By 10.00 am, we had arrived at Kagoma village center and the empty market was visible a few yards away. We quickly had to locate our work station that was an open space under a tree. All the necessities had been readily packed prior to the departure and these included; the Vitamin A tablets, Albendazole deworming tablets, Vitaglobin supplementary syrup, vaccines, Hb testing equipment, weighing scale, MAUC tapes and other such materials. It was however more likely that the consumables would not be enough to satisfy the community demand during that outreach. A number of different services were to be reached out to Kagoma community in this single event so as to maximize available resources. Immunization for under 5 years children, Growth monitoring, deworming, Hb tests (anaemia screening), Nutrition education and nutrition supplementation were some of the planned activities for this outreach. There was just 3 staff to carry out all these tasks!
The turn up was impressive much as it begun with just crowds of children most without their caretakers who had gone to the gardens. I helped with the administering of Vitamin A and deworming tablets together with Rachael who is a Congolese refugee nursing assistant. She as well immunized the children that had not previously been immunized and then recorded this in their Child Health Cards. Her multi-lingual capability together with Oris; the assistant nutritionist, were very helpful. Oris did the screening of malnourished children by taking their Mid Upper Arm Circumference (MAUC) and weighing of babies using the weighing scale for growth monitoring purpose. Latter, I helped Mr. Nyende; the nutritionist, with recording the Hb readings from the Hemocue machine. I loved the child friendly design of the microtainers that were used to prick the children’s fingers without much resistance. We decided to give the vitaglobin supplement to those children that had Hb levels less than 10Hb/g/dl since the syrup bottles were really few. Caretakers of the children that were anaemic or were malnourished according to weight measurements and MAUC were cautioned on the feeding practices especially for their children and some were referred to the Health Centers for Supplementary or Therapeutic Feeding care. By midday, the number of clients had nearly tripled and the whole place was crowded though with some on-lookers as well. The mothers were readily availing their children for the services and within no time, there was a long queue for the anemia screening. The fact that the consumables were inadequate was soon realized when only some of the clients on the queue managed to access anaemia screening services, vitaglobin syrup and Vitamin A tablets by 2 o’clock. 214 children received Vitamin A and 255 were dewormed. Over 80 clients were screened for anaemia were majority were below 12Hb/g/dl. The outreach ended by around that time with crowds scattering off and a few mothers breaking into smaller caucuses chatting about their own affairs.
Challenges and gaps identified during the nutrition outreach:
. Inadequate mobilization of the community for the outreach
.inadequate consumables and other necessities for the outreach
.Absence of caretakers for some of the children hindered health communication, referral and instructions for example on prescription for the vitaglobin syrup.
.Some mothers who do not report with the Child Health Cards complicate recording and monitoring processes.
.There was inconsistence of Hb results from the Hemocue Machine for the same blood sample in some cases. (An example was when the blood for the same blood sample, the machine measured 3.1Hb/g/dl and 11.0Hb/g/dl the second time).
. The follow-up system for the malnourished and anaemic clients identified during the outreaches is either weak or inexistent.
.The community seems to lack adequate information of nutrition and related issues.
Suggestions to solve the challenges and bridge the gaps:
. Mobilization should be done some time prior to the outreach date. The community leaders/workers should be greatly involved in this work and consulted on the community dynamics especially concerning timing/seasonality and involvement of caretakers.
.More lobbying for supply of consumables for the outreach services could be realized through documentation. This will reveal the magnitude of the problems and thus justify the dire need for more supplies.
.There is need for routine calibration of the equipment to ensure that the results obtained are consistent. However, this as well calls for refreshers on the mode of operation through reading of the manufacturers’ instructions prior to usage by the operators.
.A stronger referral and follow-up system has to be observed or established especially for the screened cases. However, more information on the value of follow-up by the clients and on services available should be regularly passed unto the communities.
. The nutrition education/sensitizations and food preparation demonstrations should be improved and increased.
No comments:
Post a Comment