ADRA Child Survival Project in Guinea
Date Range: 2000-2005
Organization: Adventist Development and Relief Agency (ADRA)
This project was conducted over a 5-year period in the Siguiri Prefecture of the Republic of Guinea, which has a total population of 167,595 persons (ADRA 2005). The project focused its efforts on nutrition, immunizations, safe motherhood, and malaria.
Health messages were disseminated through a variety of community-based organizations, including District and Village Development Committees, mothers groups, savings groups (mutuelles, which are social health insurance mechanisms focused on safe motherhood and childhood illnesses), religious leaders (Imams), husbands, and community leaders. Health Volunteer Teams (HVTs) were established and were composed of traditional birth attendants (TBAs), Malaria/Nutrition Agents (MNAs), and Family Planning Agents. The role of the MNA was to mobilize and empower communities for malaria and nutrition activities and to disseminate behavior change communication messages regarding malaria and nutrition. Paid project animators organized PD-Hearth sessions for malnourished children.
The project also provided training and retraining for MOH staff at health centers and health posts. Project animators worked with these local community groups and individuals. Thus, there were three general program strategies: (1) behavior change communication, (2) building community capacity and community empowerment, and (3) improving the quality of services at health centers.
The percentage of children 0-23 months of age who had been breastfed within the first 8 hours after birth increased from 64% to 80%, and the percentage of infants 0-5 months of age who had been exclusively breastfed within the previous 24 hours increased from 23% to 66%. The percentage of children 12-23 months of age who were fully immunized increased from 17% to 52%, and the percentage of mothers with a child 0-23 months of age who received at least 2 doses of tetanus toxoid increased from 38% to 72%.F
The percentage of mothers with a child 0-23 months of age who obtained at least 2 prenatal care visits during their most recent pregnancy increased from 41% to 63%, the percentage of these mothers who knew at least two danger signs during pregnancy increased from 5% to 47%, and the percentage who knew 2 dangers signs of delivery increased from 0% to 43%. The percentage of these mothers whose most recent births were assisted by a trained provider (doctor, nurse, midwife or trained TBA) increased from 50% to 72%. The percentage of mothers who reported that their delivery was attended by a trained provider who advised them to exclusively breastfeed increased from 16% to 65%.
The percentage of mothers of a child 0-23 months of age who reported that they knew that fever is a reason to seek treatment for a child increased from 56% to 79%. The percentage of mothers of a child 0-23 months of age who knew that the duration of malaria treatment is 3 days for their child increased from 26% to 44%.
The percentage of children 6-23 months of age with severe malnutrition (< - 3 SD of weight-for-height Z score) decreased from 20% to 5%, and the percentage of children with moderate malnutrition (< - 2 SD) decreased slightly (from 23% to 20%). Levels of statistical significance could not be determined.
From 2003 – 2008, USAID funded five international NGOs, (CARE, Catholic Relief Services (CRS), Mercy Corps (MC), Save the Children US (SC), and World Vision International (WVI)), to implement Positive Deviance in Indonesia as part of food security programs. Together, the five NGOs reached 9,997 children across the country. Of this number, 59.6% gained 200g between admission into the program (Day 1) and graduation from the program (Day 10). Of 4,847 participants who were weighed again at the end of the month, 45% had gained the recommended 400g. Results differed slightly (but not significantly) between implementers; however, they differed dramatically between different communities.
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