We aimed to improve the health of mothers and children in 12 villages near the LXML mine in Vilabouly district by providing better care during the antenatal, natal and postnatal periods, improving the nutrition of young children, and increasing the capacity of district health personnel to plan and manage health programs.

The project started in August 2008 following a baseline survey to document the existing health of mothers and children and to determine the priorities of the project.

Both the baseline assessment and the evaluation (Dec 2011) consisted of a quantitative survey and qualitative studies (focus group discussions (FGDs), key informant interviews, and observation).

Project elements

Local health system strengthening through activities to:

• improve the capacity of the project working team to develop work plans, deliver health interventions, and manage budgets
• increase the knowledge and skills of health personnel to manage common childhood illnesses
• improve outreach activities and strengthen local referral systems.

Special focus on Nutrition included:

• volunteer community nutrition teams established to monitor child nutrition and promote healthy diets and healthy infant feeding practices
• outreach activities provided regular formal assessment of child growth
• ready-to-use foods were distributed to moderately and severely malnourished children.

Outreach activities aimed to:

• improve access to antenatal and postnatal care
• promote family planning
• increase immunisation coverage of children.
• teach mothers how to manage children with diarrhoea in the home
• distribute insecticide treated bed net to households

Timeline

August 2008 - December 2011.

Results

Antenatal care

• More pregnant women could access antenatal care: 88% had at least 1 visit by a skilled health professional up from 69%; 53% had 4 or more visits up from 32%.
• More pregnant women received supplements: 86% received iron tablets compared with 55% in 2008; 79% received Vitamin B1 compared with 0%.
• More newborns are protected from tetanus: 79% of women were immune to tetanus compared with just 38% in 2008.

Care during childbirth

• More women delivered at the district hospital: 52% had a baby at the hospital up from 38%.
• Fewer women gave birth at home: 39% compared with 53%.
• More deliveries were attended by a trained health professional: 62% compared with 52% in 2008.

Feeding behaviours and child nutrition

• More new mothers feed their child soon after birth: 72% breastfed within two hours of delivery compared with 40% in 2008.
• Fewer women throw the colostrum away: 92% fed their baby colostrum, up from 69%.
• Fewer women feed their baby solids before 6 months: 41% down from 87% in 2008.
• Far fewer children suffer from acute malnutrition: 12.4% of children were malnourished in 2008 compared with just 5.3% in 2011

Child immunisations

• More children have an immunisation care: improving from 30% to 51%.
• More children received birth doses of BCG and hepatitis B: coverage of BCG vaccine went from 62% to 83%, and hepatitis B from 24% to 64%.
• More children are protected against measles: from 31% in 2008 to 87% in 2011.

Outcomes

• Improved care of women and children during the antenatal, natal and postnatal periods.
• Increased capacity of District health staff to plan and manage primary care services for women and children.
• Improved nutritional status of infants and children in Vilabouly District.