Philani Outreach/IMCI Programme

In 2000, The Philani Outreach programme and The Department of Health's Integrated Management of Childhood Illness (IMCI) launched the Child Health and Nutrition Outreach Programme. The programme, utilizing the “Hearth Model”, which is a community based approach to reducing malnutrition and other health issues affecting children.  The programme identifies children as being at risk of drug use, malnutrition, and physical abuse, and teaches mothers good caring practices based on coping mechanisms available in the community.  Support is also provided for women to develop self-reliance and a strong belief in their own abilities to raise healthy children.  The programme operates in the areas of Crossroads, Khayelitsha and Brown's Farm in Cape Town.

Initial funding for the Outreach Programme was provided by the Western Cape Provincial Department of Health (DoH), through its Poverty Alleviation Programme, while private sector and international donors provided funding for the extension of the project during the second and third years.  In 2003, due to the success of the project, the DoH asked Philani to administer the community Integrated Management of Childhood Illnesses (IMCI) project in Khayelitsha, and in 2004 was asked to take over the full management of the programme.

The goal of the programme has been to take childrens' health and nutrition concerns beyond clinics and into homes through the use of community volunteers.  During the past three years the project, together with the participating communities, have selected and trained 65 outreach workers. These workers operate in 9 informal settlements outside of Cape Town.  Outreach workers are trained how to handle rejection and anger, how to build trust, what strategies are effective in families where children are neglected and abused, and how to approach substance abuse and deal with its affects on children. Once the initial training has been completed, participants are able to physically monitor the growth of the child, have basic health knowledge and knowledge of community resources and referral channels in order to overcome obstacles in applying for child and disability grants.  Intervention takes place in the home, and is carried out by volunteers, so there are no institutions or handouts required for the service; therefore, it provides a less costly alternative to clinic based child care for health and nutrition rehabilitation programmes.    

From early 2003 to the end of 2004, approximately 2000 malnourished children have been inducted into the project.  Weekly or bi-weekly visits by the outreach volunteer to participants homes are conducted to educate parents, specifically mothers, on proper nutrition, and support positive changes at home regarding the quality of care children receive.  These visits include: ensuring the child's immunizations are current, screening for tuberculoses, children are receiving vitamin A supplements, and that children are monitored for proper growth.  Also, any HIV/AIDS positive members of the household in need of Antiretroviral Treatment are referred to community health centers for treatment, and later followed up and supported at home.

Ongoing research into the effectiveness of the Outreach Programme concerning the health, development and general wellbeing of the participants showed an improvement in all areas.  In addition, 62% of the children, under the age of 6, in the intervention programme have improved as measured by weight gain from a supplementary and therapeutic feeding programme.    

Innovation

The provision of health and nutritional education for children is taken directly into homes, without the use of traditional roles played by clinics, through community engagement with outreach volunteers.  Effective supporting mechanisms already present in communities are strengthened and utilized with support from 65 outreach volunteer participants. Much of the programme is based on adult learning practices as it trains and motivates women to rehabilitate their own children at home.

Effectiveness

2000 malnourished children have been included in the outreach intervention programme from 2003 to 2004 and 62% of those children have improved their weight in the programme.  Hundreds of children have been fully rehabilitated and discharged. 

Poverty Impact

This project targets those most in need through educating mothers and caregivers on proper nutrition and healthcare for children. 

Sustainability

With 70% of the funding coming from the Western Cape Provincial DoH, the remaining balance was sourced from the World Childhood Foundation. Funding has been secured for the next three years.

Replication

The model used can be easily replicated nationally as a cost effective child nutrition and health intervention programme.

Partnerships

• City of Cape Town (Funding)
• Provincial Administration of the Western Cape (Funding)
• World Childhood Foundation (Funding)