The Essential Nutrition Actions (ENA) framework aims to integrate and expand existing nutrition programs in a coordinated way. It pulls together vertical programs like child health, immunization, and maternal health to deliver nutrition interventions through multiple levels, contacts, and channels without introducing new programs. The ENA framework provides training to health workers and service providers on promoting adequate nutrition and feeding practices. It extends nutrition coverage within and outside the health sector through community groups, schools, media, and other partners to support optimal breastfeeding, micronutrient supplementation, and women's nutrition. The goal is to have a unified vision and coordinated implementation of nutrition actions at large scale.

1. Implementing the Essential Nutrition Actions framework

3. Essential Nutrition Actions extends nutrition coverage within the health sector… Child Health Nutrition programs Newborn health EPI Community IMNCI/CCM Health facilities IMNCI CMAM Reproductive Health Lactation Amenorrhea Method with Family Planning Maternal Health Infectious Diseases Control of Malaria (Insecticide Treated Nets & Treatment) Tuberculosis HIV/AIDS (PMTCT)

4. DELIVERY: safe delivery, FP, STI prevention, Optimal delivery, VCT, ARVs , Infant Feeding Options, vitamin A, iron/folic acid, diet PREGNANCY : TT, antenatal visits, FP, STI prevention, safe delivery, VCT, Infant Feeding Options, Safe Sex, danger signs, iodized salt, iron/folic acid, de-worming, anti-malarial, diet POSTNATAL AND FAMILY PLANNING: FP, STI prevention, child’s vaccination, VCT, Safe sex, Support IF options, diet, iron/folic acid WELL CHILD AND GMP: check and complete vaccination, VCT, Safe Sex, monitor growth, assess and counsel on infant feeding, iodized salt SICK CHILD: assess and treat per IMCI /immunization/ VCT, Support IF options, counsel on infant feeding, assess and treat for anemia, check and complete vitamin A, de-worming,SAM IMMUNIZATION: vaccinations, FP, and STI referral, VCT, Safe Sex, Support IF options, vitamin A, de-worming, assess and treat infant’s anemia Critical health contacts for infant feeding, micronutrients & women’s nutrition

5. Essential Nutrition Actions extends nutrition coverage at community level … Community Nutrition - Community based nutrition - Community volunteers - Support groups - Positive deviance Micro-credit - Women’s farmers clubs - Credit for Education Existing Community Groups - Mayors & Chiefs - Community Development - Women’s associations - Youth Life Cycle & Continuum of Care Families - Mother - Father - Grand mother - Siblings DELIVERY PREGNANCY IMMUNIZATION POSTNATAL & FP GMP SICK CHILD

7. Food Production Homestead food production Women’s Marketing Groups Agricultural Extension Food Security Income Generation Conditional Cash Transfer Social Safety Net programs Water and Sanitation Hygiene activities Essential Nutrition Actions extends nutrition coverage outside the health sector… Women in Development

8. Essential Nutrition Actions extends nutrition coverage outside the health sector… Schools Children & Adolescent (girls) diet De-worming Iron supplementation Mass media TV Radio Local broadcasting New Technology Pre-service Education Doctors, Nurses, Midwives, Agriculture school Teacher training colleges

9. Tigger and the Art of Chaos Many different potential partners doing many different things in their own corners of the country Lack of synergy, cohesion and harmonization No unified vision of nutrition

10. Small Group Work #2 - Discuss question below (10 minutes) - Report back (2 minutes) Question: As a NGO Country Director, what are three key steps you would take to implement the ENA framework at large scale?

11. The preceding slides were presented at the CORE Group 2010 Fall Meeting Washington, DC To see similar presentations, please visit: www.coregroup.org/resources/meetingreports