6. RECOMMENDATIONS
- Consideration should be given to blanket feeding of the community. The current Christian Care programme targets all households, but not all household members, and therefore needs to be extended. A general ration would meet the objectives of restoring people's ability to obtain and produce food and provide an income transfer with which people can recover their health, welfare, education and a reasonable existence. Detailed recommendations on this were provided in the Household Economy Assessment report.
- Supplementary feeding needs to be considered in order to complement general or targeted distributions since, on its own, it is less holistic, not taking the adverse long-term effects of coping strategies and the complexities of intra-household food distribution into consideration. Complementarity of the two interventions is demonstrated in the collective impact of the Binga district SC (UK) and CCJP programmes. If a general ration is in place, then the supplementary feeding should be targeted to acutely malnourished children.
- The fact that the current Christian Care ration limits household rations to that of a maximum of five individuals compromises mean per-capita calorific returns from the programme. Considering the household sizes of poor families of 10 to 12 individuals (Nyaminyami HEA), each individual ends up receiving an inadequate fraction of their RDA. Consequently, greater impact would be realised by targeting based on actual household size.
- Due to the poor agricultural production and costs of coping so far experienced, it will be necessary to start rebuilding lives and livelihoods. Means of supporting communities to get back on their feet in the coming season need to be explored. This can be in the form of agricultural input support mechanisms, since little grain will be available to serve as seeds. If implemented, it should be coupled with training in the production of appropriate crops and input use for the agro-ecological conditions of the district. These can be distributed either free, through input credit schemes or through an "inputs for work" programme. These activities will serve the purpose of increasing the amount of grain harvested as well as building the capacity and improving self-sufficiency of the families in the district.
- Sanitation coverage improvement is essential in this context. Lack of toilets predisposes communities to unsanitary practices and concomitantly sanitation related communicable diseases. Consequently, sanitation improvement coupled with health and hygiene education has the potential to reduce diarrhoeal disease prevalence and eventually to improve nutritional status.
- The current and envisaged future conditions may result in increasing significance and necessity of health centre based therapeutic feeding. In fact, SAM levels were found to be 2.1%. In spite of this, therapeutic feeding in the District Hospital is inferior to the conditions stipulated in the WHO recommendations in Management of Severe Malnutrition in Children, mainly due to reported budgetary constraints. This may have the effect of delaying or inhibiting recovery of patients and consequently impacting on child mortality. As such, action is necessary, at implementation or advocacy level to improve the treatment of such children.
|
