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.