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Implementers REG. NO 
Oriba Dan Langoya 11/U/1019 
Mugalu Denis Edward 11/U/1007 
Nabukalu Ssentongo Angela 11/U/1044 
Bal...
Contents 
ACRONYMS ..........................................................................................................
ACRONYMS 
FM…………………………………………………………..Frequency Modulation 
IMR……………………………………………………….…Infant Mortality Rate 
IYCF……………………………...
ABSTRACT 
Background 
Meeting the Nutrition requirements of children aged 6months to five years has become a major global ...
Methods 
The sensitization project will be carried out in 3 of the villages; Kalubanga, Matuugo, and Buruuli in Nakasongol...
Background 
Meeting the Nutrition requirements of children aged 6months to five years has become a major global challenge ...
progress has been achieved especially in promotion of exclusive breast feeding through policy making, health education and...
an energy gap is created. This gap can be filled with food values that are found in the semi-solid foods that are introduc...
The health problems in Nakasongola include malaria, poor diet, upper respiratory tract infections and diarrheal diseases a...
METHODS 
Project area: 
The project will be carried out in Nakasongola sub county, Nakasongola County, Nakasongola distric...
guidelines that are provided by ministry of health in preparation of a local formula called “ekitobeero”. 
 Occasional ra...
Evaluation; 
Objective 
To assess the level of awareness gained about the importance of a balanced diet to children aged b...
WORK PLAN. 
Activity 
Responsibility 
Week one 
Week two 
Week three 
Week four 
Week five 
Week six 
Resource mobilizatio...
DETAILED IMPLEMENTATION PLAN MATRIX. 
OBJECTIVE. 
ACTIVITY/METHOD. 
NO. of days 
SOURCE OF INFORMATION. 
To increase the k...
BUDGET EXPENSE ITEMS UNIT COST(Ush) AMOUNT(Ush) JUSTIFICATION 
Preparation 
Meetings with village health team, DHO and LC1...
 Homes 
 Campaign sites. 
needed as well. 
Evaluation 
 Data collection, 
 printing of questionnaires for the post- in...
PROJECT FRAME WORK 
Project Component. 
Aim/Goal. 
Indicator/ Outcome. 
Project activity. 
Risks, Limitations, 
Assumption...
REFERENCES 
1. World Health Organization. Technical note: Supplementary foods and management of Moderate Acute Malnutritio...
APPENDIX 
Questionnaire after providing Nutritional Knowledge. 
1. Do you think what you were eating was a balanced diet? ...
10. Does nutritional knowledge help in maintaining good health? 
a. Yes 
b. No 
11. Do you feel you can get sufficient nut...
Malnutrition project proposal ( Increasing knowlege about importance of a balanced diet in children 6month to 5years in Na...
Malnutrition project proposal ( Increasing knowlege about importance of a balanced diet in children 6month to 5years in Na...
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Malnutrition project proposal ( Increasing knowlege about importance of a balanced diet in children 6month to 5years in Nakasongola District)

This is a project proposal implemented by Students of Makerere University Under Community Based and Education Research (COBERS)
Meeting the Nutrition requirements of children aged 6months to five years has become a major global
challenge and as such an estimate of 55 million pre- school children globally are malnourished. In 2010,
the nutrition status of children under five in Uganda was estimated to be 38% stunted, 16% acutely
malnourished and 19% undernourished and by 2011 the statistics stand at 33% for stunting,5% for
wasting ,14% for underweight, vitamin A deficiency at 38%. The current levels of malnutrition hinder
Uganda’s human, social, and economic development.

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Malnutrition project proposal ( Increasing knowlege about importance of a balanced diet in children 6month to 5years in Nakasongola District)

  1. 1. Implementers REG. NO Oriba Dan Langoya 11/U/1019 Mugalu Denis Edward 11/U/1007 Nabukalu Ssentongo Angela 11/U/1044 Baluku Andrew 11/U/15559/PS Acam Joan 11/U/1079 Kalungi Jonathan 11/U/1021 Tumwesigire Samuel 11/U/47 SITE SUPERVISOR CONTACT EMAIL Dr. Edith Nakku Joloba 0701682846 SITE TUTOR Dr. John Kamulegeya
  2. 2. Contents ACRONYMS .............................................................................................................................................................................................. 3 ABSTRACT ................................................................................................................................................................................................ 4 Background ....................................................................................................................................................................................... 4 Problem statement ........................................................................................................................................................................... 4 Intervention ...................................................................................................................................................................................... 4 Justification ....................................................................................................................................................................................... 4 General Objective.......................................................................................................................................................................... 4 Methods............................................................................................................................................................................................ 5 Evaluation ......................................................................................................................................................................................... 5 INTRODUCTION ....................................................................................................................................................................................... 5 Background ....................................................................................................................................................................................... 6 Problem statement ........................................................................................................................................................................... 8 Intervention ...................................................................................................................................................................................... 8 Justification ....................................................................................................................................................................................... 8 OBJECTIVES ............................................................................................................................................................................................. 9 General Objective ............................................................................................................................................................................. 9 Specific objectives ............................................................................................................................................................................ 9 METHODS .............................................................................................................................................................................................. 10 Project area: ................................................................................................................................................................................... 10 Target population: .......................................................................................................................................................................... 10 Ethical approval: ............................................................................................................................................................................. 10 Community Entry ............................................................................................................................................................................ 10 Project duration .............................................................................................................................................................................. 10 Quality control ................................................................................................................................................................................ 10 Project activities: ............................................................................................................................................................................ 10 Implementation .............................................................................................................................................................................. 11 Tools and equipment ...................................................................................................................................................................... 11 Evaluation; ...................................................................................................................................................................................... 12 Analysis plan and presentation of findings..................................................................................................................................... 12 WORK PLAN. .......................................................................................................................................................................................... 13 DETAILED IMPLEMENTATION PLAN MATRIX. .............................................................................................................................. 16 BUDGET ................................................................................................................................................................................................. 17 PROJECT FRAME WORK ......................................................................................................................................................................... 19 REFERENCES .......................................................................................................................................................................................... 20 APPENDIX ........................................................................................................................................................................................ 21
  3. 3. ACRONYMS FM…………………………………………………………..Frequency Modulation IMR……………………………………………………….…Infant Mortality Rate IYCF…………………………………………...…Infant and Young Child Feeding LC 1…………………………………………………………….…..Local Council 1 MDG……………………………………….…….Millennium Development Goals NCHS………………………………………....National Center for Health Sciences RUTF……………………………………………...Ready to Use Therapeutic Food SSA…………………………………………………………….Sub Saharan Africa UCG…………………………………………………..Uganda Clinical Guidelines UDHS………………………………...…Uganda Demographic and Health Survey UNICEF……………………United Nations Initiative and Child’s Education Fund
  4. 4. ABSTRACT Background Meeting the Nutrition requirements of children aged 6months to five years has become a major global challenge and as such an estimate of 55 million pre- school children globally are malnourished. In 2010, the nutrition status of children under five in Uganda was estimated to be 38% stunted, 16% acutely malnourished and 19% undernourished and by 2011 the statistics stand at 33% for stunting,5% for wasting ,14% for underweight, vitamin A deficiency at 38%. The current levels of malnutrition hinder Uganda’s human, social, and economic development. Although the country has made tremendous progress in economic growth and poverty reduction over the past 20 years, its progress in reducing malnutrition remains very slow. In Nakasongola Sub County, the majority of the households sampled had high calorific diet which included root tubers and cereals, but greatly lacking in vitamins and proteins. Most of the families (81%) included mainly root tubers in their diet meals. Others had maize and its products (57.1%), matooke (38.1%). Their meals are majorly in proteins and vitamins as shown by comparatively fewer families (31%) consuming animal products and vegetables. The results above depict that most families don’t have a balanced diet in their nutrition. Problem statement Although the people of Nakasongola have good food security with big gardens in which is plenty of food (61.9% of the families obtain food from those gardens), the food is majorly calorific as most families (81%) consume cassava and sweet potatoes. Yet, comparatively fewer families (31%) included vegetables and animal products. This shows the unbalanced diet burden, which puts their family members, especially the infants who make up the biggest proportion of their families (54%), at a risk of malnutrition. Malnutrition in under-fives is clinically severe especially in acute form as it accounts for the greatest contribution in the high infant mortality rates (IMR) in Uganda (76 deaths per 1000 live births) and under-fives mortality shooting up to 134 deaths per 1000 live births. Intervention Sensitization of mothers and care takers of the infants between 6 months and five years of age about the importance of a balanced diet in this age group. Justification In Nakasongola Sub County, most families (81%) feed mainly on high calorific diet expressed in root tubers and cereals, with just 31% of families including vegetables and proteins in the diet. This presents an unbalanced diet, especially for children between 6 months and 5 years of age and puts them at a risk of malnutrition, yet under-fives in this region make up the biggest proportion (54%) of their householders. Malnutrition impairs immune function, and malnourished children are prone to frequent infections that are more severe and longer-lasting than those in well-nourished children and may lead to a spiral of ever-worsening nutritional status. General Objective To increase the knowledge of a balanced diet amongst the people of Buruuli, Matuugo, Kalubanga villages in Nakasongola sub county
  5. 5. Methods The sensitization project will be carried out in 3 of the villages; Kalubanga, Matuugo, and Buruuli in Nakasongola sub county, Nakasongola County, Nakasongola district. Mothers and caretakers of children 6 months to under 5 years in 3 villages of Nakasongola Sub County will be our target population. Sensitization of the mothers and care takers about the different food groups, their nutritional value and how they can be combined to make a balanced diet shall be done by laying a demonstration table containing all the different examples of foods in order of Grow, Go and Glow foods, plus iodized salt and water present as well. Evaluation . Issuing of post interventional questionnaires to household caretakers (mothers) using simple randomized sampling technique INTRODUCTION This project is going to be carried out under the COBERS program of Makerere University College of Health Sciences. COBERS stands for Community Based Education and Research Services, a program under whom the students are sent out to the community by the college. There, they are expected to identify with the lay man. They should familiarize themselves with the way of life out there, identify the different community health problems by way of a community diagnosis and then come up with feasible and sustainable solutions to these problems. A community diagnosis was done in Nakasongola sub county, Nakasongola District by the implementers of this project in April 2013 and a number of problems were identified, including an unbalanced diet for the infants. This problem is thus, the center of focus in this proposal.
  6. 6. Background Meeting the Nutrition requirements of children aged 6months to five years has become a major global challenge and as such an estimate of 55 million pre- school children globally are malnourished. [1] Malnutrition is a major global health problem, contributing to increased morbidity, mortality, impaired mental development. Causes of malnutrition include poor feeding practices, inadequate breast-feeding, early and late weaning, inadequate nutritional knowledge, diseases and cultural practices. Intake of nutrients that are inadequate in the habitual diet can be increased through use Plumpy nuts, taking BP-5 biscuits (high energy), Ready to Use Therapeutic food (RUTF), Use soya milk. [2] All children with moderate wasting, or severe stunting, have in common a higher risk of dying and the need for special nutritional support. In contrast to children suffering from life- threatening severe acute malnutrition, there is no need to feed these children with highly fortified therapeutic foods designed to replace the family diet. Their dietary management should be based on improving the existing diets by nutritional counseling and, if needed, provision of adapted food supplements providing nutrients that cannot be easily provided by local foods. Children with growth faltering would also benefit from the same approach.[3] Although poor child nutrition status is a pervasive global problem, it is mainly concentrated in a few developing countries. According to the United Nations Children’s Fund (UNICEF), 24 developing countries account for over 80 percent of the world’s 195 million children faced with stunting. Out of the 24 countries, at least 11 are from Sub Saharan Africa (SSA). Furthermore, countries in SSA have made the least progress in reducing stunting rates from 38% to 34% between 1990 and 2008 compared to a reduction of 40% to 29% for all developing countries. . Uganda is among the developing countries with the largest population of stunted children. An estimated 2.4 million children aged less than 5 years in Uganda are stunted and this place the country at the rank of 14th based on the ranking of countries with large populations of nutritionally challenged children [4]. Malnutrition is widespread in Uganda, but generally declining. The proportion of children aged below 5 years classified as stunted declined from 38% in 2006 to 33 % by 2011.Overall, the figure shows that Uganda has registered mixed progress regarding child nutritional health indicators. However, the trends suggest that Uganda might not be able to achieve 50 percent reduction in these indicators by 2015. Despite the commendable progress in reducing child stunting rates, the progress is relatively much slower than that recorded for the decline in income poverty. [4] In 2010, the nutrition status of children under five in Uganda was estimated to be 38% stunted, 16% acutely malnourished and 19% undernourished[6], and by 2011 the statistics stand at 33% for stunting,5% for wasting ,14% for underweight, vitamin A deficiency at 38%. [5] One out of every three young children in Uganda are short for their age, according to the 2011 Uganda Demographic and Health Survey (UDHS); and the incidence of poor nutritional status is highest in the relatively better off sub region of South Western Uganda[4] The current levels of malnutrition hinder Uganda’s human, social, and economic development. Although the country has made tremendous progress in economic growth and poverty reduction over the past 20 years, its progress in reducing malnutrition remains very slow. [6] Different policy guidelines on Infant and Young Child Feeding (IYCF) have been structured to strengthen nutrition in under-fives. Efforts have been directed to promotion, protection and support of optimal IYCF spear headed by the ministry of health in collaboration with its stake holders. Much
  7. 7. progress has been achieved especially in promotion of exclusive breast feeding through policy making, health education and campaigns. Despite these impressive efforts, IYCF practices are not yet optimal. The Uganda Demographic Health Survey (2006) shows that;  Timely complementary feeding from 6-9months is 80% but of these 72% of children 6-23months receive inadequate complementary feeds with foods lacking at least 2 food groups especially vegetables and proteins but excessive in calories [7]. This is in line with the community diagnosis report of Nakasongola Sub County (2013) where amongst all families sampled had high calorific diet with 81% root tubers but greatly lacking vitamins and proteins. Most of the meals were served with root tubers included in 81% of sampled families; others were included maize and its products (57.1%). These results depict that most of the families don’t have a balanced diet in their nutrition. Their meals are majorly deficient in proteins as shown by the few animal products consumed by a few families (31%). They are also deficient in vitamins indicated by the little amounts of vegetables in their meal consumed by the fewest families (10%) [8]. Major challenges in their feeding lies in a spectrum that has ignorance about essence of balanced diet and behavioral attitudes seen in the conservative nature of the locals in a way of commercializing their garden produce especially vegetables and protein-rich foods such as fish. As a result of these mal behavioral practices;  Malnutrition is prevalent with stunting rates at 38%,wasting rates at 6% and rate of underweight children at 16%  Infant mortality rate(IMR) stands at 76 deaths per 1000 live births, while the  Under five mortality rate is currently 137 deaths per 1000 live births [7]. This conservative behavior of selling off food unmasks the ignorance of the importance of well- balanced diet in this vulnerable group. It should be noted that the greatest proportion of their family members are under five (54%) and this age group report cases with increased morbidity rate [8]. Improving the nutrition of these infants can help strengthen their immunity and in turn decrease the morbidity rate. The habit of selling off such nutritious foods instead of consuming it at home therefore puts people, especially the infants, at a risk of malnutrition and its effects. Great emphasis has been put on changing the practices so as to address these nutrition problems as an intervention. However the mothers and other cares takers have not been sensitized on the values of the food that they have in their homesteads. They seem not to know which foods are the glow, the go and the grow foods. They simply feed the children so that they are not hungry, not with the purpose of attaining a balanced diet. [8] Mothers therefore need to be educated about complementary feeding. This is where the child is breast feeding but along with breast milk, other semi solid foods are given. It is started after six months of exclusive breast feeding. Breast milk contains almost all food values required by an infant, however, after six months, the quantities in the breast milk are no longer adequate and hence
  8. 8. an energy gap is created. This gap can be filled with food values that are found in the semi-solid foods that are introduced at this point so as to prevent malnutrition in the under-fives. [9]. Complementary food can be prepared from locally available cheap and affordable foodstuffs with high nutrient value. The foods should be representative of the grow, go and glow foods in appropriate quantities. The Glow foods have two categories i.e. plant products like beans, peas and ground nuts and animal products like milk, eggs, mukene, nkejje, ants and grasshoppers. The Go foods are also divided into two categories, the fresh/wet like matooke, cassava, yams, potatoes and the dry like millet flour, sorghum flour, maize flour ,rice and pumpkin. Glow foods as well are of two categories that is fruits (bananas, oranges, passion fruits, and water Mellon) and vegetables (young pumpkin, tomatoes, avocado, and nakati). Problem statement The people of Nakasongola have a good food security. They have big gardens with plenty of food in them. However the food is mainly root tubers; cassava and sweet potatoes. This unbalanced diet puts their family members especially the infants who make up the biggest proportion of their families (54%), at a risk of malnutrition. Malnutrition in under-fives is clinically severe especially in acute form as it accounts for the greatest contribution in the high infant mortality rates(IMR) in Uganda(76 deaths per 1000 live births) and under-fives mortality shooting up to 134 deaths per 1000 live births [6] in concert with respiratory and diarrheal infections. In chronic form, however it is seen to impact stuntedness (33% of the under-fives in Uganda [4], wasting and poor psychosocial development. Ignorance, attitudes and conservative nature of the Nakasongola sub county citizens about the essence of a well-balanced diet for their children under five have certainly played a pivotal role in establishing this unbalanced nature of the diet in this age group. The food is instead grown for sale since most of them are low income earners. Being near Lake Kyoga, they even have access to the proteins from the fish but they sell it off instead so as to cope with the ever increasing standards of living. Also the foods commonly grown are the root tubers. This puts the population, especially the infants at a risk of malnutrition due to unbalanced diet [8]. Despite the interventions that have been in place to promote good nutrition and discourage people from selling off their food, the practice still goes on especially due to the ever increasing costs of living. This is probably because the people don’t know the values of the nutrients in the food they are selling off. They lack the knowledge about the importance of a balanced diet and therefore need to be sensitized. Intervention Sensitization of the people of Nakasongola, especially the family heads about the dangers of selling off food. Sensitization about what should be added or reduced from diet so as to make it balanced. This will help curb the disease burden by improving the diet, nutrition and eventually the immunity. Justification In Nakasongola Sub County, most families feed mainly on high calorific diet with 81% carbohydrates expressed in root tubers with less than 10% vegetables and proteins in the diet. This presents an unbalanced diet for children between 6 months and 5 years of age and puts them at a risk of malnutrition, yet under-fives in this region make up the biggest proportion (54%) of their householders.
  9. 9. The health problems in Nakasongola include malaria, poor diet, upper respiratory tract infections and diarrheal diseases as observed in the community diagnosis in 2013. Improved nutrition increases the level of immunity causing a reduction in occurrence of these health conditions. This is also in line with the Millennium Development Goal (M.D.G) number.4 that aims at addressing the nutrition situation causing a reduction in child mortality rates especially of the under-fives. Nationally, the malnutrition challenge is acknowledged and different health policies are made to deal with it. The policy guideline 2 for integrated infant and young child feeding(IYCF) by MOH stipulates that parents should be counseled and supported to introduce adequate, safe and appropriately give complementary food at 6 months of the infants’ age while they continue breastfeeding for up to 2 years or beyond. [8] This calls for more efforts in increasing knowledge about the nutrients of the different foods and on how to balance them appropriately. OBJECTIVES General Objective  To increase the knowledge of a balanced diet amongst the people of Buruuli, Matuugo, Kalubanga villages in Nakasongola sub county. Specific objectives  To increase the knowledge of mothers and care takers about the different food groups and how they can be combined to make a balanced diet.  To increase the knowledge of mothers and care takers about the importance of complementary feeding, preparation, frequency, amount and types of feeds so as to maintain a good nutrition status for their children.  To sensitize people about the dangers of an unbalanced diet.  To improve the skill of mothers and care takers on how the locally available food is prepared and, served in order to maintain its nutrition content and value, with their full participation and involvement.  To assess post interventional knowledge and practice.
  10. 10. METHODS Project area: The project will be carried out in Nakasongola sub county, Nakasongola County, Nakasongola district. The district covers an area of 3509 sq.km. It is occupied by swamps (wetlands) and part of the Lake Kyoga. The project will be carried out in 3 of the villages in Nakasongola Sub County: Kalubanga, Matuugo, and Buruuli. Most of the occupants go for low income generating activities like peasant farming whereby they rear cattle and grow food especially root tubers, and selling food items in their local market place. Target population: Mothers and caretakers of children 6 months to under 5 years in 3 villages of Nakasongola sub county; Kalubanga, Matuugo and Buruuli. Ethical approval:  Approval will be obtained from the District Health Officer, local leadership and College of Health Sciences.  We shall also seek for consent from the people whose homes we are going. Community Entry The implementation team shall introduce themselves to the community leaders including the Local chairpersons of Matuugo, Kalubanga and Buruuli villages and request them for their permission to carry out our project in their area. Project duration The project will run for 5 weeks. Quality control The implementers have met a nutritionist, Dr. Hanifa Namusoke at Mwanamugimu Nutritional unit for a teaching about the complementary feeding. They have also had a session with her at Mwanamugimu Nutrition Unit for technical training on how to prepare and serve a balanced diet to children of complementary feeding age. Project activities:  Mothers and care takers of the target group infants in 3 villages of Matuugo, Kalubanga and Buruuli shall be mobilized for community meetings by the local leaders on two days per week in 3 different villages and on each occasion, records about their particulars such as address, contacts, will be established and kept.  Mothers and caretakers will be sensitized about the different food groups and how they can be combined to make a balanced diet.  Education of the mothers of the ten key messages for complementary feeding laid out by the ministry of health.  Demonstration of how the different foods can be combined to make a balanced diet.  Demonstrations on how the balanced diet is prepared and served in order to maintain its nutrition content and value, with their full participation and involvement. This will be done following the
  11. 11. guidelines that are provided by ministry of health in preparation of a local formula called “ekitobeero”.  Occasional radio talk shows at Buruuli FM to sensitive to teach the importance of a balanced diet to infants between 6 months and five years.  Community nutrition campaigns at least once in each of the three different villages to further sensitize the locals about the importance of a balanced diet to infants between 6 months and five years.  Distribution of fliers, demonstrative charts and calendars to homes with our target population.  Planting a demonstration garden in each of the 3 villages.  Demonstrative videos on nutrition will be used during the community gatherings to aid sensitization about a balanced diet. Implementation  Mobilization of mothers for the different community gatherings through the LC 1 chairmen and the village Health Team.  Implementation shall be done twice a week that’s Tuesday and Friday for each village including health education and demonstrations and preparation of tools and materials for implementation done mainly over the weekends.  Sensitization of the mothers and care takers about the different food groups, their nutritional value and how they can be combined to make a balanced diet. This shall be done by laying a demonstration table containing all the different examples of foods in order of Grow, Go and Glow foods, plus iodized salt and water present as well.  Different menus shall be prepared during demonstrations using the locally available foods to give different choices of different combinations so as to aid flexibility during preparation back at home. This will help the community to own and aid continuity of the program. Tools and equipment  National counseling cards for health workers  Training guidelines from the ministry of health of the republic of Uganda  Locally available foods like cassava, sweet potatoes, groundnuts, beans and greens.  Manila paper, markers and videos for demonstration.  Modem and laptop.  Evaluation questionnaire, key informant interview guides
  12. 12. Evaluation; Objective To assess the level of awareness gained about the importance of a balanced diet to children aged between 6 months and five years. Study Area 3 villages in Nakasongola sub county, Kalubanga, Buruuli, and Matuugo villages Study population A target number of 90 families of our target population (household caretakers of children aged 6 months to five years); 30 from each of the 3 villages will be assessed. Evaluation methods Both qualitative and quantitative methods to assess the impact of the project will be executed as follows; Quantitative methods will involve;  Issuing of questionnaires about nutritional knowledge specifically about a balanced diet, to household caretakers such as mothers, of households with children aged 6 months to 5 years; a pre-interventional questionnaire to establish their knowledge about nutrition and post- interventional questionnaire to determine in knowledge, if any.  During the nutrition assessment day at the health facility, we shall ask questions in line with the importance of a balanced diet in infants aged 6months to 5 years and scores will be assigned accordingly. Qualitative methods will involve;  Interviewing key informants such as the Village Heath team, LC 1 of Kalubanga, Matuugo and Buruuli, using key informant interview guides about attitudes and knowledge of the locals on the importance of a balanced diet.  Assessing of knowledge via feedback from listeners during radio talk shows about nutrition. Analysis plan and presentation of findings The data obtained from quantitative data shall be analyzed, using frequency distribution tabulations, measures of central tendency, graphs and curves by the aid of Microsoft excel. For interviews with key informants, information gathered will be transcribed through attaching a numerical value accordingly to establish significance. Feedback from the radio talk shows will be quoted to depict the attitudes and insights of citizens about the impact of the project.
  13. 13. WORK PLAN. Activity Responsibility Week one Week two Week three Week four Week five Week six Resource mobilization and training:  Collection of implementation tools.  Preparation of evaluation tools (questionnaires).  Mobilization of funds  Training at Mwanamugimu clinic. All group members Presentation of project to the district and funders for approval and financial support. All group members Acquisition of community support and approval through the LC1 chairperson and the village health support (VHT). All group members Preparation of demonstration and assessment tools and materials. All group members Pre- intervention assessment All group members and a VHT. Sensitization and demonstration  Home visits: talks and demonstration  Radio talk show Nutrition campaign  Nutrition day :at the health center (weekly) All group members and a VHT. Post- intervention evaluation All group members. Report writing All members
  14. 14. DETAILED IMPLEMENTATION PLAN MATRIX. OBJECTIVE. ACTIVITY/METHOD. NO. of days SOURCE OF INFORMATION. To increase the knowledge of mothers and care takers about the different food groups and how they can be combined to make a balanced diet. To increase the knowledge of mothers and care takers about the importance of complementary feeding, preparation, frequency, amount and types of feeds so as to maintain a good nutrition status for their children. To educate people about the dangers of an unbalanced diet. To improve the skill of mothers and care takers on how the locally available food is prepared, served and preserved in order to maintain its nutrition content and value, with their full participation and involvement. To assess post interventional knowledge and practice Sensitization: about the different food groups and how they can be combined to make a balanced diet.  A radio talk show is to be held at Buruuli FM.  Talks shall be given during home visits.  Talks also shall be held during the community nutrition campaigns (one in each village)..  Distribution of Fliers/leaflets, calendars and demonstrative charts during the community nutrition and home visits.  3 Training guidelines from the ministry of health of the republic of Uganda. Mwanamugimu nutrition unit. Demonstrations: to be done in each of the three villages.  Using demonstration gardens planted at three sites (one in each village).  Using demonstrative videos on balanced diet.  Using the National counseling cards for health workers.  Locally available foods - cassava, sweet potatoes, groundnuts, beans and greens – shall be used to demonstrate the different food groups, their nutritional value and how they can be combined to make a balanced diet. 3
  15. 15. BUDGET EXPENSE ITEMS UNIT COST(Ush) AMOUNT(Ush) JUSTIFICATION Preparation Meetings with village health team, DHO and LC1 chairperson.  Transport.  Logistics. 50,000 (mobilization per week for 3 weeks) 30,000 (logistics for the meeting per week for 3weeks) 240,000 Preparatory meetings prior to implementation with Stake holders shall be held, including motivation for the mobilizers Tools and materials for implementation and evaluation.  Demonstration charts  Demonstration videos  Questionnaires.  Certificates.  Registers  Fliers and stickers.  Markers  Pens  Masking tapes  Garden equipment, seeds and foods  Demonstration charts (30000)  Demonstration videos(20000)  Questionnaires  Fliers.200(500@)  Markers (10000)  Pens 6 (500@)  Masking tapes 2 (3000@) 172000 Required for Education and demonstration At the implementation sites. Lunch for the investigators and support staff from the community and at the health centre. 10 people (3000 @ for 6 visits) 180,000 The implementation team and the recruited members from the community shall need to be provided with lunch during the implementation process. Communication Communication costs  Airtime  Radio talk show. Airtime; 10,000 per week. Radio talk show: 50,000 80,000  For coordination  For sensitization purposes. Transportation Transport to implementation site  Radio station 100,000 per day for 6days. 600,000 A vehicle shall be hired and fuel shall be
  16. 16.  Homes  Campaign sites. needed as well. Evaluation  Data collection,  printing of questionnaires for the post- intervention evaluation process. 50 copies.(Ush400@) 20,000 Implementers shall sample homes randomly from the villages where the implementation process was done and evaluation questionnaires shall used. Personal Medical needs(first Aid Box) Feeding and accommodation . 100,000 @ 700,000 Emergency management of minor ailments during the implementation process Miscellaneous 100,000 For the sake of any added unplanned expenses TOTAL AMOUNT 2,092,000
  17. 17. PROJECT FRAME WORK Project Component. Aim/Goal. Indicator/ Outcome. Project activity. Risks, Limitations, Assumptions. Mitigation of risks. Increasing knowledge on the importance of a balanced diet to children aged 6 months to five years , in Nakasongola subcounty. To increase the knowledge and utilization of a balanced diet amongst the people of Buruuli, Matuugo, Kalubanga villages in Nakasongola sub county. Scores from the evaluation questionnaires. Observation checklist. Scores from key informant interviews. Level of turn up for the demonstrations. Radio talk show feedback. Resource mobilization and training. Acquisition of community support and approval through the LC1 chairperson and the village health support (VHT). Pre- intervention assessment Community Sensitization and demonstration activities. Post- intervention evaluation Language barrier . Adverse weather changes such as rain. Wastage of implementation tools and materials during implementation process. Recruitment of Interpreters. Identification of alternative implementation sites. Securing a reserve of implementation tools. `
  18. 18. REFERENCES 1. World Health Organization. Technical note: Supplementary foods and management of Moderate Acute Malnutrition in infants and children 6-59months of age. 2012; Pages 2-3. 2. World Health Organization. Management of Severe Malnutrition, Save the Children, US. 1999 3. The United Nations University. Food and nutrition bulletin.2009 (supplement). 4. Sara Ssewanyana, Ibrahim Kasirye. Policy Brief-Addressing the Poor Nutrition of Uganda Children. July 2012; Issue No. 19. 5. Uganda Bureau of Statistics. Uganda Demographic and Health Survey 2011 Preliminary Report . Calverton, Maryland, USA. (March 2012) ;Pages 18-21 6. Ministry Of Health. Uganda Clinical Guidelines. 4th edition, 2010; Pages 28–32. 7. Ministry Of Health .Uganda Nutrition Action Plan: Scaling Up Multi-sectorial efforts to establish a strong nutrition foundation for Uganda Development. 2011; Pages 7-15. 8. Mugalu DE, Oriba DL, Nabukalu SA et al. Community diagnosis report of Nakasongola sub county. Makerere University College of health sciences 2013. ( not published) 9. Ministry of Health. Integrated Infant and Young Child Feeding Counseling.2009. 10. COBERS report of Nyakibaale 2013 (not published). .
  19. 19. APPENDIX Questionnaire after providing Nutritional Knowledge. 1. Do you think what you were eating was a balanced diet? a. Yes b. No 2. After nutritional education do you think it will help you to improve your diet? a. Yes b. No 3. What changes you have been able to do in your diet? 4. Do you feel that now you are able to take judicious decisions related to your diet? a. Yes b. No 5. Do you consider yourselves that you know about different food and food groups and their proportion? a. Yes b. No 6. Which type of foods provides energy to our body? 7. Which type of foods builds and repairs our body tissues? 8. Which type of foods provide vitamins and minerals to protect and regulate our body function? 9. Do you feel nutritional knowledge is basic requirement for the individual? a. Yes b. No 20
  20. 20. 10. Does nutritional knowledge help in maintaining good health? a. Yes b. No 11. Do you feel you can get sufficient nutritional knowledge from TV, Radio, News Papers, Magazines, relatives & friends? a. Yes b. No . If no.  No knowledge of program timings  Do not have time to see the program / read articles.  Missed few of the episodes  They are not satisfactory 12. Do you think that imparting nutritional knowledge will help to improve nutrition and health of society? a. Yes b. No If yes, what method can be followed?  Nutritional education of adults at their working place.  Nutritional knowledge providing through TV, Radio, News papers & magazine.  Nutritional education in schools.

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