Currently Skimming:
5 Using Existing Platforms to Integrate Services on the Ground
5 Using Existing Platforms to Integrate Services on the Ground
Pages 43-52
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From page 43... ...
has developed an integrated childhood development intervention through its Maternal, Neonatal, and Child Health Program that delivers a wide range of services in a very cost-effective way. In Pakistan, the Lady Health Workers Program has combined a nutrition intervention with an early childhood development intervention that has been studied as a model of integrated programs.
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From page 44... ...
Conception to postpartum period Children 60+ months (transition to • Parenting • Play and • Essential education activity based newborn care • Age curriculum • Maternal • Exclusive appropriate • Tracking • Indoor and care breastfeeding balanced diet of children outdoor play • Nutrition • Stimulation graduated • Stimulation – • Community • Mental • Play corner at from SBK massage and involvement health bathing courtyard • Parenting • Parenting • Referral (13-36 education education • Responsive for months session parenting • Annual health complica- children) check-up • Referral of • Monitoring of tion sick newborn • Monitoring child child • Parenting development education development • Referral of • Referral of sick child sick child BRAC Education Programme BRAC Health, Nutrition and Population Programme FIGURE 5-1 BRAC has adopted an integrated early childhood development model that includes both health and education in homes and centers.
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From page 45... ...
From January through December 2014, more than 2,000 pregnant women and lactating mothers were counseled on maternal health, nutrition, early childhood development, newborn care, breastfeeding, and massage and bathing technique. About 90 percent of the children in the program have achieved age-appropriate gross motor development, Chowdhury reported.
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From page 46... ...
They serve primarily to promote family planning, provide antenatal care provision and some commodities, conduct health education, and make referrals for very ill children and women. They do not, in general, provide curative services beyond oral rehydration and simplified antibiotic therapy for respiratory infections.
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From page 47... ...
However, adding education in early childhood development to enhanced nutrition information did not produce an additional benefit in terms of developmental outcomes. "That was a bit of a surprise," said Bhutta, "because we expected intuitively that that group would do the best, but it did not in terms of its overall impact." Also, integrated delivery of particular services proved more effective than the enhanced nutrition intervention but no more effective than the early childhood development intervention, although all three groups did much better than the control cluster.
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From page 48... ...
Integrated counseling could be promoted through curriculum development and training that highlights the links between new and existing messages; the ability of lady health workers to answer questions on health, feeding, and care; and the promotion of responsive care using play, communication, feeding, and teachable moments. The augmented program involved not just health but input from such areas as promoting food security, gender empowerment, issues related to education, and environmental issues.
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From page 49... ...
Bhutta also pointed out that global reviews have been conducted showing that community health worker programs generally have not been able to integrate early child development interventions at scale. The health sector always has limitations, including lack of contact between health workers and people in other sectors.
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From page 50... ...
At the health level, it is part of a continuum of wellness promotion, health promotion, prevention, and risk reduction. It provides primary health care, sexual and reproductive health care, mental health care and psychosocial support, dental care, optical care, special services (including services for the lesbian, gay, bisexual, transgender, and questioning community, HIV, substance abuse, victims of interpersonal violence, and teen parents)
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From page 51... ...
Participants in the program have a much lower teen pregnancy rate than other youth in New York City, and sexually transmitted infections like chlamydia receive treatment to prevent their spread. Participants in the program have fewer emergency room visits, and 90 percent stay in school, which is a much higher percentage than for African-American and Latino youths in general.
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From page 52... ...
Basically, I am trained as a physician, but I spend my time raising money to be able to see these youth." The evaluation now being done is expected to produce data that could help show policy makers how cost-effective the program is, not just in terms of human lives saved but money saved on health care, education, and jobs "because these young people stay in school and can be trained instead of putting them in prisons." Research results have shown that the program is effective, "but people are not going to be able to do it unless they know how to sustain it." Diaz closed with several recommendations drawn from her experiences at the center. It is important to integrate as many elements as possible within one clinical service, including primary health care, sexual and reproductive health care, and behavioral and mental health care.
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