Evaluation of maternal - child supplementary food programs in Haiti

480 Title II foods at maternal/child health (MCH) centers in Haiti. Special evaluation covers the period 1979-8/83 and is based on document review, a sample survey of 39 of 519 centers, and interviews with center directors and mothers. Much improvement is needed. Positively, although the number of pregnant and lactating mothers receiving food for themselves is small, mothers are generally pleased with the program; 49% of those interviewed acknowledged that the program has led to changes in their cooking habits. The PVO"s - CARE, Catholic Relief Services, Seventh Day Adventist World Service (SAWS), and Church World Service - have made considerable efforts in the past year to upgrade their training programs (SAWS built an up-to-date training facility) and their staffs possess good training abilities, but more training is still needed, especially for the roughly one-third of center directors who lack basic training in nutritional assessment and intervention. On the debit side, inappropriate selection criteria and poor monitoring have helped make it difficult to assure regular participant turnover at the centers, and in almost one-third of the centers surveyed little or no effort has been made to target food to the most nutritionally deprived. While children are for the most part weighed regularly, growth monitoring is not directly linked to participation in the program. Again, although food preparation, child care and hygiene, and oral rehydration therapy are taught at a significant number of centers (and all but three provide some form of instruction), both subject coverage and attendance by mothers vary widely and little attention is paid to growth monitoring and family planning. Supervision and control of the centers, especially in regard to programmatic components, is seriously inadequate, although there are exceptions, the most notable being the Centre Integre de Nutrition Education Communautaire, which comprises 20% of the centers. Also, overall community participation in the centers has been low because few centers offer activities such as crafts likely to attract participation; outreach has had little impact on agricultural practices; and more coordination with Government of Haiti agencies is needed.