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B. Growth Monitoring

The number of mothers who have had their children weighed in the past four months has increased.  This may be the first step for decreasing the prevalence of stunting and wasting.  Mothers can’t be told their child is stunted or wasted unless the child’s growth is monitored frequently.   Even though there was an increase in the number of children monitored, there was also an increase in the percent of children (-1Z) who were at risk for moderate to severe wasting.  This in conjunction with only the slight decrease in diarrheal episodes is cause for alarm.   On the positive side, the percent of chronically wasted children in these REDES is less than the percent of wasted children (<5 yrs.) in the entire Region San Martín

(4.6% children in project areas compared to 14.3% in the region.)  The growth monitoring volunteers could be the key people to decrease these prevalence rates even further.  During home visits or monthly community events the volunteers should be able to counsel mothers not only on the topic of proper weight and height, but on healthy eating habits, and personal hygiene.  It should be explained to the mothers about the consequences of stunting and wasting.  One channel for these explanations could be using photographs and pictures.  Finally, the goal of reducing growth faltering from 55% to 40% has been reached.

C.  Diarrhea Case Management

Diarrhea is still a leading cause of morbidity in the project areas.  It is encouraging though, to report the prevalence of diarrhea having decreased since the midterm survey.  On the contrary to these decreases, the goal set by the DIP of reducing diarrheal episodes to 50% has not been reached.  This may be due to many things, including more time needed to change behaviors, seasonal patterns, use of latrines, clean water, and/ or parasite loads.  It is believed (but was not tested for this final survey) that the parasite loads for the children in these areas are still quite high.

Since MINSA has been collecting data on this topic, this is another area where Project HOPE can work more closely with them.  Another reason for only these slight decreases may be that the mothers do not perceive diarrhea as a problem, but as a normal part of life.  When MINSA was asked about this theory  (diarrhea is normal for a child) the Director of Children’s Health Programs, Sophia Velasquez, R.N., confirmed that this is the belief of many of the mothers.  More interventions will need to be created to change this mindset, education alone will not do it.  

The amount of “more or equal”  foods given during a diarrheal episode has decreased, and thus the goals surrounding this objective have not been met.  It should be noted though, that if you only look at the amount of “more “liquids given approximately 28% of mothers at baseline gave more liquids compared to the final results of 37%.  An additional note (as stated in the results section) is that only mothers who reported their children having diarrhea at some time or in the past 15 days answered the questions about the amounts of foods and liquids given, what medicines they used (ORS, antibiotics, etc.), and where they seek help.  Therefore, a large group of mothers were excluded from giving their answers about diarrheal

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