Tag Archives: VHV

Meeting of the Nutrition Working Group

Posted on October 28, 2012 by | Leave a comment

This week we attended the Nutrition Working Group (NWG) meeting at the National Maternal and Child Health Center, which is hosted monthly by Cambodia’s National Nutrition Programme.

On the agenda were two presentations; one on the work of International Relief & Development (IRD) in Boribo Operational District in Kampong Chhnang Province and another is on Liger Charitable Foundation, a boarding school in Kien Svay that supports orphaned and impoverished children with education.

Since 2010, IRD has worked to address pronounced nutrition and childcare challenges in Boribo. The program uses Evidence-based Interventions for Improved Nutrition to Reinforce Infant, Child and Maternal Health (ENRICH). 

IRD’s activities in Boribo District include:

  • Hearth program – uses positive deviance or Hearth model to identify beneficial indigenous practices or behaviors by mothers and inform these messages to other communities with malnourished children. Since its implementation, Hearth has been successful in reducing the number of moderately underweight and severely underweight children by about 70% in its target communities.
  • Focus on men – following IRD’s ‘whole family’ approach, the project is employing a strategy aimed at increasing men’s involvement in key maternal and childcare issues.
  • Cooking demonstrations – with IRD’s contribution of  oil and peanuts, the VHVs and mothers organize nutrition rehabilitation sessions for malnourished children. During the sessions, they share knowledge and experience on child feeding and demonstrate how a nutritious meal (Bobor Krup Kreung) is cooked.

Liger Charitable Foundation – still in its early stages, Liger is working towards its objective of improving child health by integrating nutrient and health education into its various projects, including a school garden and sanitation/irrigation system. Through careful growth monitoring, Liger believes that children can make a difference in their country’s future and are the best agents of change in their own communities.

To find out more about the activities of IRD and Liger Charitable Foundation, you can follow the links below:

IRD: http://www.ird.org/en/our-work/programs/child-survival

Liger: http://www.theligerfoundation.org/

One of the most important roles of NWG is to establish and strengthen linkages, collaboration and communication between the various sectors working in nutrition and food security. I find this coordinated approach of dissemination of nutrition information among the partners to be an efficient use of resources that has high potentials for the development of intervention programs and national nutrition policies.

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Blood Analysis: Part 1

Posted on August 17, 2012 by | Comments Off on Blood Analysis: Part 1

 As promised, I wrote about the “5Ws” of our blood collection: who, what, when, where, and why. I even threw in the “how”. Today’s post focuses on what happened in the field.

One of the most important (and expensive!) components of FoF is the blood collection and subsequent analysis. This process provides us with concrete evidence that there are more (or less) nutrients in a person’s body by looking at biochemical indicators of nutritional status. Obtaining this information is what sets FoF apart from previous homestead food production interventions.

During baseline blood was collected from 450 women. We will collect samples from the same 450 women during endline for a paired analysis. While we considered collecting blood from children as well, it was decided this would be too traumatic. Plus, we had other less-invasive methods available to assess whether or not children were anemic (finger-pricking to measure hemoglobin).

When we arrived in each village, a random lottery was held. Each house was assigned a number (1-10) and slips of paper with those numbers were randomly selected. In the end, we selected 5 women from each village. Women were given an ID number and asked to report to their local Health Center the day after our visit to their village.

The morning of collection, the local Village Health Volunteer (VHV) came with the women and their children to the Health Center. The VHV was responsible for making sure everyone who agreed to provide samples was present. Most mornings everyone was at the Health Center by 7:30 am, as they had to fast for a minimum of 3 hours before providing samples. When all the women assembled, they were briefed by Mr. Tee from HKI.

One at a time, the women entered a room where a technician was working. The technician drew 3 vials of blood. After, the women were given a sarong as a thank you for their participation.

Two of the vials collected were 4.5 mL test tubes containing Ethylenediaminetetraacetic acid(EDTA), which is an anticoagulant, that prevents blood from clotting. They were then packed on ice and transported via a car we dubbed the “Blood Taxi” to the National Institute of Public Health Laboratories (NIPHL) in Phnom Penh for further processing.

The third tube collected was a 7 mL trace element free tube. It was centrifuged in the field. This separated the blood into 3 components: the serum plasma, the buffy coat (most of the white blood cells and platelets), and the erythrocytes (red blood cells). The serum was packed on ice and sent to the NIPHL, where samples were stored at -70 degrees Celcius until the end of baseline.

Some pictures:

Check back tomorrow to find out what happened once the blood arrived at the NIPHL.

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Baseline: Day 14 (VMF)

Posted on July 17, 2012 by | Leave a comment

This afternoon our anthropometry and hemoglobin analysis stations were set up at the home of a Village Model Farm (VMF). I was really excited because I hadn’t seen a VMF yet, AND because our VMF concept just received press as of yesterday! (Click here to read an article about FoF in the New Agriculturalist) I had the chance to speak with the VMF representative in the village of Svay Trai, and thought I would share what I learned on the blog.

The backstory: Sophal Eab used to be a wedding stylist, but when her children were old enough to attend school, she needed a job that required less travel. When the opportunity to have the VMF in her village arose, she took it. Until her farm is up and running, she sells corn for income. She purchases 500 ears of corn for $40 USD from her local market (160,000 Riel at 320 Riel/ear). She then boils all of the corn and sells it from a stand in front of her house for 500 Riel per ear (sometimes she has to sell it for less if it’s not good quality corn). Taking the cost of fuel into account, she makes roughly 100 Riel per ear, leaving her with a profit margin of anywhere from  50,000 Riel ($12.5 USD) per day to 100,000 Riel ($25 USD) per day depending on the quality of the corn available at the market.

Sophal's corn stand.

A happy customer!

Making the most of leftovers.

Sophal has already impressed FoF with her dedication. Within one month she has raised the height of the land on her property to better support the beds needed to grow fruit and vegetables. She purchased wire and sourced local bamboo to make a fence to keep animals off of her farm. She also bought mango seeds so she could start growing mangoes. Luckily, she already had a fishpond, but she is considering expanding it. FoF will provide her with other seeds for her farm and fingerlings (small fish) for her pond. For now, all she knows is that she has to grow a variety of fruit and vegetables and follow the guidelines given to her by HKI and FoF, but she is looking forward to her training. She hopes to grow enough of her own corn so that she can increase the profit margin of her corn stand by not having to purchase corn from the market.

The back of Sophal's farm.

Facing Sophal's house from the back of the farm.

The fishpond that was already at Sophal's house.

The new fence is working out quite well!

The VMF will play a very important role in FoF. Each village will have a VMF, and the VMFs in the aquaculture villages will also have a fishpond. The VMF representative will be a woman who receives training and inputs as part of our intervention. She will learn about homestead food production (HFP), aquaculture, and sustainable agricultural practices. There will be a marketing component to her training that will include information on how to plan the planting and harvesting of crops according to the seasons (of which there are 2 here – wet and dry), how to price crops, how to pick a good market to sell her produce, and how to form a marketing group to share information with VMF representatives from other villages. For instance, the marketing group may discourage women from growing morning glory (a common leafy green vegetable here) because it can be grown anywhere and with little input, so it doesn’t fetch a good price at the market. There will also be gender-specific training, as one of our goals is to empower women by improving both their health and their opportunities for income. The VMF representative will teach the FoF households in her village how to use their new farms and fishponds. Her knowledge will be e a local resource for other households in the village. She will be monitored every 4 months by FoF to see how her farm, her fishpond, and her “students” (the other FoF households in her village) are doing.

There is also a nutrition education component of our project that is being carried out by Village Health Volunteers (VHVs). The details, however, are another story for another day.

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