Project News

The MCH RB Project (The project) trained 990 health workers in focus 11 districts with 3-day training curriculum in 2019. The Project conducted the first monitoring and supervision (M&S) to assess the skills of health workers as well as the general conditions of health facilities for the provision of the Nutrition Counseling Services and Respectful Care (NCSRC) using MCH RB in January and February 2020. 37 Districts and 4 Regional facilitators visited 129 facilities and assessed the skills of 265 health workers.

Major findings

• 128 facilities out of 129 facilities visited started using MCH RB.
• 65 facilities (51%) stated the current shortage of MCH RB. On the other hand, 11 facilities (9%) answered no shortage in the last three months.
• NCSRC utilizing MCH RB started in most of the facilities. Out of 129 facilities, 100 facilities (77.5%) changed the organization of antenatal care and Child Welfare Clinic (ANC/CWC) for counseling after the training. 77 facilities (59.7%) have designated area for counseling.

Health worker’s skills

Skills for the introduction of the MCH RB and the provision of health education messages to women had improved. During the skill observation, measurement skills for weight were done properly: however the measurement of length for children and the plotting in the growth curve needed more practice. Counseling was done well while the recording of counseling was not done well. 79.1% of observed cases of health workers were familiar with 3As (Assessment, Analysis, and Action) approach; 80.0% of them at ANC and 81.4% at CWC completed assessment and analysis before taking action. The filling rate of the nutrition counseling table was 57.6% for women and 51.9% for children. Health workers expressed concerns about difficulties in providing counseling with the standardized flow of service delivery and filling the counseling table. The completion and recording sometimes interfered with the time pressure of providing services to large numbers or to cope with the record inappropriately filled by other health workers outside of the focus districts.

Mother’s knowledge and experiences

Among the observed cases (111), around 90% of the mothers remembered well the content of the counseling. More than 90% of the mothers were able to answer danger signs and next visit. 89.3% of the mothers felt free to ask questions.

Way forward

The project will continue periodic M&S to strengthen health workers skills by on-site coaching especially on the measurement of length for children, the plotting in the growth curve and recording nutrition counseling table of ANC/CWC.

Nutrition counseling

Visiting health facility at the community