T Belachew1, H Nekatibeb. 1. Department of Population and Family Health, Faculty of Public Health, Jimma University, P. O. Box, 1104, Jimma, Ethiopia.
Abstract
OBJECTIVE: To document the experiences and lessons for rolling out of the OTP service at the wider scale with the aim of assessing the strengths and weaknesses of the project and suggest recommendations for future programming. DESIGN: Qualitative methods of data collection including focus group discussion, observation and in-depth interview of key informants were employed to get relevant data. Review of health facility, reports and programme documents were done to capture further- information. SETTING: Out Patient Programme (OTP) pilot programme implemented by CONCERN/ VALID in three administrative regions of Ethiopia namely: South Nations and Nationalities Peoples Regions (SPNNR), Addis Ababa and Oromia regions. A total of thirteen health centres which had started OTP service from the three regions were included in the study. SUBJECTS: Thirty six key informants and 30 focus group discussants were involved in the study conducted from 16th to 25th November 2006. RESULTS: Out Patient Programme (OTP) has enhanced community's understanding of malnutrition as a health problem through an excellent entry point it created for behaviour change communication (BCC) on optimal infant and young child feeding (IYCF). It has also enhanced utilisation of the existing equipments of the respective health services to promote nutrition and increased mental satisfaction of the providers who observed rapid recovery of malnourished children taking the plumpy nut. It also resulted in increased awareness of the community about malnutrition and its treatment, which resulted in increased need-based demand for the OTP and self-referral of children to health facilities. Shift in the thinking of the providers on the fact that malnutrition can be treated without admitting the child and reduction in the burden of malnutrition and associated mortality are other positive findings of the study. CONCLUSION: While it was observed that the programme was very effective in treating case of severe acute malnutrition and is highly acceptable by planners, health care providers and beneficiaries, there were different operational issues that needed to be strengthened. The irregularity and incompleteness of supply availability, high attrition of trained human power, inadequate supportive supervision especially from local ministry of health, inadequate community mobilisations are some of the shortcomings identified. Based of these findings recommendations were forwarded.
OBJECTIVE: To document the experiences and lessons for rolling out of the OTP service at the wider scale with the aim of assessing the strengths and weaknesses of the project and suggest recommendations for future programming. DESIGN: Qualitative methods of data collection including focus group discussion, observation and in-depth interview of key informants were employed to get relevant data. Review of health facility, reports and programme documents were done to capture further- information. SETTING: Out Patient Programme (OTP) pilot programme implemented by CONCERN/ VALID in three administrative regions of Ethiopia namely: South Nations and Nationalities Peoples Regions (SPNNR), Addis Ababa and Oromia regions. A total of thirteen health centres which had started OTP service from the three regions were included in the study. SUBJECTS: Thirty six key informants and 30 focus group discussants were involved in the study conducted from 16th to 25th November 2006. RESULTS: Out Patient Programme (OTP) has enhanced community's understanding of malnutrition as a health problem through an excellent entry point it created for behaviour change communication (BCC) on optimal infant and young child feeding (IYCF). It has also enhanced utilisation of the existing equipments of the respective health services to promote nutrition and increased mental satisfaction of the providers who observed rapid recovery of malnourished children taking the plumpy nut. It also resulted in increased awareness of the community about malnutrition and its treatment, which resulted in increased need-based demand for the OTP and self-referral of children to health facilities. Shift in the thinking of the providers on the fact that malnutrition can be treated without admitting the child and reduction in the burden of malnutrition and associated mortality are other positive findings of the study. CONCLUSION: While it was observed that the programme was very effective in treating case of severe acute malnutrition and is highly acceptable by planners, health care providers and beneficiaries, there were different operational issues that needed to be strengthened. The irregularity and incompleteness of supply availability, high attrition of trained human power, inadequate supportive supervision especially from local ministry of health, inadequate community mobilisations are some of the shortcomings identified. Based of these findings recommendations were forwarded.