1. COMMUNITY BASED INFORMATION SYSTEMS FOR IMPROVED IYCF
FLORENCE ONI, PhD PUBLIC HEALTH (NUTRITION)
NUTRITION SPECIALIST, UNICEF NIGERIA
SECOND WORLD BREASTFEEDING CONFERENCE 11TH – 14TH DECEMBER 2016
BIRCHWOOD HOTEL, JOHANNESBURG, AFRICA.

2. Introduction
We know the importance of breastfeeding and infant and young child feeding (IYCF)
It is not easy to improve what we do not know
We know the importance of breastfeeding and infant and young child feeding (IYCF)
It is not easy to improve what we do not know
UNICEF

3. Unfortunately, we do not know the situation at the community level.

4. Community Based Information System Partway to Equity in IYCF
Data generated at community level, information on the most disadvantaged and hardest to reach.
Provide Integrated intersectoral and multidimensional information, when applied to address deprived and denied children will lead to a fair chance in life
Data collection at Community level has the potential for emergence of dynamic innovation to accelerate change through new approaches to solve developmental problems
Such data, information & innovation can be used by Governments and development partners to target programmes and opportunities to the most disadvantaged
This approach will require commitments of governments, development partners and civil societies to shape policies and programmes for solution that will enhance fair chance for appropriate IYCF for every child
UNICEF

5. Community-Based Information Systems (CBIS)
Involves data collection, management, and analysis at the community level (effective decentralization)
Engages community members
Gives voice to the most disadvantaged children and women
Provides community members with an avenue to health services, and hold them accountable, contributing to the goals of sustainability (Jeremie, 2014; Sabitu, 2004)
Shares information with and between community-based services and health facilities
Feeds into the national HMIS

6. Benefits of CBIS
Increases awareness, understanding, and capacity at community level (Bamako initiative)
Enhances knowledge of problems, assessment and application of resources for appropriate action to address problems
Mobilizes communities
Has the potential for emergence of dynamic innovation to accelerate change through new approaches to solve developmental problems
Contributes to increased retention of organizational, human and financial resources for women and children at the community level

7. Standard IYCF Outcome Indicators
Early initiation of breastfeeding
Exclusive breastfeeding
Introduction of solid, semi solid foods
Minimum meal frequency
Minimum diet diversity
Minimum acceptable diet
Continued breastfeeding at 1 and 2 years of age
Most of these are only collected during population-based surveys conducted every 3-4 years
So, here are the standard IYCF indicators.
Most of these are only collected during population-based surveys every 3-4 years.
AND they are usually not representative of the community or given to the community.
They are usually only useful at the state level.

8. C-IYCF Process Indicators
No. of community volunteers trained in C-IYCF
No. of functioning C-IYCF support groups
No. of C-IYCF support group meetings
No. of C-IYCF support group participants, by type
No. of pregnant and lactating women reached with at least one C-IYCF counselling session
No. of referrals to community volunteers / support groups
No. of referrals to health facilities by community volunteers
No. and % of community volunteers who received a monitoring or supportive supervision visit

9. Data Sources C-IYCF support group registers
Community Volunteer C-IYCF Monthly Summary Form
C-IYCF support group registers
Health management information system (HMIS) forms:
Growth monitoring /Nutrition registers
Immunization registers
Supervision tracking
BUT MIYCN often not considered during supervision

10. COMMUNITY INFORMATION BOARD
COMMUNITY INFORMATION BOARD Our Children, Our Future Name of Community: …………………………… Year: ……..… Total Population (Adult): Male: …… Female: ……. Total number of children less than one year: …… Total number of children under five years: ……….. Number of primary schools: ………….. Children (6-12 Years) Male: ……….. Female: ……….. Children (13-15 Years) Male: ……… Female: ……… Total enrolled in primary school at start of the school years Girls: ……. Boys: …… No of Community Improved water source: ……………..
S/N
INDICATORS
Jan-Mar
Apr-Jun
Jul- Sept
Oct-Dec 1
Number of children born 2
Number of children registered at birth 3
Number of children under one year who have received first dose OPV at birth 4
Number of children under five years who have received DPT3 5
Number of children not gaining weight 6
Number of Orphans 7
Number of children attending primary school segregated by sex 8
Number of households with long lasting insecticide treated nets (ITNs) 9
Number of households with latrine 10
Number of functional improved community water sources 11
Number of pregnant women attending antenatal clinic 12
Number of women who died during pregnancy or within 6 weeks of delivery 13
Number of children who died within one month of birth 14
Number of children who died before five years of age 15
Number of community dialogue sessions held 16
Number of village development association meetings held 17
Number of MIYCN support groups* 18
Number of people attending MIYCN support group meetings * 19
Number of caregivers counseled one-on-one on MIYCN*
* Indicators not yet included in the community information board

11. Data Available from HMIS (Niger State, Nigeria Data 2015)
Month
Indicators
Underweight Rate
Nutrition Treatment
CMAM program admissions
Child Defaulted from CMAM program
Children 0-59 months weig
Children below bottomline
Children Exclusively breastfed
Deworming medications
Vitamin A 12-59m
Vitamin A 6-11m
January
271.2 34
10419
240
2254
1102
1191
869
February
245.5 26
13843
270
3127
2002
1677
1375
March
238.6
232
22752
461
3543
31275
69149
32557
April
537.8 16
14389
636
3835
779
551
476
May
335.8 14
15778
450
3657
619
1526
590
June
509.1 20 1
17062
714
3437
578
776
362
July
234.1 8
14890
296
2872
940
August
369.4 11 7
21450
673
3907
5357
465
431
September
454.9 36
23698
886
4971
1239
610
539
October
412 27 3
24975
874
5324
606
471
Total
360.84
399 46
179256
5500
36927
44497
77343
37966

12. Standard IYCF Outcome Indicators
Early initiation of breastfeeding
Exclusive breastfeeding
Introduction of solid, semi solid foods
Minimum meal frequency
Minimum diet diversity
Minimum acceptable diet
Continued breastfeeding at 1 and 2 years of age .

13. National Platform (District HIS)
Routine IYCF Data Flow
Community 4
Community 5
Community6
Community 7
Community 8
Community9
Community 1
Facility A
Facility B
Facility C
Community 2
Community 3
National Platform (District HIS)
1PHC/ Ward
LGA

14. CBIS: The Nigeria Experience
Community outreach register ( Under review to make it more robust to key into DHIS platform
Revitalization of Village /Community and Facility Development Committees
Institutionalization of CIYCF SG through community volunteers
Community volunteers are linked to health facilities
Re-invention of 1 PHC per Ward
Ward level data collated at LGA level
LGA data fed to the National platform: DHIS
DHIS Platform 12 registers on the platform, 1 monthly summary

15. Challenges Lack of technical capacity of those collecting the data
Added workload of data collection and associated activities to the health workers or volunteers assignments
Addition of new responsibilities to health workers workload
Integration of CBHIS to formal HMIS

16. Way Forward
Identify and strengthen existing community systems which generate and spread information on health and nutrition for improved engagement of households and communities in making decisions and taking actions
Increase capacity for data collection analysis, understanding and deriving action and taking decisions on the immediate and underlying causes of diseases and death
Increase resources at local level for action
Revitalize village, community and facility development committees
Ensure information shared receives appropriate action
Ensure information flow to district level for resource allocation and action
Holistic integration of the IYCF data into the existing CBHIS

17. Thank you
UNICEF