Implementation of nutrition education and rehabilitation programs (NERPs) in Viet Nam
Abstract:Rigorous assessments of program quality are uncommon in developing countries. We evaluated the quality of the two-week, volunteer-facilitated, caregiver-child rehabilitation "hearth," or nutrition education and rehabilitation program (NERP), sessions in Save the Children's integrated nutrition program in Viet Nam. Field workers observed attendance, food contribution, food preparation, meal consumption, health message delivery, hygiene, and weighing at 240 NERP days at 59 NERP centers during seven months of implementation. Participation in cooking NERP meals (75.8%), washing mothers' and children's hands (75.7% and 81.6%, respectively), and weighing (74.5% on days 1 and 12) were high, but attendance rates (50.3%), food contributions (20.3%), and health message delivery (20.0%) were lower than expected, all with wide variation among communes, ecology, NERP day, and NERP round. Contrary to protocol, food was often delivered to malnourished children who stayed at home to accommodate caregivers' workloads and other constraints. While home-delivery of food prevented caregivers from learning from each other in a group, it did bring "tangible messages" (i.e., a large serving size of a new food) to the doorstep. Health volunteers were wise to stress active learning over repetitive message delivery. In summary, these NERPs were probably typical of previous NERPs although comparable quality measures are lacking. Despite imperfect implementation, the NERP's active-learning and local problem-solving helped achieve measurable impact on growth, diet, morbidity, and empowerment despite uncommon program challenges, such as uncharacteristically low baseline levels of malnutrition and high population dispersion. Regular quality monitoring may enhance impact even further.
Document Type: Research Article
Publication date: December 1, 2002
Established in 1978, the Food and Nutrition Bulletin (FNB) is a peer-reviewed journal published quarterly by the Nevin Scrimshaw International Nutrition Foundation.
The focus of the journal is to highlight original scientific articles on nutrition research, policy analyses, and state-of-the-art summaries relating to multidisciplinary efforts to alleviate the problems of hunger and malnutrition in the developing world.
Food and Nutrition Bulletin's 2012 Impact Factor: 2.106
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