Process Evaluation of Nutrition Intervention Strategy in a Local Philippine Setting (original) (raw)
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Children
Nutrition and feeding interventions are important for children’s growth and development. Holt International’s Child Nutrition Program (CNP) is a child nutrition and feeding intervention. This study aims to describe and explore the implementation of CNP in Mongolia and the Philippines using mixed methods including qualitative and quantitative data analysis. The analysis framework was guided by the WHO’s Monitoring the Building Blocks of Health Systems. Key informant interviews (KIIs) were conducted, transcribed, translated and coded. Knowledge, Attitude and Practice Surveys (KAPS) and pre-/post-tests from routine program audit data were analyzed. Analysis of nutrition (Mongolia: 95% CI: 7.5-16.6 (p = < 0.0001), Philippines: 95% CI: 7.6-15.7 (p= < 0.0001)) and feeding (Mongolia: 95% CI: 11.7-23.9 (p = < 0.0001), Philippines: 95% CI: 6.6-16.9 (p = < 0.0001)) tests indicate improvement post-training in both countries. KAPS indicate changes in desired practices from pre-train...
This review aims to provide a comprehensive synthesis and determine pooled effectiveness of food interventions on the nutritional status of undernourished children ages 0-5 years old in low-and middle-income countries. Specific objectives include identification, selection, and appraisal of interventions that target undernourished children ages 0-5 years old. This study included Randomized Controlled Trials, Pre-post Interventional, Case-Control, and Cohort Studies that were conducted from 2 0 1 6-2 0 1 9 that target Undernourished children, 0-5 years old. The outcome is improvement in Nutritional Status: Weight-forage , Length-forage , Weight-for-length, Weight Gain, Mean Weight, Mid-Upper Arm Circumference, Length (cm). The search and identification of studies, supplemented with the inclusion and exclusion criteria, was done through an online database (Pubmed, Ebscohost, ScienceDirect, and Google Scholar) and in the Department of Agriculture Library. The study used four (4) tools in appraising the studies. The four tools differed in terms of their indication of use by study design: Risk of Bias-2 for Randomized Controlled Trials (RCTs), Risk of Bias in Non-Randomized Studies-of Interventions for Non-Randomized Studies (NRSI), and Heller's Public Health Checklist for quasi-experimental (within-group) designs. Out of thirty-one (31) studies, this paper compiled seven (7) interventions. The interventions are local and homemade food, nutritional education, food production, milk-based formula, reduced dose of RUTF, rehabilitation programs, and positive deviance approach. Risk of Bias: (ROB-2) 100% of the studies have low risk in random sequence generation, blinding of outcome assessment, and selective reporting domains. Only 10% of the studies demonstrated unclear or moderate risk under attrition bias due to incomplete outcome data. Roughly 20% of the studies also showed unclear or moderate risk under selection and performance bias. (ROBINS-I) 6 7 % (6 / 9) of the included studies are low risk for overall bias. (Heller) Studies were appraised by Heller's checklist where identification of strengths and weaknesses were identified. This review found that local and homemade food improves the nutritional status of undernourished children below five years old. Findings show that nutrition education has little to no effect, while food production needs more studies to increase its certainty. Other interventions mentioned need more similar studies to obtain a pooled effectiveness. This review has excluded studies that are of high risk of bias to minimize low certainty of evidence. However, this review was unable to examine adverse effects of the interventions. This review has some studies not pooled due to missing values such as standard deviations and confidence interval.
Budapest International Research and Critics Institute (BIRCI-Journal): Humanities and Social Sciences, 2020
There are five districts with the highest stunting rate in North Sumatra and in Langkat district by 38.7 percent in 2017. This research looks at the analysis of the implementation of specific and sensitive nutrition intervention programs to reduce stunting rates in langkat. This research is a qualitative study with a phenomological design using purposive sampling method with 8 informants with the criteria of program implementers and field implementers and the community using CFIR tools to see the implementation of specific and sensitive nutrition intervention programs to reduce stunting in toddlers in Langkat. From the analysis of 31 CFIR constructs, there are 6 strong constructs of influence, where 4 constructs have a positive effect, namely the characteristics of the agency structure, pressure to change, self-confidence, program adoption and 2 constructs have a negative effect, namely external networks and external needs and incentives. There are 4 constructs that have a weak but ...
Jurnal Gizi Indonesia (The Indonesian Journal of Nutrition), 2021
Background: Health status can affect the Human Development Index (HDI) of a country. To improve the quality of human resources, the Indonesian Government has applied various policies, such as the nutrition improvement program, since there are still lots of toddlers suffering from underweight, wasting dan stunting. Even one out of three toddlers in Indonesia were detected stunting.Objectives: This study described the implementation of a nutrition improvement program for toddlers in the Central Buton District Health Office.Materials and Method: This was a qualitative study that involved ten informants. Three of those informants are nutritionists in the District Health Office, Head of Public Health Department, Head of NutritionDepartement. Also, two nutrition workers in primary healthcare centers and two mothers of malnourished toddlers.Results: These findings showed that in terms of input, trained human resources on nutrition were lacking, and the budget for the nutrition improvement ...
Journal of Health Education, 2021
Background: Malnutrition among children becomes one of public issues in the population. Community-based nutrition programs provide opportunities to improve current child nutrition and in later life. Objective: To explore the implementation of a community-based nutrition program in Sedayu Subdistrict, Bantul District. Methods: A qualitative study with a single study case was conducted between March and May 2017 in the community feeding center in Argorejo Village, Sedayu Subdistrict, Bantul District. Data were collected from a focus group discussion among mothers of children under-fives, in-depth interviews to community health workers and a nutritionist, and observation during the program activities. Analysis was done by developing coding and themes on the implementation of the program. Results: Several activities were identified in the community-based nutrition program such as anthropometric measurement, nutrition counselling and education, providing healthy snacks during the progra...
World Nutrition
Background: Malnutrition among Filipino children persists; underscoring the value of nutritional assessment procedures. In the Philippines, this is carried out at the local level in its annual Operation Timbang [weigh] (OPT or OPT Plus). Local government unit officials observed higher malnutrition prevalence rates in nutrition survey reports of the Department of Science and Technology’s Food and Nutrition Research Institute (DOST-FNRI) compared with its OPT. A revisit of the OPT provided evidence on the comparability of the two data sets and sources of variance analyzed. Objectives: 1) describe municipal level assessment of OPT in 10 barangays of Abra de Ilog municipality; 2) identify facilitating and hindering factors in OPT; and 3) compare OPT results with DOST-FNRI local nutrition survey in Abra de Ilog and identify potential sources of variance therefrom. Methods: Primary data were collected using focus group discussions and key informant interviews. Height and weight data were...
Nutrients, 2018
Comprehensive assessment of nutrient intakes and food sources of nutrients in Filipino children under 5 years old are lacking. We studied energy and nutrient intakes and food sources in 4218 children aged 6–59.9 months using two 24-h dietary recalls. Usual energy and nutrient intakes were estimated using the PC-SIDE program. Reported foods and beverages were assigned to one of 85 food groups. Percentage contribution of each food group to nutrient intake was calculated. The results showed that the intake of total fat as a percentage of energy and of most micronutrients were highly inadequate. The prevalence of inadequate nutrient intakes, defined as the percent of children with intakes less than the estimated average requirements (EAR) ranged from 60–90% for iron, calcium, vitamin C, and zinc and ranged from 30–50% for others such as vitamin A, thiamine, riboflavin, niacin, vitamin B6, and phosphorus. The diets of these children were composed of limited foods, namely a large amount o...
2019
Introduction This study measured the impact and outcome of an inter-professional community nutrition program labeled as “NUTRI-CHIKA: Usapan Tungkol at para sa Nutrisyon.” The program was a multidisciplinary approach towards the attainment of proper nutrition for identified malnourished preschool age children in Barangay San Isidro, Rodriguez, Rizal. Methods This was a mixed quantitative-qualitative program evaluation. The quantitative part consisted of a longitudinal observational study design, which reviewed the data of the children who received the nutritional intervention. The qualitative study was done with a phenomenological approach, using a thematic analysis for the process and impact evaluation by means of a focus group discussion and key informant interview processes. Results There was a statistically significant increase in weight (2.32 kg) and height (3.04 cm) in terms of Z-scores. A total of 29 out of 30 malnourished children graduated with 1 to 3 degrees of improvement...
EVALUATION OF A SCHOOL-BASED FEEDING PROGRAM IN A PUBLIC SCHOOL IN CENTRAL LUZON, PHILIPPINES
The Department of Education has directed school heads in public schools nationwide to feed malnourished pupils. In a rural school in Tarlac City, 40 pupils were found to be wasted and severely wasted in SY 2017-2018 based on their Body Mass Indices (BMI). Upon request of the school head, a double meal feeding program was conducted for 90 days by Tarlac State University -College of Education Extension, in partnership with government and nongovernment supporters. The study then evaluated the outcome of the feeding program in terms of its outcomes bases on the pupils' improvement in nutritional status, academic performance and their attitude in school. Participants of the study were 40 pupils under the feeding program, eight teachers and a school head and six parents who assisted the feeding program. Findings revealed that the nutritional status of 83% of the pupils became normal and their attitude towards classroom tasks, teachers, classmates, self-esteem and confidence improved but had not significantly improved pupils' academic performance. Further findings revealed that the best practices in the feeding program were the active participation of various school stakeholders, including the direct involvement of the external donors during the actual feeding days. However, there were some problems encountered along the process, which included pupils who did not report to school regularly and therefore had not completed the 90 days feeding program; some pupils who lacked appetite, especially in the morning; and some parents were too demanding. The study recommends drafting of policy when conducting feeding program; livelihood training skills for unemployed parents so they can provide nutritious meals at home; and training for mothers in preparing low cost nutritious meals. on Based on the findings of the study, A trAC School-based Feeding Program model was developed.