Mother, Infant and Young Child Nutrition & Malnutrition Mother, Infant and Young Child Nutrition & Malnutrition - Feeding practices including micronutrient deficiencies prevention, control of wasting, stunting and underweight
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Protection, Promotion and Support of Healthy Maternal, Infant and Young Child Feeding

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Home  »  Nutrition Protection, Promotion & Support  »  The Essential Nutrition Actions (ENA) Approach  »  Service Quality Self Assessment Tools  »  Tool 1: Facility Based  »  Ante-Natal Contact

The Essential Nutrition Actions (ENAs) Approach

Service Quality Self Assessment Tools - Facility Based
Ante-Natal Contact

Performance self-assessment tool for use by Key Stakeholders at key contact points - The following Essential Nutrition Actions (ENAs) are recommended:

Recommended ENAs at Ante-Natal Contact.

Key stakeholders: health workers, supporting staff, VHT

Rating* Discuss and identify key gaps in provision and utilization of ENAs at Ante-Natal Contact.
Maternal Iron Deficiency Anaemia (IDA) control:

1. Malaria prevention and control:

  • All pregnant women receive 2 Doses of IPT:
    - First dose = 3 tablets SP once during the 4th to 6th months of pregnancy.
    - Second dose: 3 tablets SP once during the 7th to 9th months of pregnancy.
  • All pregnant women are counselled on how to use the ITN.
Total 1: …..  
2. Iron/Folic Acid or multiple micronutrient supplementation:
  • All pregnant women receive 30 Iron/Folic Acid tablets a month for six months (180 tablets in total).
  • All pregnant women are counselled on side effects, compliance and safety of IFA supplements.
  • All pregnant women are counselled on importance of adhering with daily intake of one tablet of Iron/Folic Acid for six months.
  • All pregnant women are screened for pallor on every visit.
  • Pregnant women with pallor receive Iron/Folic Acid supplementation according to protocol.

NOTE: Supplementation can continue also after delivery if the six months are not completed during pregnancy.

Total 2: …..  
3. De-worming:

All pregnant women receive one Mebendazole 500 mg two times during pregnancy at the same time as SP.

Total 3: …..  
Maternal nutrition improvement:

All pregnant women are counselled on:

  • Increased energy intake through one additional meal a day.
  • How to improve variety (cereal/starchy roots plus animal foods/legumes/nuts plus fruit/vegetable).
  • Reduced workload (or at least having resting moments).
  • Daily use of iodized salt for all family members.
Total 4: …..  
Preparation for exclusive breastfeeding:

All pregnant women are counselled on:

  • Initiation of breastfeeding within 60 minutes.
  • Importance of colostrums or 'First Milk".
  • Feeding only breast milk, no water or other liquids/foods for the first six months.
Total 5: …..  
Infant feeding options for HIV+ pregnant women:
  • All pregnant women are encouraged to have an HIV test
  • All HIV+ pregnant women are counselled in private to make informed infant feeding choices based on the AFASS criteria (Acceptable, Feasible, Affordable, Sustainable and Safe).
  • All HIV+ pregnant women who choose replacement feeding are encouraged to have the food ready ready/available at the time and place of delivery
Total 6: .....  
OVERALL SCORE (TOTAL 1 + 2 + 3 + 4 + 5 + 6): .....  

Rating: 0 = insufficient; 1 = fair; 2 = good; 3 = very good; 4 = excellent

14 September, 2019

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