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Mother, Infant and Young Child Nutrition and Malnutrition |
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
Sick Child Contact (IMCI at facility and community level)
Performance self-assessment tool for use by Key Stakeholders at key contact points - The following Essential Nutrition Actions (ENAs) are recommended:
| Recommended ENAs at Sick Child Contact (IMCI at facility and community level) Key stakeholders: health-workers, supporting staff and VHT
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Rating* | Discuss and identify key gaps in provision and utilization of ENAs at Sick Child Contact (IMCI at facility and community level) |
| Exclusive breastfeeding (0-6 months): |
All lactating mothers are encouraged to:
- Increase the frequency of breastfeeding during and after illness to limit the weight loss and speed recovery.
- Consult a health worker for all children not feeding well or with any condition (including oral thrush).
- Not give other fluids, except prescribed medicines.
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Total 1: …. |
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| Infant feeding for HIV+ mothers/caregivers, who opt to use breast-milk substitute before the child is six months: |
All HIV+ mothers/caregivers are encouraged to:
- Increase the frequency of feeds during and after illness to limit the weight loss and speed recovery.
- Give prescribed medicines only.
- Not to breastfeed the baby (avoid mix feeding).
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Total 2: …. |
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| Complementary feeding for children over 6 months: |
All mothers are encouraged to:
- Increase the frequency of breastfeeding (or replacement feedings for those not on breast milk) and offer additional food to limit the weight loss during illness.
- Give one additional meal of foods with high energy and nutrient density each day for the following two weeks to improve child recovery after illness.
- Give ORS for children over 6 months with diarrhoea.
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Total 3: …. |
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| Early detection and referral of children with malnutrition: |
1. Checking the growth of the child during and after illness
- All mothers are alerted on the importance to check if the baby is loosing weight during illness and/or is not regaining weight after illness.
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Total 4: …. |
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2. Malnutrition screening for children using MUAC tape
- Children over 6 months with length above 65 cm are screened using MUAC tape if they look malnourished and if they do not have a previous growth record.
- Children with moderate and severe malnutrition are promptly referred / treated.
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Total 5: …. |
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| Infant Vitamin and Mineral Deficiencies (VMD) control: |
1. Infant Iron Deficiency Anaemia (IDA) control:
- All children are screened for Anaemia using pallor and are referred or treated according to protocol (WHO 1998 – Uganda Anaemia Policy 2002).
2. Zinc:
- For children with diarrhoea, provide zinc supplementation for 10-14 days according to WHO protocol.
3. Vitamin A:
- For children with measles, provide Vitamin A treatment according to WHO protocol.
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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
02 January, 2009
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