The below resources are considered useful for regional nutrition officers (RNuOs) or district nutrition officers (DNuOs). Where available, tools are also provided in Swahili.
Overview of stunting reduction toolkit
This document provides an overview of the purpose and contents of the toolkit.
This document provides a complete list of acronyms that you'll find in the toolkit resources.
Personalised support groups for action
A number of implementing partners - including the Government, international NGOs, and CSOs - use support groups regularly. However, when done poorly, they are often simply vehicles for sharing messages. In Tanzania, support groups may fail to respond to the needs of the community and are not tailored to group members. They are often used to tell group members what they “have to do,” and don’t commit support group members to adopting healthy practices. As part of the ASTUTE project, PANITA worked with 50 CSOs to strengthen their capacity in the management of support groups. In Geita region and elsewhere, PANITA piloted the use of Personalised Support Groups for Action. This document outlines the steps to conducting personalised support groups for action—including “teach back” and commitment.
Positive Deviance/Hearth (PDH) is an assets-based strategy for improving nutrition and related behaviours. It requires community mobilisation and includes 1) identifying positive deviants (at-risk, poverty-stricken families) whose children are well-nourished 2) learning from them 3) encouraging parents of underweight children to adopt the same practices using hearth sessions, and 4) following up with families in their homes to make sure that they are able to maintain the positive deviant practices they learned about during hearth sessions. This document shares lessons learnt and recommendations for the government and others who implement PDH.
PDH for stunting reduction
These are the state-of-the-art training manuals and handouts developed by World Vision, to be used with PDH programs globally:
CHWs and home visits
This document is a job description for CHW supervisors. In initial trainings for CHWs and their supervisors, these roles and responsibilities should be spelled out first so that supervisors understand how their day-to-day activities align with their overall roles and responsibilities.
This document summarizes CHWs’ roles and responsibilities. In initial trainings for CHWs, these roles and responsibilities should be spelled out first so that CHWs understand how their day-to-day activities align with Management their overall roles and responsibilities.
This document is a checklist CHW supervisors can use to ensure that CHWs are implementing high quality home visits.
The training guides use findings from ASTUTE’s Trials of Improved Practices (TIPs). By following the steps in this guide, CHW supervisors can help CHWs discuss (step 5 of negotiation) and recommend (step 6) practices people can try to improve the nutrition of their children. These new, detailed messages on exclusive breastfeeding are based on extensive research in multiple settings within the Lake zone of Tanzania and can help CHWs help families overcome challenges such as babies crying a lot and mothers struggling to breastfeed exclusively. This training guide is on exclusive breastfeeding.
This training guide is similar to the training dialogue for exclusive breastfeeding but it focuses on complementary feeding and includes lessons on giving children a variety of foods to eat, encouraging children to eat (responsive feeding), and giving healthy snacks.
This toolkit includes a number of resources that when used properly will improve health behaviours known to positively impact maternal and child nutrition. As part of ASTUTE, Community Health Workers (CHWs) conduct home visits using a proven strategy known as negotiating for behaviour change. Details of this strategy can be found in the USAID-funded manual Make Me a Change Agent (included here for easy reference; see lesson 3 of the manual). One reason for ASTUTE’s success is a focus on small, do-able actions (SDAs). SDAs are behaviours that CHWs (and CSO volunteers) promote and that household members can easily try because the practices themselves are not complex. When considered collectively, SDAs add up to large changes in health behaviours and outcomes.
This is a USAID-funded manual for front-line health workers that provides training curricula for many SBC activities, including negotiated behaviour change. Make Me a Change Agent manuals are also available for agriculture and WASH. Lesson 3 contains information about negotiated behaviour change.
Make Me a Change Agent
Strengthening government capacity
District Nutrition Officers (DNuOs) are a key component of the Government of Tanzania’s efforts to improve nutrition. In addition to DNuOs, ASTUTE’s organisational structure also includes CHW supervisors who are able to more efficiently supervise CHWs, given their larger numbers. Under ASTUTE, DNuOs meet monthly with all CHW supervisors and in turn, CHW supervisors meet on a monthly basis with CHWs. This document contains guidance for the DNuO on what he or she should discuss with CHW supervisors during the meeting including classroom-based and community-based skills building in negotiation.
Monthly meetings are the primary means of strengthening CHW capacity in behaviour change. This document contains guidance for the CHW supervisor on what he or she should discuss with CHWs during their meetings, including classroom and community-based skills building in negotiation. The guidance includes topics that must be discussed every month as well as subjects that can be discussed less frequently.
This document describes important things a CHW supervisor should look at when conducting supportive supervision to CHWs.
Conducting supportive supervision to CHWs
This form was used in ASTUTE’s initial census and includes questions to elicit basic socio-demographic information. This information was then used to target households with pregnant women and children <2 years of age. All M&E forms include instructions and definitions of terms.
The household visit form is filled out by the CHW every time he or she conducts a home visit. The form includes space to record the major behaviours CHWs promote in a given visit, as well as visit date. This form is important because it helps CHWs keep track of which behaviours they have (and have not) negotiated with the family. In the aggregate, the form also helps programme planners and implementers understand which topics are being covered and whether some topics (e.g., WASH and gender) are not being given enough attention.
Monthly meetings are the primary means of strengthening CSO volunteer capacity in behavior change. This document contains guidance for CSO staff on what they should discuss with CSO volunteers during their meetings, including classroom and community-based skills building when implementing personalized support groups for action. The guidance includes topics that must be discussed every month as well as subjects that can be discussed less frequently.
CSOs and personalised support groups for action
This document summarizes roles and responsibilities for CSO volunteers. In initial trainings for CSO volunteers, these roles and responsibilities should be spelled out first so that volunteers understand how their day-to-day activities align with overall roles and responsibilities.
This checklist is for CSO staff and is to be used when they observe CSOs while conducting personalized support groups for action. There is a checklist for the support groups as a whole as well as checklists for nutrition, early childhood development, WASH, and the health of the mother.