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Strategies for community out-reach Identifying key nutrition issues and analysing determinants of eating behaviour The task of planning nutrition education interventions integrated into nutrition improvement programmes, requires that the various causes and effects of nutrition issues and problems be addressed in a concerted manner.
Only through a systematic analysis of the nutrition and health-related needs of a community, can an effective nutrition education programme be developed.
Any nutrition education intervention should consider the socio-cultural, economic, political, and technological environments which include food and nutrition issues. Thus, the first step is a situational analysis examining the factors that would draw out pertinent issues to be addressed through nutrition education.
An assessment determines the priority issues, problems, local power structures, supporting institutions, communication resources, as well as relevant policies, and the degree to which these affect the state of nutrition and health of the community.
An analysis studies the underlying factors that impinge on the issues, problems, structures, resources and policies. Action, in terms of community out-reach strategies, includes: In designing appropriate community out-reach strategies, nutrition education planners need two major types of information.
Information about people Information about people is sometimes referred to as audience predisposition in communication models Gillespie, The information about people will help identify the nutritional needs of the community.
Four basic methods are employed to describe the nutritional status of "at risk" groups in the community: This describes what and how much people usually eat. It determines whether the amount and variety of food intake is adequate for the individual and the household.
It also tells if there is food scarcity at certain times of the year. Morbidity and mortality rates and their causes are indicators of the interrelationships between nutrition and prevalent disease patterns, including infections and infestations.
It also guides planners in choosing interpersonal and mediated approaches. Types of occupations, incomes and educational attainment of family members, and whether women work outside the home, indicate if money is regularly available to buy food.
Food expenditures also provide an index of the percentage of family income spent on food and non-food items. Child care providers should also receive nutrition education. Food habits, practices, superstitions, attitudes, social and religious customs, and breast-feeding and weaning practices are useful in determining and designing appropriate nutritional messages and activities.
The structure and flow of nutritional information or misinformation among women and men in the community help to identify specific target participants for nutrition education interventions, e.
These studies relate nutrient deficient patterns to spatial, ecological, socio-economic, and demographic characteristics of a population. For example, a study of upland dwellers can yield useful information for designing intervention programmes based on an "area level", integrating a development planning approach rather than a sectoral approach.
Information about local resources Information about local resources that will help identify problems related to food and nutrition in the community include: This helps to identify possible sources of infection and whether enough water is used to maintain hygiene standards.
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It also indicates if it is possible to increase agricultural production. This identifies the kinds of foods that are locally available for consumption, including their seasonal availability.
This gives an idea of what crops are sold locally, the process by which a quantity and quality of foods becomes available on the market, and the presence of street-food vendors, snack stands, and other outlets for prepared food.
It should be determined whether food storage facilities are available, whether enough food can be stored properly for future needs, and whether lack of storage facilities causes specific losses and a shortage of supplies. This indicates the adequacy of kitchen, toilet and other sanitation facilities.
It is also used to measure space adequacy or crowding among family members. This shows whether the local government officials recognise the importance of nutrition in the overall development plans and programmes in their area of jurisdiction.
It also determines if there are existing policies that guide local officials, organisations, extension agents, and non-government organisations so that they can participate and provide support services for nutrition interventions. The availability of farm-to-market roads and public utility vehicles affects the flow of farm products to the market, the availability of food in the local market, and the mobility of individuals to visit health and educational facilities.
The availability of these resources indicates the extent to which the members of the community have access to instrumental information and to formal, non-formal and informal education.
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A community diagnosis is carried out by collecting the information listed above, either from primary or secondary data.
Whichever information-collection method is used, the people from the community are the focal participants in this initial planning step. Some techniques that have been used for drawing out needed primary information are the participatory rapid appraisal or PRA technique, focus group discussion or FGD, problem tree analysis, village assembly, dialogue and consultation, communication network analysis, and community survey.
Selecting target groups The members of a community can be divided into specific groups, or segments of participants, for a community out-reach programme based on information made available. Audience segmentation is the term used for planning a nutrition education and communication intervention when a population is divided into fairly homogenous groups.
Each group may then be selected for distinct nutrition education messages. The basic premise is that everyone in the population does not have the same need for a particular piece of information, resource or service.Excellent nurse managers possess strong leadership and communication skills and create a vibrant culture of teamwork and trust among their staff.
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