Health and nutrition start in the home! Each member of the family has a responsibility towards the wellbeing of the entire unit. Since women are the primary caregivers in the family, the focus of nutrition education for children is on mothers. However, elder women, be they mothers, mothers-in-law, grandmothers, traditional midwives or community leaders prepare the next generation of women and mothers to care for their families. The elder women are a reservoir of cultural knowledge, beliefs and practices and serve as the gate keepers in many households or the filter for what is acceptable behavior. Nevertheless, it is becoming increasingly recognized that men have roles in improving family nutrition as well. Fathers, husbands, and community leaders are key decision-makers facilitating access to resources and services and providing support to women in their caregiving roles.
Therefore Partners of the Americas’ Nutrition Security Program in Haiti has taken a family-centered approach to its nutrition behavior-change interventions. Utilizing the Care Group model as the foundation of the program’s family-centered approach, the staff of NSP are working in 7 selected communes in four departments; North, Northeast, Artibonite and West. The Care Group model, originally developed by World Relief and promulgated by Food for the Hungry and the Core Group, is designed to deploy a small number of paid staff who engage a larger number of volunteers to provide key health and nutrition messages to an even larger population of pregnant and lactating neighbor women.
The Nutrition Security Program is expanding the model to include other household influencers. In addition to the Care Group Volunteers, NSP is mobilizing fathers, grandmothers, and youth in the same communities to increase their knowledge and awareness, and promote their support of mothers to improve dietary and feeding practices. The approach uses a cascading model of health promotion, see figure below. Since the program started in August 2013, the NSP team has hired and trained male and female promoters who work with Care Groups, father groups, grandmother groups and youth groups. Partners Nutrition Security Program has offices in Port-au-Prince and Cap-Haitien.
NSP HAITI FAMILY-CENTERED APPROACH THROUGH CARE GROUP MODEL
Adapted from Food for the Hungry, Oct. 2011 presentation
Table 1: Care Group training
Source: Nutrition Security Program, Sept. 2014
Each female Promoter has four Care Groups comprised of 10-12 Mother Leaders (Care Group Volunteers). Each Mother Leader reaches out to 10-12 neighbor women who are either pregnant or lactating or have a child under 5 years of age. These Mother Leaders meet twice a month in their Care Groups to learn key messages about nutrition and caregiving of children under five years of age and pregnant and breastfeeding women.
Each meeting is focused on a key message and uses the Ministry of Health’s (MSPP) chart book on infant and young child nutrition.
The Promoters also provide support to the MSPP by spending one day per week at either the Rally Post (mobile clinics), health center, or hospital in their assigned areas providing nutrition counseling to mothers who attend these services.
Each male promoter has one or two father groups and one or two youth groups in the same communities as the Care Groups. Adapting the Men’s IYCF Dialog Group manual developed by PATH, the father and youth groups take a gendered approach to discussions of the roles and responsibilities of men in the family, nutritional needs of women and children, gender-based violence, and best communications approaches within the family to name a few. Men are encouraged to share their concerns and experiences to provide support to women and children in their households.
Elder women also play a vital role, as they are the knowledge reservoirs for health and nutrition practices in the family. Sometimes, their knowledge needs updating and their experience needs to be valued anew. NSP staff are meeting with groups of grandmothers who share their knowledge while learning new practices they can share with their families and the community. These grandmothers also become credible resources for Mother Leaders to use as they work with their neighbors.
Since youth are a new target group for NSP, by partnering with FOSREF, male and female promoters are working together to engage single and mixed sex groups of young people in the communities we serve. NSP is developing training materials to better engage young men and women in appropriate gender sensitive ways.
An important aspect of the nutrition program is the integration of livelihoods and the promotion of locally available nutritious foods. So far, almost 100 Mother Leaders have been provided demonstration gardens to manage and share knowledge of diet diversity and use of nutritious local foods with their neighbor families.
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