Dominican Medical Missions
CHILD HEALTH PROMOTION —
A COLLABORATION OF DRMP AND LIGHT A CANDLE FOUNDATION (FUNDACION ENCIENDE UNA LUZ)
Families living in the villages among the sugar cane fields of the Dominican Republic face many challenges.
The small children are especially vulnerable to the effects of poor nutrition and limited access to health care.
DRMP of Village Church collaborates with a small Dominican foundation to monitor the growth of the children and discover those dealing with malnutrition and related health issues.
The Dominican team consists of two physicians and four other trained staff members who weigh and measure the children, record and interpret data on growth charts, provide counseling, report data, and make recommendations for child health promotion to DRMP.
The families receive counseling on good practices in nutrition and prevention of illness. Many times, just changing the practices contributes to a child’s improved growth.
The children discovered with significant problems receive special interventions such as pediatric referrals, needed medications and sometimes emergency food assistance to be followed by a long term plan to empower the families to sustain good nutrition for the children.
The Health Promoters in these villages also play a role in supporting the families and serving as a health resource to them. Training is provided to the promoters to improve their capacity as health resources.
WINDOW OF OPPORTUNITY
Children under five years of age are particularly at risk for short and long term effects of inadequate nutrition.
Growth and brain development during these critical years may be impaired due to inadequate intake of nutrients. This, in turn, may impact the child’s potential for academic performance and earning potential later in life. If a child’s poor nutritional status is not corrected in these early years, the damage may be irreversible. These factors can greatly contribute to the ongoing cycle of poverty.
A curriculum of growth monitoring from the World Health Organization is utilized in this program. Correct ages are calculated and correct techniques are employed for weighing and measuring height. This data is recorded on WHO growth charts over time to observe positive or negative trends of growth for each child. Growth problems are identified using WHO growth standards. One-on-one counseling is provided for the parent(s) of each child with a growth problem. General community education is also provided to larger groups of parents during the batey visits.
IMPORTANT TOPICS FOR COUNSELING
Often growth problems can be addressed by increased understanding and implementation of good practices by the parents.
One of the most universally recognized problems in childhood nutrition is lack of diversity in the diet.
In this program, the families are counseled about the importance of a diverse daily diet, including foods from the protection group (yellow, green, orange fruits and vegetables), from the energy group (rice, potatoes, bread) and growth/strength group (eggs, milk, chicken, beans). Often a neighbor may have a chicken who lays eggs and there may be a nearby tree that yields mangos or avocados. If parents understand the essential need for these foods, it is often feasible to incorporate these foods into their child’s diet even within limited resources.
Good feeding practices such as exclusive breastfeeding for the first 6 months and patient supervision of the toddler while eating are also presented to the parents.
Emphasis on good hygiene practices is included in the counseling on topics such as the 3 critical times for hand washing, options for purifying water and safe food handling practices.
CHILDREN WITH SEVERE PROBLEMS
The Dominican team works with the village Health Promoter and the family to develop the most appropriate plan of intervention for children with severe growth problems.
Malnutrition and illness contribute to the other. A malnourished child gets sick more often. A child who is sick does not eat well. These conditions may perpetuate a child’s growth problems. Children with severe growth problems may need a referral to a pediatrician who provides a physical exam, and possible lab work and medication.
Occasionally a family will require emergency food assistance to stabilize the growth of a child. This assistance is always followed by a conversation with the family, promoter and team to explore ways that the family might be able to develop a sustainable plan to earn the income needed to provide adequate nutrition for their family.
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