New born children who are premature and/or with low-birth weight are identified for further follow-up.
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Total 3 ….. |
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3.Vitamin A supplementation to all postpartum mothers:
- All mothers receive one 200,000 IU dose of Vitamin A after delivery.
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Total 4 ….. |
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| OVERALL SCORE (TOTAL 1 + 2 + 3 + 4): |
..... |
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Rating: 0 = insufficient; 1 = fair; 2 = good; 3 = very good; 4 = excellent
11 April, 2013
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