Process Evaluation of Community Based Nutrition Programin Soro Woreda, Hadiya Zone, Southern NationsNationalities and People’s Region, Ethiopia

Abstract

Background: Malnutrition is continuing to be implicated in more than half (55%) of child deaths worldwide. Children and women are most vulnerable to malnutrition in developing countries because of low dietary intakes, infectious diseases, lack of appropriate care, and inequitable distribution of food within the household. In Ethiopia, national prevalence rates of stunting, underweight and wasting among children were 38%, 24% and 10%, respectively. In Soro Woreda, Weighted children under two years are 78 % in average, Normal weight children 84%, underweight children 13%, and severely underweight children 3%. However, the program status and level of implementation is not clearly indicated despites its long term implementation in soro woreda. So this process evaluation was conducted to assess implementation status of community based nutrition program in the woreda. Objective: Toevaluate the process of community based nutrition program in soro woreda Hadiya zone Southern Ethiopia. Method: Single case study design with quantitative and qualitative data collection methods was employed at selected health posts of Soro woreda from March 05- April 7, 2017.The evaluation was focused on process part of the program with dimensions; availability, compliance and caretaker satisfaction in the dimension of acceptability. Resource inventory, document review; key informant interviews and observations were conducted. Caretaker satisfaction was assessed through exit interview; with sample size of 382.The qualitative data were analyzed manually using thematic analysis and quantitative data were analyzed by using SPSS version 20 software. Bivariate and multivariate logistic regressions weredone to determine the predictor of client satisfaction.The findings were compared with preset criteria for the final judgment. Result: Out of 14 health posts studied, 92.2%had trained health extension workers oncommunity based nutrition. Around 85.7% and 71.4% of the health post were had family health card and growth chart respectively. All health posts were had guideline,Mid-upper arm circumferencetape, registration book, vitamin A, and functional weight scale, 85.7% of the required resources were available for provision of community based nutrition programand theresult wasjudged asGOOD. The result of Compliance was 83.2% which was judged to be GOOD,but many of health extension workers were not participated on performance review meeting and not supervised with in third quarter of Ethiopian fiscal year. Seventy-five point nine percent of the care takers were satisfied with service provided by the health posts GOOD in judgmental.Possessing of family health card,(AOR=2.558, 95% CI=1.134, 5.771) Counseled and Appointed(AOR=3.952, 95% CI=1.567, 9.964)and Waiting time to get community based nutrition service(AOR=2.883, 95% CI=1.406, 5.913)were predictors of care taker satisfaction. Conclusion and Recommendation: the overall implementation of community based nutrition service in health post of Soro woreda wasjudged as GOOD withagreed judgment criteria. There was inadequate supportive supervision and performance review meeting on community based nutrition program. Zonal health department, woreda health offices, health centers and development partners have to strengthen regular supportive supervision, performance review meeting and improve the program.