wfp angola nutrition work

World Food Programme Angola

Senior Project and Optional Rotation

June 5, 2006 – August 4, 2006

Cathy Hsu

Overview

• Introduction to Angola• Current situation in Angola• WFP Angola’s SMI program

Projects done in Angola1. Senior project: Focus groups with women2. Side project: Data analysis 3. Side project: Community nutrition assessment

• Conclusions

Introduction to Angola

• Colonized by the Portuguese• Independence in 1975• Quickly followed by a civil war• Cease-fire in 2002

Current situation in Angola

• Rich with diamonds, oil, and fertile land

• 70% of population under the poverty line• 4 million people displaced from the war• Heavily mined country interior• Devastated infrastructure: transportation,

sanitation, education, health systems

Maternal and Child Health in Angola

• Maternal mortality: 1850/100000

• Hemorrhaging • Malarial and iron-deficiency anemia

• Infant mortality: 150/1000

• Malaria• Vaccine preventable diseases• Vitamin A deficiency

Reduce by increasing attendance of women at prenatal and postpartum health care.

Saude Materno Infantil (SMI)Maternal and Child Health

• Distribute food rations to women attending prenatal and postpartum health centers

• Goals1. To reduce maternal and infant mortality

through increased usage of health services

2. To improve the nutrition status of pregnant and lactating women and infants

SMI

• Rations provided: Corn-soy blend, fortified maize meal, vitamin A fortified oil, iodized salt

• Two areas– Rural Huambo– Peri-urban Viana

1. Senior Project: Focus Groups

• Conduct focus groups with pregnant women at health centers implementing SMI

8 focus groups

4 in Huambo 4 in Viana

2 small 2 large 2 small 2 large

Methods

• Received IRB approval from Medford Social Sciences

• At each health center– 6-8 women were recruited to participate– All women were orally consented– Asked questions regarding:

• Health care access• Health care quality• Food rations

Preliminary results

1. All women believe that prenatal care is very important for a good pregnancy outcome.

2. Women in semi-urban areas have more sources for health information than women in rural areas.

3. Women make health center choices based on quality of health care provided.

4. Quality of care suffers from inadequate medication supply.

5. Adequate transportation is a barrier to health care access.

Preliminary Results

5. Knowledge of the importance of mosquito nets has not translated into the practice of using mosquito nets.

6. All women breastfeed for 1-2 years, but knowledge and practice of exclusive breastfeeding varies.

7. Food rations are not a universally motivating component of the program.

8. Most women spend less money the month that they receive the rations.

2. Side project: Data analysis

• Data from Government of Angola survey– 214 children under five – Huambo province– Nutritional, household, health information

• Software used– Epi-Info for stratified frequency and means– WHO Anthro 2005 for z-score calculations– ArcView for chloropleth maps of data

Results

• Average household size: 5.5• Average prenatal consults: 5.1

• 7% of children were wasted• 28% of children were underweight• 60% of children were stunted

• 73% of children received vitamin A• 55% of children received measles vaccine

Stunting graphs

3. Side project: Nutrition assessment

• UNITA community of displaced people• WFP Angola to continue or end assistance

• Conduct an assessment of nutrition status of children under five– 57 Children– Weight, height, MUAC– History of sickness, vitamin A, measles vacc– Clinical indicators of severe malnutrition

Results

• Wasted: 10%• Underweight: 18%• Stunting: 26%• 32% had diarrhea in past 2 weeks• 33% had ARI in past 2 weeks• 93% had measles vacc and vitamin A• No children had edema, Bitot spots,

cheilosis, angular stomatitis

In conclusion…

1. Focus groups• Follow-up for qualitative analysis • Follow up with Field Exchange publication• Discuss with WFP Angola possible changes

and improvements to SMI program or implications for future programs

2. Data analysis• Submitted analysis and graphics to GSA• Discussed results and use in future

3. Nutrition assessment• Submitted analysis to FAM and Dep.

Country Director• Discussed and decided to discontinue aid

Thank you, obrigada, and tuapandula!