the positive deviance hearth nutrition model. 2 basic causes -resources and control (human, economic...
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The Positive DevianceThe Positive DevianceHearth Nutrition ModelHearth Nutrition Model
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Basic CausesBasic Causes
-Resources and -Resources and controlcontrol ( (human, economic human, economic and and organizational organizational))
The ContextThe Context
Underlying CausesUnderlying Causes
--Inadequate Inadequate maternal and child care maternal and child care
-Insufficient household-Insufficient household food security food security
- Insufficient health - Insufficient health servicesservices and unhealthy and unhealthy environmentenvironment
Causes of malnutrition among young children are Causes of malnutrition among young children are complex, interrelated and can take complex, interrelated and can take yearsyears to overcome to overcome
Direct CausesDirect Causes
--Inadequate intake of Inadequate intake of foodfood
-Disease-Disease
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The ChallengesThe Challenges
• Extreme povertyExtreme poverty• Complexity ofComplexity of
factorsfactors• Immediacy ofImmediacy of
needsneeds malnourished children at risk malnourished children at risk
TODAYTODAY
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Goal of the Hearth Nutrition Program Goal of the Hearth Nutrition Program (HNP)(HNP)
To enable poorTo enable poor
communities tocommunities to
sustainablysustainably
address the address the problemsproblems
of malnutritionof malnutrition
TODAYTODAY
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What Development Approach…What Development Approach…can alleviate current childhood can alleviate current childhood
malnutrition quickly, affordably & malnutrition quickly, affordably & sustainably in a culturally acceptable sustainably in a culturally acceptable
manner?manner?
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Positive Deviance (PD) Positive Deviance (PD) ApproachApproach
Identifying Solutions to Community Problems Identifying Solutions to Community Problems WithinWithin the Community Today the Community Today
What enables some poor What enables some poor members of the members of the
community to have well community to have well nourished children when nourished children when their neighbors do not?their neighbors do not?
…… We call these peopleWe call these peoplePositive DeviantsPositive Deviants
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Positive Deviance ApproachPositive Deviance Approach
We must discover what PDs are doing We must discover what PDs are doing differently from their neighborsdifferently from their neighbors
The PD InquiryThe PD Inquiry is the tool that is the tool that
provides clues to PDprovides clues to PDspecial practicesspecial practices
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PD PROCESSPD PROCESS
1. Define the problem, issues & community norms affecting the nutritional status of children
2. Determine the presence of well nourished children from poor families in community(Positive Deviant Children/Families)
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PD PROCESS
3. Discover what they are doing differently by conducting home visits. (PD Inquiry)
4. Design activities based on demonstrably successful practices and strategies
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Step 1 – Define the Step 1 – Define the ProblemProblem
Explore current feeding, caring, hygiene and health Explore current feeding, caring, hygiene and health -seeking practices with the community through-seeking practices with the community through
Target groups: caretakers, stakeholders and Target groups: caretakers, stakeholders and decision makersdecision makers
Focus Group Focus Group DiscussionDiscussionPLA PLA
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Step 2 – Determine Presence of Step 2 – Determine Presence of PD Children and PD FamiliesPD Children and PD Families
With members of the community:
1: Weigh all children in target group
& plot them on giant growth chart
2: List all well-nourished children
3: Select well-nourished children from poor families (wealth ranking)
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Step 3 – DiscoverStep 3 – Discover PD PD Practices Practices Demonstrably successful uncommonDemonstrably successful uncommon
- Feeding- Feeding- CaringCaring- Hygienic Hygienic
- Health Seeking Practices- Health Seeking Practices
PD Inquiry via Home PD Inquiry via Home VisitsVisits
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Example of PD Caring Example of PD Caring Practices Practices (step 3)(step 3)
- Experienced secondary caretaker (older Experienced secondary caretaker (older siblings)siblings) Supervision during feeding (active feeding) Supervision during feeding (active feeding) Gender equity in child care Gender equity in child care
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Example of PD Feeding Example of PD Feeding Practices Practices (step 3)(step 3)
- Frequency of feeding, minimum 3 times a Frequency of feeding, minimum 3 times a dayday Variety of food in the child’s diet Variety of food in the child’s diet Amount of food and consistency Amount of food and consistency
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Example of PD Hygiene Practices (Step 3)
• Washing Hands Before & After Eating
Environmental Cleanliness
Keeping Food Covered
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Example PD Health-Seeking Example PD Health-Seeking Practices Practices (Step 3) (Step 3)
-Timely seeking qualified help when child -Timely seeking qualified help when child is sickis sick - Appropriate child feeding during & after - Appropriate child feeding during & after illness illness - Identification of danger signs - Identification of danger signs - Home management of minor illnesses- Home management of minor illnesses
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Analyze PD FindingsAnalyze PD Findings
And select only PD practices And select only PD practices ACCESSIBLE TO ALLACCESSIBLE TO ALL
Vet PDI results with the communityVet PDI results with the community
Food Care HealthHygiene
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Step 4- Design a PD informed activity or HEARTH
Involvement of community in the Involvement of community in the designdesign
Inclusion of PD concepts & PDI Inclusion of PD concepts & PDI findingsfindings
Multi channels Multi channels
Multi target: including all Multi target: including all stakeholdersstakeholders
Learning by doing: Interactive Learning by doing: Interactive Learning Learning