A Model for Community-Based Growth Monitoring System

Acting on a request form the community of Ndunakazi; a rural area bordering the Valley of a Thousand Hills; Kwa Zulu-Natal; South Africa; a comprehensive situation analysis was conducted. The results were used in an objective orientated programme planning approach; during a workshop attended by community representatives. One of the outcomes was the establishment of a model for a community-based growth and health monitoring system for pre-school children. As their contribution to the programme; families would make their homes available on a voluntary basis; once or twice a month to be used as community-based centers (called Isizinda). From a nutritional point of view; the programme has a hoslistic approach and is run by nutrition monitors. The programme was initially launched with one centre; but in response to requests received form the community; a further seven centres have been established. Approximately 500 pre-school children are currently being growth-monitored regularly; with an average monthly attendance of around 70 per cent. The nutrition monitors are responsible for conveying health and nutritional messages to the mothers and for collecting morbidity and mortality data. Children who are either not growing well or who are ill are referred to the nearest clinic. When available a community nurse attends to minor illnesses during these sessions. A soup kitchen is run during the winter; providing the mothers and pre-school children with soup and bread. Attitudes of mothers and nutrition monitors towards the programme are assessed regularly; the outcome of skills development that is an integral part of the model. This model falls within the scope of the policy objectives and principles on which the United Health System of South Africa will be based. The National Research Programme for nutritional Intervention (NRPNI) is in eh process of establishing a partnership with the department of Health of KwaZulu-Natal. Should the Department take long-term responsibility as an overall coordinator of these monitoring centers; the sustainability of the project will be increased and could then be extended to other areas

Development of vitamin A control programs : an exemple from Tanzania

This article describes the rationale for starting vitamin A deficiency control programs and the experience from Tanzania on starting such programs. The objective is to draw lessons which could be applied elsewhere as countries move towards the elimination of vitamin A deficiency by the year 200. The successful development and implementation of sustainable national vitamin A programs is possible even in poor countries like Tanzania; provided that there is a political will

Feasibility of an Insurance Program for HIV/AIDS Financing in Uganda

This paper presents the results of a U.S. Agency for International Development-funded project in Uganda to develop a new financing mechanism for HIV/AIDS services for government workers.Presently; the service delivery and financing systems for HIV/AIDS care are a mix of specialized vertical programs and health care providers from public and private sectors. The integrated financingprogram (being designed as a pilot) is to develop a new approach for financing all HIV/AIDS services in a more coordinated way; allowing financing from multiple sources (donors; employer; and worker contributions) to support service delivery by a network of full-service providers (both public and private) that can be chosen by enrollees. The concept is to establish an independent entity to collect premiums and make payments to qualified providers of covered services on behalf of workers and their dependants. Premiums are established on the basis of a formal costing study of a comprehensive HIV/AIDS benefit package completed in 2004. The paper describes the financing concept and related governance; the model developed for premium calculation; the provider payment design; a survey of government workers done in 2005; and the issues relating to the feasibility of developing an integrated insurance model for HIV/AIDS care in Uganda including issues related to governance; copayments; and relationship to ongoing social health insurance activities