(0060' tf-' - (j) Pt>- RR6--n/-CI UNCL CCiilI FICAt ION PROJECT EVALUATION SUMMARY (PES) - PART I "-,Symbol u..47 1. '''OJlcr TITI..I 2. ' ..OJICT NU .... E .. /3. MI&aION/AIOIW OFFICE 608-0123/0141 USAID/MOROCCO (CRS) - OPG NUTRITION EDUCATION i4. iiiAL,UATlON NU~.E"" (Ent.. ttl. num_ rneiflU!l"!d by ttl. ~ ... unit Lao. Country or AIOIW Admln'-atlv. Code, , ... Y_. S.. 1eJ No. bellnnl,. with Na. 1 .en FY) 1 13 l'lIEOUI.,A" EVAI..UATION o S,eCIAI.. EVAI..UATION 5. KEY .. FlOJECT IM'UM&NTATION OATES II. ESTIMATED 'FlOJIICT 7. "ERIOO COVERED 8Y E"A~~~TION FUNDINO From (monthlyr.) _ May, 1 A. '1 ... a. '1- c. FINI 1,500,000 " .. o-AO or Obl",aon Input A. Total To (moml'l/yr.) 6ecem6er, 1979 ECll''''elem E.~ O""':gv • I'Y-1.L ,!,y_7_ B. U.s. {t~JIQQQ FY12. • ,~=,: .. v .. u.lon March 16, 1979 II. ACTION DECISIO .... A ..FlOVID 8Y MUION 01'1 AIDIW OFPICi DIRECTOR B. Noll ... E OF A. I..In _1aIone WtdlOJr unNeOi...a '-: c'" .-dine RUdy. a.-'- fum- OFFICER C. DATE ACTION (NOTE: ...... ,on _laona which enttcl_ AID,...." 0Jr .-.1-- offloe IIG'don ahould TO SE RESPONSI81..E COMPUTED _tty tYpe of dOCurnem, Lg." _rgrwn. S'AR. Plo.whlch wlllll_t ....Ied _ ....) FOR ACTION
1. The "Final Report and Evaluation" of CRS (attached) I marks the termination of this project. There are no unresolved issues.
2. CRS and USAID believe a follow-up evaluation should be carried out in late 1979. (Recommended to AID/W per Rabat 7337, Nov. 24, 1978, attached).
9. INVENTORY OP DOCUMENTs TO 8E REVISED PER ABOVE OECISIONS 10. AI..TERNATIVE DECISIONS ON FUTURE OF PROJECT ImplemenuRlon Plan o Prol"ct Pa!)er O Le.. CPI NetWOrk DOt,*, (Specify) A. 0 Comlnu. Project Wlthuut C:-'ange o F'nencl.1 Plan o PIOIT B. 0 Chang. Project O ..",n and/or Change Implementation Plan o Logical F run_ari< D PIOIC o Othar (Specify) o Olacomlnu. Project o Project A"r..nent o PIOIP 11. PROJECT OFFICER AND HOST COUNTRY OR OTHE RANKING PAFlTICIPANTS '- ? APPROPRIATE (N.mea and Tltl.) ~ Sue Gibson, Project Manager_~~~ ______
Alfred W. Ford, Evaluation Date March " • 1979
AID 133~1!1 (3-78) " •. ~- I, I";-"'. t.; -cn'C'O"'Pf','"~ " .. ';: ...... --7337:' . . ,r''':··-·,~·-· +_ .. - ~.- - :- - ~ "-I~f~\ /1, A.A-' _?414-"" ....:-'78· •.• ., ..,., •• ,... • .- --!, ..,.. _.', " l 4 .,: ; J ~ ~ .... n-., • . f j'#: : '.': .'-, .' • ~.. I r~ • '.2 ~ .\ ~ 4 ' .. I . T t' ," • .I '. .' . J '~ ,'. , ':U ' I ~ 1;1 --,:j .; - ".'1 ~ ," r:J I f.1.-, ., ... ~-..) ~.I~r.·,.J :'-I.,;--~:..)~ .. -- ! ..... , . .'.:-:- __... /. ".. :1 ~.~.-:" ',""l''; -...&. . __ .• ;, f t , .<1 'C·'':.JaJItI •• , • -,,, .. _ _ -'v 'l1"iJ'
1''''10 1.& ·------~/...... I:·.':Q•. , . . 1 ~~ASSY itM.A'r macwsu .' I --______~~--~--~~~~~~~
.. ' E.&F t'lss;:;' tl' MIA ~AG~;
0 oJOS~123/0141 SUBJECT; CllS tiutrition t\ducaUon . '. I "'-- Grot .\l&dmSA~ .. l1:S~ -"'CTII"'N: I Secetatc '.lASliDC HN-2. I UNCLAS U&Al. 7337 ceg O(,:1 AI.D.\C C~~~'\l i . K tr 1 ., . as/boat !!d"i Q~a and of ~t'Oj ect :;;oaport which· j I I AIl)
OaRGE ECON ~ "'"~tant Agr~ent Att~r.~nt j p,S. JAO I PI caRON I 2. project 1n cUd or late 191'~ 11 ctmlJ 0'':'IJ'J:i.de useful 5 cis ! I additional d,Ji.:a on 1m?ace on CCH in~UtutiQr.8. I I ! I f I ! 3.
...... ,...-' CRS/llabat: :CS:lnborn (iulili) PIlDG:.\WL"ord Q...... V~ A/DII..;mriff-;"l i ' I. <_
OI"TION.U. lIo:IRM 1!! (It arn-r.. I't,.& T onlftu ... n' 08ll1.oi CATHOLIC RE~IEF SERVICES USCC MOROCCO
NUTRITION EDUCATION PROGRAM A.IDiNESA.·G·1169 (po ~ o/1/o0u;~o I
FINAL REPORT AND EVALUATION
of NUTRITION EDUCATION PROJECT CRS/MOROCCO
GRANT NUMBER: AID/NESA-G-1169 TlIlLE OF CONTENTS
FRONTISPIECE - MAP OF MOROCCO
I. INTRODUCTION 1
II. prRPOS~ OF THE GRANT 1
III. PROJECT PERSONNEL 2
IV. SPECIFIC OBJECTIVES 3
V. PREPARATORY "i,'ORlf 4
VI. PROJECT ACTIVITIES 4 1. Training of Personnel 4 2. Curriculum Development and Lesson Plans 8 3. Nutrition Education for Mothers 10 4. weight Surveillance of Children 11 5. Field Supervision 11
VII. EVALUATION OF PROGRAM 11
VIII. PROJECT COM1mDITI~S 18 IX. ADDITIONAL ACTIVITIES 19
X. ~DDITIONAL RESULTS 23
XI. FINANCIAL REPORT 26
XII. FINANCIAL SUPPORT 2T
XIII. PLANS FOR THi FUTURE 30
XIV ACKNOhLEDG1!:MENTS 32 ~ P P E ~ D ICE S
1. Implementation Schedule
2. List of Pr~vinciel Directresses
3. Summaries of theses presented by Long-term Trainees
4. NW!lber of Monitrices fro!!l various Provinces having attended Seminars for _tudies of 1st and 2nd Cycles ~f Lesson Plans for Mothers' Classes
5. Lesson Plans for Mothers' Classes a) First Cycl8 b) Second Cycle c) Third Cycle
6. Attandance of Mothers and Children at Selected Social Education Centers
7. Visits byeRS Field Ins~ectors
8. Baseline Survey a) Baseline Centers in the Sevan Economic Regions of Mor:)cco b) Preliminary Survey c) Responses to Baseline Survey '~uestionnaire d) Baseline and Final Survey Results
9. Sur1ey of Dietary Practices
10. Inventory of Property Procured with Outside Funding o Province 'longer ~t~touan (14, (12) ~ School of Nutrition Social Education C~nters ( ) • . ~Al Hoce~_~_ / .. , Chaduen • N.>.dor \ ~ ~ (5) (6) 0 >oj lie OUJda• o (1') ~ • Taza (6) g (10 ) n o
,Fea (13) (5) • Khemissat • Meknaa (ll)
• Set tat (5) • Boulmnne (4) .40 Khouribga (7 ) ~ Khenifr3 (6)
Safi "Beni-Mellal (9) ( 5) • Errachidia (14) •
Essnouira ~Marrakech(19) (4)
• Ouarznzate (13)
.i>gndir (9)
• Tizn1t ( 4) S A H A R A Tarfaya (:~) FINAL REPOR'!' AND EVALUATION OF NUTRITION EDUCATION PROJECT
CRSCJOROCCO - GRANT NUMBER:AID/NESA-G-1169
I. INTRODUCTION
The office of Catholic Relief Services-United States C~tholic Conference (CRS) in Morocco in collaboration with the ENTRAIDE NATIONALE (EN), now Ministry of Social Affairs, in 1972 began to organize a nutrition education program directed to mothers with children of preschool age.
To be able to further expand this effort CRS/Morocco in January 1975 prepared a project proposal for a three year nutrition education project for submission to the United States Agency for International Development, ·Nashington D.C. (AID).
rhe Agency for International Development (AID) on May 30,1975 granted to Catholic Relief Services-USCC (CRS) the sum of Two Hundred Eighty Two Thousand Dollars ($282,000) to provide
support to a program to conduct nutrition ~ducation in Morocco for the period April 1,1975 to December 12,1977.
An amendment to che above grant of September 29,1976 provided additional funds in the amount of One Hundred Seventy One Thousand Dollars (3171,000) and the project was extended to .August 31,1978.
A second amendment of .August 31,1978 further extended the
project to Novem~er 30,1978.
II.PURPOSE OF THE GRANT
In accordance ~th the Grant document, the purpose of the Grant was to establish in Morocco a basic nutrition education program in 250 ENTRAIDE NATIONALE (EN), now Ministry of Social Affairs, Social Education Centers, that would reach 125,000 mothers.
To achieve this aim CRS was to recruit Project staff and arrange for training of four Moroccan nationals at the Institute of Uutrition in Tunis (NINT), enabling them to continue the program upun termination of the AID/CRS supported Project. 2
III. PROJECT PERSO~~L
The pr~paratory work for the Nutrition Education Project was undertaken by CRS Assistant Director in Morocco, Mrs. Conchita Sanborn, Who also served as Director of CRS sponsored Mother/ Child programs, throughout the Project period.
Mrs. Sanborn's close contact with the Ministry of Social Affairs and with the office of USAID in Morocco, her concern for and supervision of the Moroccan trainees while in training at the NINT and later ulofJn their return to Morocco and her constant efforts on behalf of the nutrition program has ensured its continuity in spite of changes in personnel during the life of the Project.
The following personnel have been attached to the Project:
Technical Staff: Name Position !'1:Q! . To Carol Pass Nutritionist February 15 December 15 Sandra Copple :-:rutri tionist September 14 November 15 Ds-ly Belgasmi :-:rutritionis~-Arabic August 1915 August 1918 speaking Samia 3elgllsmi Nutritionist-Arabic August 1915 August 1918 speaking
Ghi ta ~ylaj bar Home Economist January 16 August 1918 _-irabic speaking Mohamed Mansour :-:rutritionist-Arabic February 76 March 1911 speaking ~ Mary Brennan Nutritionist/Project April 1976 August 1918 M.S. Nutri~ion Supervisor
Ahmed Ben Mansour Food Technologist March 1917 August 191~ Arabic speaking Administrative Staff: Gilberte Hrdlicka Administrative May 1915 November 18 Assistant Najia Ben Bella Secretary April 1915 November 18 Rabea Ouldtalbarkia Arabic/Translator July 1915 February 18 Typist Ahmed Mehdaoui Dri"ler January 16 November 18 Peace Corps Volunteers:
The following volunteers helped in the administration of the program, the 1avelopment of audio-visual aids and the gathering and analysis of baseline data:
Angie Pace Rebecca 3rooks
Richa~d Bogutski Richard Laffin
The conscientious ~ork of the personnel attached to the Project has contributed to its success.
IV. SP~CIFIC OBJECTI'ffiS OF THE PROGRAM
The specific objectives of the Grant supported program were:
1. to provide short-term training at NINT for 25 Provincial Monitrices, one EN Regional Delegate and two CRS local Assistants;
2. to provide long-term training of four Moroccan Nationals at a three-year Nutrition degree program at NINT, who upon
graduation should return to ~orocco as nutrition teachers at the EN School of Nutrition at Marrakech;
3. to organize in-service training seminars for 500 Center
Monitrices, ~orking in 250 Social Education Centers;
4. to establish a basic nutri.ion education program in the 250 Social Education Centers, reaching 125,000 mothers with children of preschool age;
5. to develop and refine nutrition seminar curriculum and basic nutrition education lesson plans for Mothers' Classes at the EN Social Education Centers;
6. to reduce the incidence of malnutrition, so that the greater percentage of 250,000 ctildren beneficiaries of food supplementation are within accepted weightnorms for LDC:s. 4 v. PREPARATORY 'N0l~
A considerable amount of preparatory ~ork had been undertaken by CRS/Morocco befcre the ~ID grant was received.
The drafting 0:' a baeeline questionnaire was begun in November 1974.
A preliminary survey of socio economic conditions and of dietary practices was undertcken in March and April 1975. The results served to prepE.re the nutrition education program plan and to develop a more extenEive survey.
To this should be adced the gradual introduction of nutrition related activi-;ies at a number of EN Social Education Centers
during 1972 - ~974.
~he close work:.ng relations established with the Moroccan
Government dur~ng thtse years helped to prepare the way for the Government s reqt',est for assistence '/lith a Nutrition Education Proj'!ct, tr at ?lould reach into all the Provinces of Morocco.
Th~ Government ?las plepared to provide financial support to the program, and b'tdgetary allocations were provided at the initiation of ~he rlID/CRS sponsored Project. rr •PROJECT ACTIVrIES
The implementa~ion schedule prepared for the Project Activities
?las followed w~th necessary adjustments as the ~ork progressed. Appendix 1.
The main proje~t act~vities included:
1. Training Of Personnel (1) Short-t3rm trrining of Provincial Monitrices
During the sp:"ing of 1975 seminars ?lere held in 23
Provinc3s to ~ntroduce new aspects of the Center activities, adminiscrativ., procedures and a revised administration guide, lnd to select candidates for the posts as Provincial MOllitrices. 5
A national contest ~es held ~nd an exmination "given in Rabat 1n June 1915, under the supervision of representa tives of the Ministries of 50ci&1 Affair8 and Education and of CRS to select candidates for further training at NINT. A prerequisite for admission to the NINT course was education up to the Baccalaureate level.
A one-week seminar was held in Rabat before the success ful candidates left for Tunis for enrollment in a 2i months course at the National Institute of"Nut~ition, Tunis.
Twenty six Provincial Monitrices attended the Course.
The main subjects of their study program included:
- the nutritional needs of different age groups; - food hygiene;
- childhood dise~ses; - teaching methods nnd - survey techniques.
Upon their graduation the pnrticipants returned to Morocco to take up positions as Provincial Directresses of the nutrition educnti~n progr~m at the EN Social Education Centers in their respective PrOVinces, as from January 1916. to our regret one of the graduates died. She was replaced at an early stage of the program.
Seven of the graduates resigned from their posts, four of them have been replaced, at the time of writing. Appendix 2.
In addition to the training received a:~ UDJT, the .. Provincial Directresses had an opportunity to continue their training at three yearly seminars held at the
School of Nutrition ~t Marrakech. These seminars
provided them ~ith information relevant to their work, up-dating their knowledge of nutrition and offered them 6 opport"..Ulit1es to Hscuss matters concerning administration and prJbl.:ms encountererl in their "lork.
The Provincial Directresses assisted the teach~rs and
con~uc~ed study gessions during these seminars for monitrines.
~2) Long-tar= training at NINT
Four Moroccan nati~nals with one or two years of previous studies at the Medical School in Rabat, were selected to • st~dy Nutrition at a thr~e year course at the National " Institute of Nutrition in Tunis (YINT). This course leads
to a diploma of "~achnoloGie Superieur".
The curricu:'UI!l includes the following subjacts, for: First year - physiology - bioche!;istry - food requirements and normal diets - nutritional value of foods - food. hygiene - nutrition ~nd agriculture - food economics and statistics - ~sychosociology of food consum~tion - food prepRr~tion and - home science Second 'rear - metabolic iisor1ers - therapeutic diets - pediatric diets - food preparGtion - toxicology - foed legis12ti~n - nutrition ~duc]tion Third year short seminars on a number of subjects - work as a dietitian in the Institute's Clinic - final exam.
~ae stUdents choose the following for their theses: - Tea Drinking Practices, by Fctima Balaouchi - foeaning Fractices, by Nc.i iba Beld iel ti - NurSing Practices, by Abnelialil Cherkaoui - Feeding Young Children and Social Cultural Factors, by Amina KaI!lri.
Summaries of these theSe,S are found in Appendix 3. 7
Kiss Amine Kamr~ ~ho f3iled her final exam in June 1978, passed the final QXdOination in Septe~ber 1978.
In addition to :ieir studi~s in Tunis the students were
working together ~ith the teachers at the Marrakech School
and in th~ fi~ld during their summer holidays in 1916 and 1911. Durine the sunmer of 1918 they drew up their
own schedule of ~ork and of lesson plans, in preparation
for their ~ork as staff nutritionists at the School of
Nutrition in Mar~akech.
All the four graduates of the NINT have now returned to Morocco and re)laced the earlier project teaching staff.
One of the graduates will be assigned as Nutritionist in the Ministry of dociel Affairs to coordinate with the
nutrition progr~ms of other Ministries.
(3) Training of Monitrices for the Social Education Centers.
The EN Social Education Centers are usually staffed by
two Monitrices, ~ssisted by a helper or a third Monitrice.
The Monitrices a~e selected locally and usually work near their own hoces. Some of them have been attaohed to their Centers since these were opened about six years ago.
The Monitrices a::-e responsible for the weighing of the children, for nutrition lessons 5iven to the mothers, for food distribution and record keeping.
To up-grade thei::- of+.en limited training a series of four week seminars was organized at the School of Nutrition in Marrakech for groups of 50-60 Monitrices.
The first crcle of seminars covered background I!Iaterill.l for and prc.ctice teeching of th3 first cycle of 13 lessons 8
for mothers. Lessons dealing with the operational proce dures at the Canters were included as also practical
experiance in center operations, 1.e. the ~ighing of children, the use of weighcharts, record keeping etc. A booklet "Ahmed and Rnchid", provided by the Ministry
of Edu~atiGn, s~rved to introduce the three food g~oups in a simple ?-Ild a=.sily understood .''1y.
A pilot Social Education Center located on the grounds
of the Marrake~h School provided opportunities for prac
tical experience in conducting mothers cl~sses and other
activities relev~nt to the ~ork.
Ten first cycle in-country seminars were held from
February 1976 to Febr~ary 1977.
The second cycle of lessons for mothers was discussed during the second cycle of semin2rs, which also included field trips to food production factories and wor.k in the
gardens at thE: -~gri~'.ll tur~ 3:igh School in :,Iarra,kech.
Nine second cycle in-countrJ semin2rs ~ere held from kpril 1977 to M2rch 1978.
So far about 75% of the ~onitrices who attended the first cycle of seminars have also attended the second cycle. Appendix 4.
1.11 the training was conducted in rirabic.
The third cycle of in-country seminars is scheduled for October 1978 to June 1979, under the tutelage of the new
llutrition staff, the graduates of the ~UNT.
2. Curriculum Development 2..nd Lesson Ple.ns
The develop~ent of a ~utrition course curriculum and of lesson plans began early in 1975. Thirteen lesson plans for mothers' classes and course work for the four-week in-country seminars
~ere prepared by ~he f=.ll of 1975.
~fter ~ slight revision the lesson plans were presented to
the ~onitrices attending th~ first seminar at the School of 9
Nutrition in Merrakech, in the beginning of February 1916. All the material had been translated into Arabic.
With dxperience gained during the seminars and during field trips the lesson plans were further refined to meet the needs of the Monitrices and of the mothers.
A survey in the field during the summer of 1916 had the result that in the second cycle of lesson plans more emphasis was pl~ced on the subject of hygiene and on more practical demons trations. Lessons dealing with the nutritional needs of the entire family were included, beginning ~ith the care of the pregnant and nursing mother, the feeding of the child from birth
to two ye~rs, and from two to five years, and of other family members. The importance of more vegetables and legumes in the diet ~as given more emphasis, as also home food production through the family garden and small animal raising. Vaccinations and illnasses during early childhood ~ere included in the second cycle lesson plans.
A third cycle of lesson plans was prepared to further strengthen certain important aspects, brought to light by the responses
to a questionnaire on dietary pr~ctices, presented to partici pants in mothers' classes, and by observations at the School of
Nutrition and in th~ field.
A special lesson on the value and importance of breastfeeding was prepared.
The third cycle af lesson plans is the most practical one, including basic cooking practices, how to keep the house and the clothing clean, how to feed the sick, how to prevent and care for accidents and how to promote the health of all the family members.
Through experience it has become clear that although the object of the intervention is to teach Nutrition, this subject is part of a family 11 ving pattern which includes hygiene and sanitation, and prevention of disease. This should result in better health, normal weight for age of the child, recuperation 10 from coaocn illnesses, such as mea3les, without serious effects.
The lesson rlcns for ~others' clas~es for the third cycle were presented tc the Provincial Directresses gt the seminar held in July 1978.
All the lessJn plans for the three cycles have been printed in -Arabic and !I!lde ftvailabla to the 250 existing and 50 prospective
Social Educ~tion Cent~rs.
Th·,~ three cycles of lesson pl3.ns a('e found in Appendix 5a 5b 5c 3· Nutriti: 1 Education for Moth~n Nutritioll education has been Lltroduced at the EN Social
Education Ce~ters operating in 30 ?rovinces in Morocco (See Map of ,,iorocco). Presently t:lerE: b.re 250 centers, with a prospect of 50 additional center3 being Jpened in the near future.
125,000 moth~rs with children belo'v the age of five years were enrolled in the program. The moth,rs attended a nutrition
lesson once ~onthly. The lesson pLans dev~loped by the
Nutrition st~ff were f~llJwed. Th~ lessons had to be short, to hold the ltt6ntion of the mothe:s, usually of 15-20 minutes
duration, fo~lowed by a practical le~onstr~tion of food
pre~ar~tion, child care etc.
Visual aids ?repared by the Monitr~ces during their tr3.ining and at the G·.::nters '.vere used to il_ustrate the lessons and to make them be:ter understood by the often illiterate mothero.
Each partici)ating mother recaived a monthly supplementary
'food ration :'or herself and t-vo ch~lc.ren per family, in all
375,000 ratijns were distributed p:r ~onth.
Ii sample stuJy of the attdndance :): ~others and e;hildren in
centers in six Provinces throughou ~ Morocc·J showed an average of 473 mothers out of 500 register,d. Apr,endix 6. 11
4. Weight Surveillance of Children
Duriug the monthly sessions for mothers the children enrol led in the program were weighed and their weight recorded on -:veightcharts, being kept by the mc..thers ..
The significance of the weight curves were interpreted by the Monitrice3 to the mothers, to make the weighing more meaningful to them.
Any deviation from a normal weight curve prompted a further investigatton of its cause and special attention and follow-up by the Monitrices.
5. Field Supervision
The Provincial Directresses supervised regularly the work of the Monitrices, by visits to their Centers of work, auditing lE:3sons, checkillg weighing, reportEl and records.
Members of the teaching staff ~t the School of Nutrition in Marrakech made occesional visits to the Social Education Centers.
The NINT trainees together with members of the teaching stnff visited a number of Centers during the summer holidays.
Teams of CRS Field Inspectors in coordination with CRS/OPG office in Rabat visited tne Centers during 'the dur~tion of the Project. Appendix 7.
VII. E'Til.LU./:,TION OF PROGRAM
ks outlined in the Grant documdnt evaluation of grant-funded activities should be on two levels.
The first level should involve the measuring of outputs, e.g.
that personnel are trained in a timely f~shion and utilized
as planned in nutrition educ~tion activities, that nutrition seminars are held, that basic nutrition curriculum for the semi
n~rs and nutrition education lesson plans for the EN center
classes are developed ~nd refined to meet local needs. 12
All thesd requirements have been met during the ~roject periods
Short-term training for 26 ~orocc~n Provinci~l Monitrices and 10ng-terI!l training for four Moroccan counterparts have been
3.ccomplish~d as schedule~.
The trainees huve been utilized as planned in the nutrition educ~tion activities, though over the three year period a few of them have hud to leave their work due to marriage, sickness or other reasons.
Nutrition semin~rs h2v~ been held for the various regions and the re~uired nuober of 500 Monitric~s h~s been trained.
Basic Nutrition se'!',inar curriculum:1.nd I-iutrition education lesson plans ha~~ been developed, tested and refined to meet the needs of the Monitrices :1.nd of the mothers.
The second level of evaluation should involve the measuring of the differences between beginning-of-project ~ni end-of-project nutritional knowledge of the 125,~00 mothers attending the 250 Social Education Centers, and the difference between the average
~eights and gains in weight of children enrolled in the program, based on Canter records, children's weight ch~rts, and before and after questionr,aires of mothGrs' kno~ledge of pr~ctical and applied nutrition.
32.seline survey.
As basis for the ccntinuous evaluation of the effectiveness of the program and its ~chievements a baseline survey was conduc ted in the summer and fall of 1915.
The baseline survey involved 26 centers or about 10% of the
250 Social Education Centers in Morocco. At e~ch one of the 26 centers 30-35 mothers, each one with a 2-5 year old child and a young:Jr child, par<;icipcted in the survey •
.A 24-nour dietary rec!J.ll was mnde :1.nd a questionnaire dealing· with nutrition relat~d pr~ctices ~~s administered to 845 mothers •
.a tot':!.l of 1626 children were ;reighed a.nd measured. l~
The participants in the baseline surv@y were followed-up throughout the project period.
A final survey ~as made in the spring of 1978.
The different times of the year for the baseline survey and the final survey must be tak9n into account when considering the numbers ~nd types of illnesses, the amount of clothing worn for
~eighing and the foods available for consumption. A food price check showed that in many areas food was more abundant and cheaper in summer or in fall but prices tend to vary greatly daily or ~eekly according to a crop harvest.
Over~ll, the conditions were treated as being relatively equal because other f~ctors are not known.
~~onometric measurements
Anthr~pometric me?surements, ~eight and height, were taken in 1975 and ag~in in 1978, to test the effectiveness of the supplementary food program and of the mothers' lessons on child growth.
The children from each family ~ere measure~, a 2-5 year old and his younger sibling.
The group of children fell randomly into about half boys and half girls. The data used are from children whose age was 'rerified by the family book that each family has.
Comparison of Older !md Younger Sib lin. ',s
The weight of the older child in 1975, before his mother had received nutrition education, and the weight of the younger chilu after benefitting from his mothers nutrition training are compnred. The following graph sho'lls that the younger child fared better than the older child when he had been at approximately the srune age. 14
Table 1.
Comparison of Siblings before and after based on Percentage of Harvard Standard Weights for Age.
50 ______~------i--~! 0~1~d~e~r~c~h~i1~d~1~9~7~5_ r:: Q) 40 M 30 ____ .. __ .c:~ ~~~ ~-- ~~~~----~~------() 20 ~o ------~--~~~--~--~~+_--_r---~------~ 10 ____~--_+~~---+--~~+_--~--~~~--~------
91-100+ 71-80 71-60
Percentage of Harvard Standard Weight for Age
normal weight for age mild to moderate malnutrition severe malnutrition
In a comparison of 317 weight charts of olter children and their younger siblings, the weights of the younger were taken
at the time of the ::'978 3urvey. The 7l~ight :)f the older child when he was at the S2.Jlle age in :nonths ':Vas found. In 37% of
the CRses the older child was in a higher ~eight for age category and in 58/~ of the cases, the younger child was in a
higher weight for age category. Five ~ercent of the children were within the sane category at the same'lge. 15 Comparison of Younger Siblings with thems~lves The younger siblings were compared with themselves. Their weights f;:,r age in 1978 were somewhat betto3r than in 1975 as
shown in T~ble 2.
l'ablo3 2. i=: a) ; 50 Younger child .... 111; 1975 ~o 40 ___~4_2~,~~~,~ ______~~ ______~,j_---: __ ~~~ ___ - '---""'0;';j 40 ----1 ~ 30--~r!--~!,',_,':~.~~.1,----~~I'~'~~~"------______~~~ __1_9_78 __ _ :l . 23 ~ 2 20 --+-....j.;I."":')>.,.'~~.--+--~'r..·I !""'f -I,\\J' '>.,;,~~+-_~2;.:;:0~ ______
~ 10 ____1 __ ~:~~",~~~~~_+!--~~~'~~\\~.~~~--~:~1~3~--~~1_1~ ______
~ 0 i :~::,! ! :l~ ~ ~lb ,La 91-100 81-90 71-80 71-60 60 =
Percantage of'Harvard Standard Weight for Age
Tab 103 3.
Comp~rison of Younger Siblings betwe~n 19;5 and 1978 progress.
Younger. child 80 79 0-1/2 years
c 1/2-1 years Q) 70 I~ M .....'0 60 .~ ..c 0 .... 50 0 J.) 40 40
+'c'" 30 t1) 0 M Q) 20 16 Po. 10 10 2 0 ! , 81-90 71-80 61-70
Percentage of Hr.rv:'rd 3tand~rd Waight for Age 16
About 80~ of all the children were born in the norma.l weight range and remained there until about six months of age. The drop in relative weight at age 6 months is drastic and the chil~ren do not regain a normal weight for age as they reach five yea~'~ and leave th .. centar.. Tabla 3.
Of younger sibljngs includl:'!d in th~ baseline those less than 6 month~ of age gained weieht b€!tter than those who were alr~~~y at la~st 6 months old at the time of registra tion. Table 3.
The weaning age appears to b~ the commencl:'!ment of lower weight pl:'!rcenta{!es for many children, but in the southern provinces of Goulimine, Ouarzazate and Errachidia, birth weight for some of the children appear to be low. These are areas where water and food are often scarce.
Teaching the mothers effective breastfeeding and weaning practice~ should continue to be the priority at the centers as poor practices result not only in low weight for young children but ~ay effect their stature permanently.
The mothers' lessons on ~eaning are evidently being heard ~9 their responses on the questionnair8s show.
Further results of anthropometric measurements of children participating in the baseline survey and later in the final survey are found in Appendix 8. 17
Final Survey of iiat~rr habits
A second questionnaire on dietary prectices was ~dministered to mothers in Januery and again in May 1978, by the Provincial Directresses. Besides providing information the excercise gave the Provincial Directl'esses practical experience with the evaluation process, which they had studied at the National Institute of Nutrition in Tunis, and leter discussed at the seminars in Marr~kech.
The responses to the questionnaires ~dministered at th8 begin ning and at the end of the Project shoW a significant improve ment in child feeding prnctices over the last three years. This is an indication th8t the mothers have accepted and been
~ble to implement what they have been t~ught in the classes offered at tha Social Educ2tion Centers.
Since the lessons for ~others emphasize the value of growth foods for body building, of fruits and vegetables for protec tion of health and prevention of disease, and of milk products for growth and the form~tion of bonGS and teeth, the inclusion of these foods in the diet were checked through a 24-hour dietary recall also in the final survey.
There was a signific~nt differenc.; in the frequ",ncy of gr01'1th foods eaten at the time of the baseline survey in 1975 and ~t the fin21 survey in 1~78.
The day before the surley ~E'.s made in -1975, 4310 of the children had had no growth foods during the dey, ill 1978 the figure ~['.s only 710.
While in 1975, 70% of the group reported eating no legumes or only once per week, in 1978 only 10; reported thus.
The number of parsons eating fish 2-3 times per week increased considtJrably.
The consumption of fish is greatar in the cORstal provinces.
The ~nthropometric data indicate that tha children in these areas are Jarger for age. 18
Weight surveillance
In addition to the measurement of children pertioipating in the baseline survey, all the children registered at the
Social Education Cer.ters were weighe~ at monthly intervals and their weights recorded on weight charts.
VIII. PROJ~CT CO~lliODITI~S
.vith the termination of the project thli! bulk of the non expendible commodities hllYe been turned over to the Moroccan
Government for use nt the ~b.rr~_kech Nutrition School. The Viewlex fi~strip/slide projectors and tr~nsformers are found with the diractresses in the provinces. The
Chevrolet station wagon will re~~in ~ith the Catholic Relief Services Rabat Offic8 for continued field supervision.
A complete inventory of ite~s purchased with the grant and expl2.nr,tion on the manner used is shown in .'lppendix 10. 19
IX. ADDITIONAL ACT:vJTIES MOTHERS CLUBS ~t the request ~f ~ID/llashington, an experiment was undertaken to find ways to reduce dependance on donat~d foods. CRS/Morocco agreed to ~ndertake this axpericcnt within the Mother/Child Program. Clubs ;vere established in five S:Jcial Centers under
the supervision of ~he Center Monitrices and the Provincial
Directresses. No PL ~80 COcrffioJiti8s were iistributed to
attending ~embers. Twenty-five mothers were enrolled in each
Club ~nd they attended classes once a week. In addition to weighing the children the interest of the :-:others wns maintened
thr~u~h nutrition classes, using local foods, with actual food
demon~trations given at every session. Lessons on facily
hygiene, sim~le sewing, knitting and embroidery were offered as part of the course and as an added incentive. The Provincial Directresses and Center Monitrices conduct0d all lessons.
In May 1977, the ~merican."omen's Association of Rab'3.t made 11 donation 0f 2,~OO dirhams (3545.00) to purchase local foods used in demonstrations of recipes in these clubs.
The mothers themselves contributed local foods, sewing materials and other items needed for their classes.
The folloWing Clubs ~ere organized:
January 1977 ~hree Clubs in the Provinces of: Marrakech, Khouribga and Errachidia.
July 1971 Two Clubs in the Provinc~s of : Errachidia and Marrakech. January 1977 One Club in the Province of Marrakech. Here is a schedule of the Clubs activities: Province of Marrakech 1.- Bab Doukkala J:muar7 - June 1977 nutrition lesson, recipes, beginn~ng sewing, embroidery, knitting crocher. weighing of children once a month about ~O ~others/week e::lch Thursday. 20
2.- O.,A.P • .l.M. J~nu~ry 1977 - still meeting nut~it~on lesson, recipe of spcc~~l holiday foods, sewi~g, embroiderJ, knitting, weighing of children once a month 25 vr more each week (very popular) encl. Thursday
3.- Ksol:..r July 1977 - still meeting nut~ition lesson, recipe, sewing, emb~oidery, knitting. weigning of children once a month 25 ffiothers.
4.- Dnol·.di2.te I Jul~' 1977 - August 1977
5.- Daot:.iiata II Jan~~ry 1978 - still meeting same courses as the others.
Of five Clubs organized, three ~r2 still operating successfully.
~nc~ n~ ~rr~chidia 1.- M'Dcghra Decemb8r 1976 - still meeting coo~ing, rdcipes, sewing, knitting, emc::oidery . wei5hicg of children once a month 25 :10thers e !!C:l '!'hurs do.y
2.- Err~chidi2. 7ille ~ug~st 1977 - still going on coc::ing, recipes, sewing (use mac lines at tha local Foyer Fen: .nin) wei;-hing of children once a month 25 :.lothers ene''! Monday
Both Clubs are operating success: lIly.
Provinc~ of Khouribga 1.- Khouribga I Ja!l'.lary 1977 - still going on se~ing, embroidery, cooking, ~eighing of children once a month 25 mothers ·3ach ~ursday
This Club has been very successfull ~nd is still operat.ing. 21
Province of Tetouan 1.- Moular HRssan Decemb~r 1977 - April 1978 cooking-nutrition, sewing, kni tting every Thursday
The ~others did not show any interest in lessons offered.
Province of Ouarznzate 1.- Zagora September 1977 - November 1977
The mothers att~nding this Club were interest~d in the program, but were vary poor and could not ~fford to purchase local foods for demonstrations or purchnse needed materials.
Province of Chuouen 1.- ChQouen January 1977 - December 1977 Y. ·l.trition, ambroidery, sewing, c. re of pl::.nts.
Attendance at this Club wes poor and the Canter Monitrice and Provincial Directress did not follow-up successfully. 22
OBSERV"TIC1S - :dOTSERS CLUB (1) 7h~ ~othdrs ~tte~ding th~se Clubs h~ve generally shown great
i~terest in t~a lclBsons offered.
(2) It h2s been necessary for them to bring their children with
th~I:l.
(3) Al though the Clubs were s t •. rted for the mothers of the exis
ting Soci~l Centers, we have seen they are more popular
among women on ~ higher economic level who can afford to
contribute their sh2re of food, threRd, and other m~teri31s. The :n('\thCl"s of most Socic:.l Centers have difficulty in
contrlDuting their sh~re of fooa us~d i~ demonstrations. Besides, they are more interest","d in th:dr own problems
of d3.i1y llvi~g then in lecrning ~nd participating in
classes without receiving ~lloc~tions of food. They
naturally attend if an ~llocntion of highly desir~ble and
JPpreci~t~d PI 480 commodicies is of:~red.
(4) ':iomen in these centers are willing t') share their knowledge
~ith others. They ~re ~nxious to participc:.te in any type of 5'''-thering. They ,ue int8restell in learning and in
soci~lizing ~ith other ~omen.
(5) ~lthough lessons h~vE oGen prep~red by the Provincial
Dir~ccresses and the teachers at the School of Nutrition in
M3.rr~krch, the :nothers have ~ontributed suggestions of subjects to be discussed, recipes to be prepared, etc ••
They h2ve t~ken ~n 2ctive part in the Clubs not only as studer.ts out 2S te2chers.
(0") .Th e progr~ h as succeeded in Centers where the P rovincia 1 DirGctresses ?nd Mnni trices supervising the centers have
taken ~n interest in the progr~I:l. The Clubs need a sche dUled progr2I:l. In two pr.ovinces the Clubs have not been
successful bec:-~use the supervisors did not h2.ve sufficient
time to ovarsee the ~ctiviti~s presented.
(7) '.;8 haYe lc.'lrr..ed th:' t 21 though f '.mds can be made 3.vailable for Furch!'se of foods "'.nd ",quipment, i: thG supervisors are not ,:.ctiv;;ly involved :md intar;stad, the Clubs ?1i11 fail. I. .aDDITIONAL RESULTS
POSI7IVE RESULT~ OF THE NUTRITION PROGRAM At the end of tr.e p:oject, the success of the program can be measured not onjy by the favorable results of the findings, both for the grC'wth of the child ane. education of the mother,
but by other factors ~hich can not be measured by numbers yet have unmeasurable v.:.lue in the social status of women and developlIlent of can-')ower.
1. DeveloPffient (f the Frovincial Directress
The ProvinciEl D~rectress in assu~ing this position is now considered a par, of the provincial administretive staff. She has been prlnided by the province in cost cases with a
separate roo~ and office facilities that enable her to supervise thE; ce:1ters assigned to her area. In this role she has deve} oped. as an adl!linistrator/supervisor and as a civil servant, responsible for the well being, education anci health oi th,' cothers and children under her influence.
The number at' mo-::hers and families reached in these centers is large and represents a great part of the ccmmunity in size
and social i~flu~nce. The position of the Provincial
Directress, ther~fore, as a part of the municipal or provin cial cowlcil, is an important one. She is now consulted to determine chc::cnee3 in important decisions affecting the families of the )rovince. This has given her status as a
representatiYe 0:' the Ministry of Social Affaixs, in charge
of the '·;elfal'e 0-' the poor in :nany other social areas.
The educatior- ga~ned in the Natianal Institute of Nutrition, Tunisia, gavE her the confidence she needed. She returned to report to the Governor af the Province she represcnted, eager to share h,:::r knowledge. She was acknowledged by the
Province and cOmLunity as a Directress responsible f~r
supervising the ~onitrices under her care.
The numerous sem~nars she attended at the School of Nutrition in these pasl three years have contributed to her development
as an educatcr, ~ivil serve.nt, and person. 24
The success of the program in any individual province has been mostly due to the interest and performance of the
Provinci~l ~irectress.
2. Development of the Cente~ Monitrice
Although the Cent.lr Monitrice h2s not directly affected the level of administration in the provincial government. her
influence W"~. th the mothers and children has affec ted the program. It is the Center Monitrice who has personal daily contact with the mothers end children of the province. Her efforts in introducing the lessons to the mothers is reflec
ted in th~ f?vorable results to the questionnaires. and in
the growth of the children. The educ~tion she received at the monthly seminars in Marrakech gaye her the knowledge and confidence she needed to instruct the mothers. She was no longer considered a younger. inexperi'3nced Moni trice.
The chnnge was evident to eV~~70ne attending the centers. The evolution and development of the Center Monitrice p13yed en import.1nt part in mcki.ng the progr:lm successful.
3. Developm~nt of the Mother
Through monthly visits to the center thJ mother was able to
break away the confines of the tr~ditional Moroccan way of
home life. This new experience was revolution~ry in some pTovinces, especially in the remote, desert provinces. Not only did she become en agsnt of change but she developed persona-lity which gained her the respect of her family and neighbors in the community.
The Ministry of Social Welfare and CRS regard the mothers
attending the centers as the logical me~ns of helping to educate other women to learn the value of e varied diet, how to spend their meagre income for foods that have the best nutritive value. and the best ways of preparing and
cooking th~ food so that the nutrients will not be lost. 25
It can be assumed, ther~fore, that the mother by acquiring some basic knowledge of nutrition, was instrument~l to overcome and prevent poor diet~ry pr~cticas in her family ana community and in the development of h~rself and her r.ountry.
4. ~.opment of the Child
RJBults seen from the findings presantad in this report show
th~ successful ~evelopment of the child enrolled in the
progr~I:I.
5. Development of the School of Nutrition, M~rrekech
The creation of a perm~nent institution the School of
Nutrition in M~rr~kech ar.d its subsequent achievements h~ve
given the Ministry of Social Affairs an addition~l activity which nas given it added recognition from the Mnroccan ministries and foreign agencies. This School, E3tablished principally to trnin the supervisors of the nutrition program
in the social centers, hos dev210ped other activiti~s and
benefits ~nd is now a cente~ for other projects -rithin the Ministry of Soci2.1 Aff::J.:i.rs. giving it an opportu.lity to serve many more poor f::J.milies in a bett8r way.
The officials of the ~ir.istry of Social Affairs ~ow represent their agency in the National Nutrition Council.
The Ministry recognizes the impact the establishwent of this school has had on society. To increase this impact,
plans have been made to expand the school ~nd a 5eparate budget item has been prepnred by the Ministry of Finance for its operation and maintanance. U.S. OOLL1.HS AI. FINANCIAL REPORT AID/Nt:SA-G-1169 BUDGET COMPAH[SON HOVtJaB1!.:H 1978
Approved Budget Expenditures Balance to date
1. Salaries ~ 211,400 196,013.06 15,386.94
2. Short-term Training at the Tunisian Institute of Nutrition, Tunis $ 31,800 31,168.69 631.31
3. Long-term 'rraining (3 years) at the Tunisiun Institute of Nutrition, Tunis. 3 35,900 35,109.20 790.80 4. Project Commodities l 39,900 82,641.69
5. Local Costs (travel, per diem and salary N suppleflli:!rl ts) ~ 124,000 101,565.67 221'131.33 0-
.~ 10,000 6,305.40 3,694.60
TOT liL: $ 153,000 45 2,803.71 * 196.29 ;;======.=;.==; ======
~ 101.29 - Actual Balance - Bun~ers Trust Account Numbel 42.073.937 i 95.00 - Actual Balance in lJil'hc1J'ls CRS/Rabat - Ci tibank Account NUl!lber 20.40.078 i 196.29 XIt- FIN.ANC.I.dL SUPPORT
Fin~ncial support for the Nutrition Educntion Project has come mc'inl,:;r from three sourc e s : the U. S. Gove rnmen t, the Govel.'nment of Morocco and Catholic Relief Services-USCC.
1. g.. S. Government - Progr9.m Oper~tional Grant (OPG)
'~'he United States ~\gency for International Development (hID) through an Oper~tional Program Grant contributed a
total of Four Hundred Fifty Three Thous~nd Dollars (~453,000) to the support of the Nutrition Education Project
in Morocco, providing s~lc.ries for the staff, traveling expenses, short-term training at the National Institute of Nutrition in Tunis, long-term training of four Moroccan
students ~t the same Institute, ~nd commodities for the
effective running of the progr~.
2. The Government of Morocco
The Gove~ent of Morocco contributed to the program both in cash 2nd kind:
(1) The Ministry of Soci~l bff~irs:
A completely furnished building for the School of Nutrition in Mc.rrakech;
Buildings, equipment ~nd m~teri~l for 250 Social Education Centers; BudgetGry allocQtions for the opcr3.tion of the School in Marrakech, as approved by the Ministry of Finance, in the amount of 3100,104.30 in 1976 and J124,420.40 in 1971,
or a tot~l of ~224,524.70 c07ering the following expenditures:
~) all utilities for th8 School; b) fue 1 c.nd m:::.in ten~ nc e of th.:; vehic Ie ·<:!s signed to the School, c) s~b.ries of st2ff 3.t the School: ,'idministr~'tor,
secretary, ~.ccount:::.nt, cle.::.ning :::.nd kitchen helpers, d) partial sclery for the Provinci -:1 Directresses for
tht:: ent ire gr~.n t pe riod, 28-.. • ) transportatiQn costs for the 25 Provincial Directresses
for work within th~ir Provinces, with payment made in accor1ance with the number of centers visited. f) transportatiJn costs .:md periiem for the Provincial Directresses to and from thair respective Provinces to the School in Marrakech, g) space and equipment for the Provincial Directresses, adjoining the office of the EN delegates located in the
Pr~vincial caritals, h) seminars at thd Schoo], including meals for an average
of 55 Monitric~s per month for 10 months per year,
i) transportatbn costs ~or all Monitrictls to and from
their centers to Marr~kech.
In 1978, the Ministry of Finance has approved a budget of 3 125,000 for the School of Nutrition and operation of Nutrition Program.
(2) The Ministry ,.,f Youth ?nd Snorts, Accomodation w~s mgde available for the 25 Provincial Directresses at the first seminar. held in Rabat in September 1975. (3) The Ministry ·of Health
Filmstri~s ,:md slides on tha subject of health and hygiene were supplied for the saminursheld at the School in Marrakech. (j.) The MinistryJf B:ducntion Available material, such as posters, charts and books,
were supplied for ~ublicati0n.
3· Cath9lic Relief Servic:"s-l!§.fQ CRS, Morocco provided I'ldI!lini,9trative support to the Project thrQughout the entire :Jroiect period, under the overall
direction of the CRS Pr~gr~m Director dnd .IIssistant Director. The 13tter also serves ss Diroctor of CRS Mother/Child Pro€rrums in MorQcco.
The servic ~s ·Jf CRS Insp.=c tors, rl'ho made regular visits
to all the Socinl Educntion Centers, ~ere also contributed. 29 CRS Hea.dqu3.rters 'l.ud Regionnl staff rendered assistaJ:lce to the Project from the initiation of the prep.!2ratory w!,ric to the end.
A grant from CRS, New York Food :md Water Fund, in the amount of .$17,550 was used to purch::'.se demonstra.tion kits to f=cilitate the operntion of the Social Educntion Centers • •
4. Additional Supnort
a) Loc31 sources
Substancial contributions were made by the mothers
particip~ting en the nutrition education program.
These funds help~d to defr~y most of the cost of the oper.'ltions of the centers, remuneretion of st,..ff, commodities ·J.sed in the food demonstrations etc.
b) Outside funding
Contributions for the Nutrition activities, begun by CRS/Morocco in 1972, enabling CRS to prepere the ground- 710rk for the future OPG Nutrition Project werp. r8cei ved from:
i. De Rance Foundation, US~, in the nmount of J 13,000
ii. R.:'..skob Founde.tion, US,I, in the ·J~ount of 3 6,000
iii. CnFOD, Engl~nd, in the ~mount of ~ 11,587.19
iv. Mr. John Guyer, Form8r Pe~ce Corps DirGctor, doneted a Volksw['.gen Minibus, presented to the School of Nutrition in Mnrrnkech. 30
XII t- PLANS FOR THE FUTURE
1. Expansion of the ~other/Child Progr~ in Social Education Canters
In view of the success ~chi~v~d in the soci21 education centers, num6rous Frovinci:l Governors have requt:!sted the
creation of n~w centers. In answer to this request, fifty more centers will be ast2blished beginning in October 1978
to reDch 50,000 ~dditional children and 25,000 mothers bringing the tot21 number of b.:meficLJ.rias to 450,000 (300,000 children ~nd 150,000 moth2rs) in 300 centers.
Th.: llonitrices supervisinr, th<::s~ c ..:ntars will be trained
in the School of Nutritior. in M~rr:!.kech. US PL 480 Title
II food COI:llIlodi ties hr:v8 b.~e:1. c.pprov8d by AID in the amount of 68,434,200 lbs. for FI 1°79 for this category of recipients.
2. School of Nutrition, M2rr2kech
In order to accorr..modc·.te the :J.dditional 100 monitrices that 'Rill be hired to supervise the 50 new centers and to conti
nue with il 3rd cycla of lessons for th~ existing 500 conitric8s, more dormitorias 2nd classrooms, will be added to the School of Nutri hon in N\r.rr:.lkech by the Ministry
of Social .;,ff~irs which hc.s giv~.n thi~ project 11 high priori"':.y.
Three long-term Moroccl1n stUdents gr~du~ted from the Institute of Nutrition, Tunis will be responsible for the training of coni trices c.nd will cnntinue with the lessons c..s prep!:red.
3. Provinci~l Directresses
The Gov rnm0nt 0:'" Morocco is ~,ssUl!ling responsibility for
the entire axpens~8 for the continuc.tion of the work of
the Provinci~l Directrc5ses. 31
4. Expansion of Dny-C-re Cer-ter Progr~m
Priority has been given by the Ministry of Social Affairs
in its Five Year Plan, for the est~blishment of day-cara
centdrs, princip~lly for children of working mothers.
There sre ~t pres~nt 3,000 children enrolled in day-care
centers all over ~orocco. With the estRblishment of these
centers 2nother 11,700 c~ildr8n will be re~ched. Plnns
for ~ nutrition progr~ for the children 2nd an adult
educ~tion progrnn: for th~ moth.;rs hCl.v-= been undert.:;ken by this Ministry. U.S. PL +80 Title II fOQd commodities in thr: amount of 2,508,408 Ibs. h.".ve been Clpproved by AID/
~~shington for these cent0rs in FY 1979.
With the receipt of two gr2nts from CRS/Hew York and the
Van Leer Found~tion for 1 taClcher tr~ining progr2m for day
care centers, the St. Dominiqu~ Institute, Cas2bl~nca will
train th~ first group of 25 teachers in a two-year course
beginning in October 1978. Fifty teach~rs will be rendy
for placem8nt ~s supervisors in 1981. 32
XIV ~CICIO'.:L.::DG2J1:NTS
Acknowledg8ment is due to all these who have contributed to the successful completion of the CRS nutrition education
prograo in ~orocco.
Gratitud~ is due to the Agency for Intern~tional Development for the grant received and for the encouragement and adviae
so readily given by the USAID representative~ in Morocco and the: hel:;J 2xtanded by the Nutritionist, ITS,HD/Tunisia.
The financi~l support provided by the Govern~ent of Morocco,
especi~lly through the Ministry Qf Soci~J Aff~irs is gratefully
acknowledged. Th~ Goverr~entls contribution to carryon the
~ctivities ensures th~t th~ ~ork started during the life ~f the projact will not be lost but will continue to benefit
the people of ~orocco.
Acknowledg\:!!lent is dUE! to the Dir'2ct')r of the Nati::mal
Institute of Nutrition, Tunisia ~nd the staff of this
Institute not only for the schol~rships given to the short
and long terl!l students but the personal interest Biven e~ch
student and the Morocco Nutrition Progr~m.
S~ecial trioute is ~~id to ~ll the personnel in the provinces, at the Nutri ti::m School in Mc.rr'C.k3ch and. the Nutrition office in Rabat who have so 1iligently worked to train the !!lany
nutrition worksrs assigned to each Soci~l Education Centers
c.nd to spread nutrition educ~tion through the mothers attanning these Centers allover Morocco.
Our appreciation goes to the many mothers who so f~ithfully haVe attended the classes and to the children for whose
benefit the prograo was d~signed.
A final word of thanks to the CRS Region I Nutriti~nist
whose adVice, support and su~e~vision helped make this program a success'. .appendix 1
IMPLZUErT.,TION SCHEDULE (a~vised)
4/1/15 Program retro~ctiv8 to this d~te 5/29/15 Grant <>gr'.::eI:l~r:.t sign"d IY CRS/New York 6/1/15 Prcject COm.J:lodi ti::s ordered 6/1/75 CRS ~nd GaM b~gin recruitment for provincial monitrices. Two-day seminars held in 23 provinces.
EN conducts nation~l written ;x~I:lin3tion in Rabat.
8jl/75 Two Tunisian nutritionists begin ',vork in R~br1t. Staff cOC'lpl02ted.
8/1/75 3aseline d~t2 coll~ction begun. 9/1/75 Four long-to:erm 'lnd 27 short-term tn.inees selected for NINT. 9/15/75 Two-week seminar in Rr:bc t for short-turm tr~inees. 10/1/75 Short-term training begins ~t NINT. Long-term training begins at NINT. 10/1/75 Twelve lesson pl~ns completed for mothers' classes at social educ?-tion Ctnters. -- Thirt"en lessons were written. 10/25/75 First shipment of project co~oditiGS arriVeS. 11/1/75 Baseline d~ta completed ~nd an~lyzed. 11/1/75 CRS subI:lits six month progress report. 11/1/75 Daily lessons planned for the one-month training seminars
'l t :1!2 rr3.ke ch .
Pl2.ns submitt2d to ~N and iliinistry of Public Health for 8.pprovc.l. 12/1/75 CRS orders 300,000 weight-for-agG ch~rts. 12/20/75 Short-term traines return from ~unis. 2 Appendix 1
1/1/76 ?rovinci~l monitrices tcke up supervisory positions in ';he:'r provinces.
1/19/76 Two-week semin~r held ~t Mcrr~kech School for provinci~l monitrices.
2/1/76 First in-countrJ semin~r for first group of 50 monitricas
begins at 3chool of Nutrition in M~rr~kech. Staff consists
of thr~e nutritionists, on~ home economist, GaM directress
~nd 2 CRS nutrition supervisor.
-- 4/9/76 CRS nutritionist/proj8ct supervisor bagen work.
The first trginee cycla includes tan seminurs from
FebruarJ 1, 1976 through J~nucry 31, 1977. The School is closed during July ".nd ;.ugust. 4/1/76 Second progress report submitted. 7/1/76 Long-term trrrinees return for 3 summdr months for home
leeve Qnd p~rticipction in project fi~ld 2nd school uctivities with nutrition steff. 9/1/76 In-country semin2rs resuma. 9/15/76 T~aching st~ff begin follow-up visits at social educntion centers. 10/1/76 Third progress report submitted. 10/1/76 Long-tarm tr~in?es r2tul~ to Tunis for second year of tr3.ining.
12/1/76 Project ev~lu~tion. Appendix 1 3
1/1/77 Twelv~ new lesson pl~ns for moth~rs ~t social education
c~nters and duily le~son plans for the second year of one
month training seminars at Mnrr~kech completed.
-- Thirteen lessons ~ere written. 1/19/77 Project Review held ~th '~/Morocco, rrSAID/Morocco and EN.
2/1/77 Visitations, ev~lu~tion ~nd repl~nning of project activities. -- Field visits sup&rceded by eleventh in-country seminar. 3/17/77 Two-week semin~r 2t School of Nutrition in M~rr~kech for
provinci~l monitrices. 4/1/77 Fourth progress report submitted. 4/1/77 Second cycla of in-country semincrs begins ~t School of
Nutrition in Marr~kech to include ten seminars from
~pril 1, 1977 through M~rch 31, 1978. The School is closed
during July ~nd ~ugust.
-- Only nine semin~rs held, as school not open during
September 1977 bcc~use of Rnmadan. 7/1/77 Long-term tr~inees r8turn during 3 summer months for home leE'.'le :md participation in pro.ject field and school
activities with the nutr~tion st~ff. 9/1/77 In-country semin~rs to resume. -- 9/2.1/77 seminars resumed. 10/1/77 Fifth progress report submitted. 10/1/77 Long-tem tr~inees !'eturn to Tunj.s fur third yea.r of
tr~ining. 12/1/77 Project evuluation. 4 Appendix 1
3/1/18 TWelve new lesson pl~s for mothers ~t soci~l education
c~nt.:rs compl~tad. 4/1/18 Sixth progress report submittad. 4/1/78 Ta:chlng 3t~f: t~kes fin3l ~eight ~nd h~ight mecsurements
of children ~nd :llioinisters quastionn3ire to mothers
3urveyed :or ori~in~l brsalinc d~ta.
-- 4/10 - 6/1/78 Survey t2.ken. 5/15/18 Survey de: ta to be~r•.. lyzed. -- 6/1 - 8/!/78 Data analyzed.
6/11/18 Two ~eek semin~r ~t School of Nutrition in Marrakech for
provinci~l ~onitrices.
-- 7/3 - 7/6/78 aIle week seminar. 7/1/18 Long-term tr2inees gr~dunte from NINT and assum~ duties in nutrition project.
One tr~inee to retake exnms in Septum~er 1978.
7/1/78 Final pl~r~ing ~nd coordination conferences on nutrition
education froject by GOM offici~ls, CRS ndministrators, project 3taff and long-term graduates.
8/1/78 Fin~l ev~lu~tion. 9/22 /78 One tr~inee r~t~k~exams ~nd passes. 11/30/78 .:!:r.d of project. 12/31/78 Finrl report submitted. Apnendix 2
LIST OF PROVINCL\L DIRECTRE!:lSES TRAINED AT
!l':'TIONAL TI~STI':''JTE OF NUTRI'!'ION! TUNISIA
FROM q OCTOBER TO 20 DECZM]~R 1975
1. E1 Abd Halima 2. Sacmoudi Malikn 3. Chcmikh F~tima 4. ~drar Sa~jia 5. Garni Aieha 6. Ben Jilali Aziza 7. Mazari Zoubida 8. F~rd Fauzi~ 9. Keeha Zhor 10. Tnabet 3~hija 11. Khlaf~ F~tim~ 12. Chckour Zoubida 13. Malki Zoubida 1~. H~dri Amina 15. Gomir~ Fatima 16. ~1 J~rissi Nairna 17. Bo· ... ni t H~fida 18. Foughaba R~bea 19. Hoimeeh Rcehida 20. Romrnani Fatima 21. Eakri Fatioa 22. Afif Fetima 23. T~ryaoui Amine 2..1.. Hdssnd I0.bira 25. Kouhlal Zoubida 26. El Ibrahimi Mouzha SE!)' Bella ~b jie. OPG/CRS Administ:;:-ativG Steff, Rabat
Chen~es in ?~rsonnel:
Miss Fauzia F2r~ of the Pr~vinee of Khouribga after returning fram the eours~ in Tunisia was taken ill and died in January 1976 :lnd ;vas r'2pl:lceri.
During these three Y8&rS seven Pravinci~l Directresses left their servicEs ,lue to v'J.ri'Jus reasons. Four of these
Directresses ~ere replaced. The two vccanci~s will be filled by c~ndid.atas appointed by the Ministry of Social Affairs.
~ll new Provincial Directresses have been given an intensive course on the program at the School of Nutritian, Marrakech, before assuming their resronsibilities. MOT HER S' L E S SON P LAN S
FIR S T eye L E
(Revised June 12, 1978) LESSON 1-1 INTRODUCTION TO SOCIAL-EDUCATION CENTERS
OUTLINE MOHI'rRICE he'l'] VIT I r~~) Tl<:i;CI/ Il4G Al VS MOl'llriL. ' ACTIVITIE
1. INTRODUCTION i"lelcome mothers. Introd.uc~ f'lonitrices i'ill-tiei r r~tlt," in in t rr,·jul: t i .. ,/lti •
II. OBJ EC'I'IV ES OF To help 2-5 year olds, es pe ciall.y from Co I'Y of dfc'cision Vi ~CU:l!l i Ull on SOCIAL-EDUCATION poor faoilies, tu grow normally. of En t ra j d (~ normal (It,VI' I oprn.,nt CENTERS 11;1 t i (JII:1 i {" to ff)rm S(lci'll-i':ducation Cente 1'3
III. OBTAINHIG 1. Weigh the child once a month. I.Qcale-weib"ht chn rt l.ni!:cu~!;ioll Oil OBJECTIVES 2. Send chi ld to clinic if'he loses ~eight. 2.])i:3 pc, nsn r.y :; lip W~ i !~h i IIi! 3· Provide the child with suppll~men tary 3.SCll'lrh~s of supl'le- ? • II i s c U [: r; i Ilfl on foods. r!IPnt.ary foods. w,, i ("h t .\: IIp:dth. 4. Give his mother lessons in nutrition 4 .liutri tiun 3 .J::x'w:i 11:1 L1 on of sUI'l'lcr:" IIt:lry and hygiene. ~os ttJr. I foods. I) .Vi scus~1i on on l~ss,)n tlll,icH. IV. CONDITIONS FOH 1. Economic situation of family. I.Certificate of llote rl!quirerr.ents REGISTHATIO:N 2. Age of child, 2-5 years. indigt"?llce for re6istr<:tion. 3· V(lccination card for child. 2.Family aook. 4· 3 photos of child. 3·Pink v'lccinntion 5. Photo of mother. card. 6. Younger child in the family. 11. Photo 7· Donatiun of one 1irham per month. A. Return on the drty Ll.ppoil'ted 8ach month. 8. Rt, tllI'Il-V i Hit c::rd.
V. BENEFl ClAHIc,S 1. Regis tered chi Id . Discussion on need OF SUP P L'J:~..;r~'r l,HY 2. Youllger brother ur sister. for sUI'pll.'lTIentary FOODS 3. Pregn.nt or nursing moU~er. fouds.
VI. WHllT WIVE; YOU 1. Hhy will your child be weighed f!Very month? L~~ilRtlED? 2. Is it. normal for a well child to lose weight? 3· \Ihy do your children raceive supplementary foods? Hesponsp. and 4· ",hy dOf;:!s '1 pregnant or nursing woman need supplementary foods? discus~lion. 5· Vlhat are the supplementary foods you will receive? 6. How will the mothers' lessons help the child ren? , , , LESSON 1-2 THE rlEIGHT CHART
'~==~--~------~======~--~------~------IIi OUTLINE MONITRICE ACTIVITIES TEACHING AIDS MOTHr;RS'hCrJVITI~ ~------~------r------~------! I. IMPORTANCE OF 1. Weight reflects stAte of development. Scale 'i.nlch "pip:hing (If MONTHLY 2. Weight increase tells that child been severnl childrt'rl. WEIGHING eating supplementary foods. 3. Stationery weight or weight decrease ~lerts monitrice and mother. 4. Regular, monthly weighing is important. 1------+------1------1 II. THE WEI GHT 1. The chart records the age of the child. Weight chart \/11 toh demollR t ra CHART 2. The chart records the weight of the child. tion. Find "Path 3. Children with weights between the two heavy to Good Health" on lines are on the "Path to Good Health" their charts. 4. Children with weights below the bottom heavy line need special attention and feeding. I). The "Path to Good Health" is upward. ----~------1------1 III. OTHER The back of the weight chart records fe~ily Discuss importance IMPORTANT information and other inrormation to the child's of informption on INFORMATION health. the Lack of the 1. Vaccinations. chqrt. 2. Record of illnesses. ------I------~~------~r_------IV. VALUE OF 1. The mother tokes the weight chart home to Discuss how the WEIGHT CHART show her husband and friends and to remind Plastic mather elln use the her of her duty of caring for and feeding envelope chart to explain ' her child. her child's growth A pln3~ic env~lope keeps the ch~~t clean_ to others. 2. ~ihen the child reach,'!3 5 years, the center keeps the weight chart as a record of child growth. I------+------~------~----~------V. WHAT HAVE YOU 1. How do we record the child's weight? Response and LEARNED? 2. \ihy does the mother t.:lke the weight chart home? disCl'.ssion. 3. Whnt doe3 it mea!} if your child's weight is recorded within the two heavy lines? 4. What does it mcan if your child's weight path is going in an up~ard direction? 5· Why are vaccin[[tions important to child development? LESSONI-} THE STORY OF RACHID .AND AHMED
OUTLINE MONITRICE ACTIVITI~S MOTIIERS I :,CT 1 VITI r':S
I. INTRODUCTION Monitrice tells the story of Rachid and Ahm~d using f'o~ tprs Li st.,rl to 1:lld .,> lch the posters, then questions moth8rs about the two -Hachici story. characters. -llhmeci
II. RACHID 1. Which is Rachid? How d08s he look? hhat is his Responsl: and state of health? participation using 2. \\hEt foods does Hachid' s mother fix? How does roster. Rnchid eat? 3. How does Rnchid do in school? h'ho is the student behind him? Vlhat is he doing? 4; How does Rachid play? Whnt does Ahmed do at playtime? 5. ~hnt does the doctor say ab0ut Rachid's height and weight? Is the doctor pleased with his development? How does Ahmed look in comparison with Rachid?
III. AHMED 1. Whioh is Ahmed? \~~t is the color of his cheeks? Response . IV. WHAT HAVE YOU LEARNED? Think about the stories of Rnchid Hnd Ahmed. Hesponse and . ciiscussion • Are your children like Rnchid or hhmed? Tell what you /DUS t do t a have children who grow well nnd are h~althy like Rachid. LESSON 1 -4 THE THREB FOOD GROUPS OUTLINE MONITHICE: 1\CTIVlTIES TEACHING 1.1 n~-j MO'l'HBRS' .. CT lV 1 T I r.S I. THREE FOOD GROUPS 1- Moni tricl) sho.;s th~ food groups poster ,end l'osll,n1 asks thn,I': r~others to nqm~ the fuods on tiw -'I'h r ... f" food red table, th.:: LIu;; table nnd the yellow Groups H.;s !")Il~le and table; • pnrticirntioll. 2. Moni. trice asks one rna the r to name th-.: foods -ftachld that Rachid's mother prcpnred and [[nother to find thel'l on the food group poster. 3· Monitricu nsks one mother to nornc the foods thC1t Ilhmed's mother pre p:-tred and another to -Ahmed find tht3m on th2 food group posl(;r. 4· From which color.:d tabl0s cto~s Rachid's meal C()!!!2? 5· FrG IV~ GROUP 3 1. Does R:'chid's mep.l come from the yellow table? r/hich foods? 2. \1h11 t kinds of foo::1s ar2 on the y,d low tnble? 3· Does llhmed's meal ~~!Tle from the Yf3110w table? V. i'ffAT HI,VE YOU 1- Does Hnchid e:' t foods from onch food group? Hdsponse flnd LElIR!lED? 2. lihRt is Hachid's state of h.J:llth? discllssion. 3· DOl~3 lihmed Ant foods from each food group? t1 • \;hnt is J\hmed's state of hel1lth? 5· \what did t:w doctor advise 1.hmed to eat? 6. If you want your children to gro'S And be healthy like Hachid, you will choose their foods from which food groups? ---- LESSON 1-5 CONSTRUCAOH FOODS J OUTLINE MONITRICE j,CTIVITIES T !:; /, C IlItH; ill j)~; Iv: ,Til r:W;' ilCT J VI TIc': I. FOOD GROUP 1 Name the foods on the red t~:b ll~. ll:l it import.::nt l'f>!ll.t! r h~t) T 'lfl3t' , !lid to eat some of th8se foods ,"very day? -'l'hrc'2 F.",d I::>llicjl)~,tj()n. "" Cn)li PH II. CONSTRUCTOR Foods fro'll 'Lhe red table are onlled oOllstrlJutor FOODS f('ods becD'-,se they build the body. 1. ivny do children nef~d constructor foods? Ri'sl'onse and 2. Vihy do pregnnnt women need constructor foods? disoussion. 3· '.\Ihy du {r..:.~'s inc; rJO::Icn nt.:t.:d consLructor foods? r:0!'structor foois also ren;] ir the bodies of adults and keep them strong and heAlthy. llI.MHMAL OH1G1N The red tabId is divided into two. 'l'he upper half contains foods of nnil!Jal origin. 1- Name these foods. R(:sp()nst~ and 2. Tell the price of e?ch. discussion. 3· Can you afford to eat some of these foods every day? Do you know recipes that oall for only a small amount of these foods? ------IV~ MILK Childr-en and pregnc:nt nnd nursing mothers need milk products two or :nore times a day. 1. Do you nurse your b V. VI~GETABLi!: The lower half of the rod tpble conte ins some ORIGIN very good constructor foods. l. N'me these foods. Respons.! r!nd 2. 'fell the price of eLl ch. discllssion. 3. Do you Qat some of these foods eVery doy? VI. WHlIT lIllVE YOU 1. f'Jp,me th-o; foods on the r~d tnblu. Re~ pOllse 2nd LBlIRN.I!:D? 2. \,hy ,! 1'(; tht~y culled constructor foods? dil3cllssion 3· Did you h,o,ve n.. const:,uctor food for breokfRst? -1. Did you hnve 11 cons t rllctor food for lunch? 5· \\hich constructor food do you plan to usc for supper? LESSON 1-6 ENERGY. fOOPQ OUTLINE MONITR1CE ACTIVITIES T81,CHll1G ;\lf~ MOTHERS' i,CTlVITJ~ I. FOOD GROUP 2 Name the foods on t,hu blu: tnb1jG ," Is it import:mt: ["oHlt'r H, ':q'nns,' ,-: nd to "at som,C! of th,-'sL; foods uver~ (by? 1'hrp8 Food pc: rti c i !I'1l1 t m , Groll ps II. BUERGY FOODS Foods from the .lue table [Ire CI!lll~d (:nergy foods! because the,}' give us (:nergy, 1 Response and 1. \,hy do we need em~rgy? I I discussion. 2. 'Ilhy do children need energy'. _ ! ' III. FliTS The blue tab I£: is divided into I,t'il'O," The first half contains fats, I 1. The foods thRt give the mos~ energy are fnts ! Respcmse and but wh3t h:lppens if we eat Il\Ol'.~ thnn l'Ie need? discussion. ~I, ;\re chlldr8I1 able to ent muc'h fat?" , .. I +------+----- I , IV. GRAINS On 1;he oUler half of the blue tob'!B are grains, I 1. Name them, Response and 2. ~,hnt other grains and grnin products do you discussion. eat? 3. Tell the price of each. Grains giv V. SUGAR Sugar i oS shown on the blu(! tnb 8' nlso. It gives energy but does not help build the body like grE:ins do. VI. WHAT HaVE YOU 1. Name the foods on the blue ~nbl~. Response nnd LElIRNED? 2. \:hy are they called energy ~oodS? discussion. ,. hhnt do grnins do b0sides g~ve energy? tJ. ~Ihat should you E;f': t wi th gr~in products to m,:ke th'.:m b,~ tter body build9rs? I LESSON 1-1 PRo'rECTOR FOODS - OUTLINE MONITRICl!; ACTIVl TIES TE,.CHlIlG JIlIJS MOTHER::;' J,e,},I VITIt;:j I. FOOD GROUP 3 Name the foods on the y"llow t.·ble. I'us t <: l' fj':SP(;llfh: :,1111 Is it import::n t to ent SOnl'-' of these foods -'l'hree; F, )od p;' r tic ii" I l i [) n • ev~ry day? Grou p~l II. PROTECTOR Foods from the yellow table ~re Culled protl~ct()r R,;spons\! Llnd FOODS foods because they protect the body from illnesses discussi0n. and help keep us in good he:!lth. 1. Why do children need protector foods? 2. vlhy do 'you netrd prot~ctor foods? III. VEGETt.BL~S The YE::llol'I table i".. divid'..:d into two. The lower half contains Vt;g;:; t[1.bl~s. 1. Nnme the: ver."tp.bles on the tnble. R,"sl'Ons,~ and 2. Name other veget~bles thnt you er~ t. discuasiOIl. 3. TEll the price of e:'!ch. <1. '.which vegetnhles cnn you grolv at home? 5· ~Ihich vegc;tnbll~s do you eat r21V, which cooked? IV. FRUITS The upper half of the yellow teble contains fruits. 1. Name them Responso:! Elnd 2. Tell the price of each. discussion. 3· Nam" the frui ts thn t are in season now. 4· Name the fruits tll1't you can afford to buy. 5· Name the fruits thd you can grow. V. WHAT HAVE YOU 1. Nal!le the foods on the yollo'.': tl1ble. Response and LEARNED? 2. Why are they called protector foods? discussion. 3· iihich vegutables did you serve for lunch? 4· Hhich vegetables do you pl~n to serve for supper? 5· "ill you s",rve nny raw vegetables today? 6. 'llill you serve any fruits today? Li!;S::iON 1-8 SUPPLEMENTARY FOODS OUTLINE MONITRICE ACTIVITIES TEACHING 11 IDS MO'l'HBRS' Itl:T 1 V1 TIE:J I. SUPPL.1AEN'l'ARY (Lesson given according to foods available) FOODS 1. Show sample of each supplementery food ·,:SB DioclIssior 2. ~bat is the monthly ration of each eSB 3. The ration is for: CSM - registered child - younger child - pregnant or nursing mother II. DEFINITION 11 monthly ration contains 2 tablespoons per day per recipient because: 1. The supplc~entary foods are rich constructor foods. Respons!! 'lnd 2. They are to be supplements to regular meals. discussi~n. 3. hhy do child ren ne8d this suppl~ment? 4. -- pregnant wo~en? I I 5· -- nursing mothers? ! , .1.1.1. IN'l'ttuDUL;l!.i , InLroduce a ne~ supplementary food with only 1 tea t FOODS spoon ~he first rl~y. I t n h]ADP0on thJ s0rnnd. et~. If the child develops diarrhea, reintroduce it more slowly. Ration for a child 0-2 yeers -~ tablespoon, 4 times a day; for ~ child 2-5, 1 tablespoon, 2 times a day. IV. INGREDI ~NTG 11. ,.SB Poster PUl'ticil'ution and 1. ~SB is made from wheat and soy. -Food Groups discussion. 2. lo'ind wheat on the postar- Group 2. 3. Soy is n constructor food - Group 1. 4. \,SB has vitamins and minerals nd C. CSM 1- CSM is made from corn, soy and milk with vitamins CSM and minerals added. 2. 'lhy is CSM a good food for children and pregnant and nursing mothers? V. PREPARATION V;SB, CSB and CSM 8re pre p~lred alike. ,/SB PartiCipation ond 1- Mix with cold water. water discussion. 2. Add w[lter to desired consistency: sUGar a. 1 part WSB/4 parts wRtar for pudding cinnnmon b. 1 pE',rt 1..SB/IO pr.rts water for drink 3· Add flavoring if desired: a. sug[!r and cinnnmoll to '\'ISB b. cumin to CSB (plus salt) 4· Heat to a boil. 5· or a f c: W tllJuonfuls of i.he preparation may be I I added to the child or moth.2r's soup or tagine. Ti------~------'------_r------+------VI. OTHER A. Soy-fortified onts Food Discussion SUPPLJ!:MENTARY 1. Oats i8 from Group 2. Groups FOODS 2. Soy is from Group 1. Soy 3· The oats is a better body builder when mixed with fortified soy. Oc!ts B. Dry skin milk ~ith Vitamins A and D added DSM wi th 1. The butter fat has b"en removed but the vit8~ins AIiD A and D readded. 2. Mix 1 part DSM/4 parts boiled, cooled water for drinking • 3. Mix 1 part DSM/3 parts boiled, warm water for making yogurt. C. Soy-fortified flour Soy 1. Flour is from Group 2 fortified 2. Soy is from Group 1. flour 3. This m~kes the flour a bet tar body builder. D. Vegetable Oil 1. Find the oil on the poster-Group 2. E. Rice, dried peas, etc. 1. Find on the food group poster. 2. Discuss its value and use • • LESSON 1-8 (Cont.) VII. STOR1.GE To stort::! th~se su Jl pl.~men t a ry foods: Discussion. ]. Us\:! tins with lids. 2. Protl;ct from sunlight. 3· Milk keeps well in fl pl~stic bag. VIII • wHAT HAVE LEARNED? 1- Why orb these foods called supplementary? Hespnllse and 2. \Ihere are they found on the food group poster? discussion. 3· "'hy should you give u rlltion to your child, yourself? 4· How do yr)U store th,~se foods durinp. the month? I LESSON 1-9 IlEED FOR SUNSHINE r-- +-______OD'l"i..1NE -;______MONITRICE ACTIVITIBS -r____ _ I. INTRODUCTION 1. Tall how HRchid nnd his molh~r ant to ke~v ~ell Pc-a t.,r and grow strong. -Rachid 2. Tell why you ::lnd your chiJ.dn:n get rations of supplementary foods. II. NEED FOR 1. Something else is needed fnr ynur children to grnw 1\:!rticil'ntirJl1 SUNSHINE well nnd for pregnrnt !]lId nursing molhers. nnd discIJssion It is the sun. 2. Children need to go out in the sun for a little while each dp,y. t,nen the sun's rays touch thei r skin, they form a substpncu which helps mnke: a. their bones stronf. Child for b. their legs find arms straight. demonstra c. nicely formed bonus with'mt knots. tion. d. a strong, wide rib cage. e. strong teeth. 3· Mothers need to hrve the sun provide for the bones and taeth of their childcen. III. DURATION 1. Hhy do childr8n need sunshin~? 2. Inf~nts from 6 weJks should get some SLn c~ch day. Inf;'nt for 1':'. rti ci pt; t iC'n Morning sun is best. demonstra dificussinn. 3. Show how to sun your baby. tion. 4. Children need sunshine -(10 minutes) ench day. Child. 5. How should children dress for sunning? 5. Mothers need to get one-hftlf hnur of sunshine each day. ! ~------~------IV. WHAT HAVE 1. Vfuy do children need sunshine? Res p'Hlse p.nd YOU LEARNED? 2. Do your children g0t sunshin l ?? discussion. 3. How do you sun your inf'nt? ~. How ~noh sun should children get avery day? 5. How Uiany of you wi 11 Si.!e th: t your children ge t some sunshine 2~ch day nnd tell us about it next lesson? 6. IIhy do pr·2gnDnt and nursing mothers need sunshine? LESSorl 1-10 Fi-:I',]IJrH; 11'. ... {;N~i!L;,lilJ rllll~ ill.; M ITi! .. t(~j -~=::;O;;l~JT;:';::f,;I:;:lj:~;' t---7':M:';:O:-:r .-;1;-;1;;-:' r;-;-~ -;-1 r.r;rE;:-:;:-:, (7':; 'nr ~l';rVr:7 n -]-;. ,-: :----.--~------======----.--::T:-j-,,-:,(7:. !::", ::",7':/j-:::r,-,-;, l:-j:-· .-:-' '-:,J:-' -::,1:-:-',:-i -, :-::-:-. --:/,-:, ':-;;T~I;-:'-;-" ;-:) r;-;I-; .:. ------+----.------~,------1------t------,----- I. Ill'l'R()"lJCT Ie:! 1. D·-,,,!:) j{':clt i ,I':; I~,. t h" 1- "t. tt. t j:l d,,· ;l t. r .r! H' q. 1 I !Jo; r'l.::s }{'!ctl i (j'~ -/( (." J d 'I'" "I . J ::. LfJok c 1 (,:,," J'y '. t. t" 1" Ii': t Ill, j ]:; ::1:. I.. ':ll.tly't 3. LrJol' c I f):> 1.1 " t. rt.:".'j':, I'," ttl . I ,i :;/": til l/,'~ -I.hr ,.:J II. PREGNArl'I' A. Bn:':)':f~,~t I CII-t.iel! .tl' I. '"OMAN 1. I'ujl.t (rill. fr',r~, 1.1..; J ,:i!.• ," U-,,: f')')fj~l th:t 11'Ik.: ': grlld ";1'1 1. I' () i I I t. '-Ii 1 I. ; I r; (J f, 'I :; lJ 1'1": r . ;). Is it lir:hl. . rid :lti I J '»lll.'lins ., v ri,~ty? I II. N"'i~ 1 HG ',fh,:rl ylJIl '1['.; rl'll',;irl,', ,j" .Y'dl n.·,:lj l'l "'It rnr)r,:" .Ihy'~ Ii •. f: I : 'lI:i" III d MOTLlwR 2. jl() .yr,u It.:·;d tr, ,j/'ink EI')r.: wi Ik ,nrl I iqllids'~ .::y? 7 I' : r·t i c ii' 'Il i, '" • ) . Jj() :y'()ll I.·;,·>! I.". t "I,r! dr-il.k f')I)lj:] th t 'iJ I b" {;1)1.rI ["Jr, ;:nrI fI,)t Ui,:;,:t, ttl': !. ,hy? How C;,l. Y"1j ilil:I';"s.; .V'JUT' illt"lk,: fl",m Grr)Uf; I? 5. fruIIl (;l'rJiJ I' !'~ 6. I------t------f'rr.fT1___ Gr')Il!, ______)'~ , ______IV. \-:11i1'1' 'Ii. VE 1. If fdlll·:d':: ~Jj:;f. I'd, I;li't t",:il' .::,lill,: fT' In !.tit: 3 fnf)d YOU L~MmEI gl'lJuI'u, wi II !'li,. h '/ ::tr'II'I: t,':ui,:u '.hdl ,JIl" n;:rri':~l'~ Jk[q,f)nnu ;~nd ~!. ',hr:n mlJ~ l ,'f")[1;:Il L.·~r i rJ :) !,' ri rl(: th -' i]' b IIi i L S fnr r>(1 th':rh~J0d? "j diRClln'li,·n. 5· '.h,.t j!j ;, r()I)d ::I,',,;k f'iT'" r,r"/;Il'I1t W')rn .n? t1. ',hy ;'r·.: V·'I, .. I,',!.j'·:l "I:d ;T'uil:; ir:q,,'T't.-nt !')(J'ls? 5· ·.hy [Jr., C'Jll'-ltruct"I' r,J(lirJ iI!II'<)rtlllt·~ LEssnN I 11 "r:MIIl!G .-=====~===-==-~----r------'------~------~ MOUITllIO; /,r:r]VITILi MUTlli-:H:; ("1 I V 11 I r::, I. I"Ti(OIJlICTTOl: 1 •.:hl1l i:, th· f'i 1"1. r·, ,;1 t h·, I ',I,,V ,": ls? 1(,·:: I" IIIl ;,11-1 !;',' 1;; r;,(.th·:c·':; 1:1i Il 1-' .1 1',,), 1.",1 i· ,I i !' C II~; I' i ". 3. 1)[, i:ll b ,l.i ., .1,,1 ,;lli Id(' II It,·" I;ii Ik? ". R'~bj "8 1:1',,1\" t··,::,. II ,'S C'II I:i d Ii J Ci 1>1' ,.j'I'~\' ul,ugh mi I k l,) k •. · f' ' t, Iy t' ("I': !' t.1. i Jil; hUII!:C'Y? 5. ilo\\' L;~ll y' :11 t.: 1 I 'sir, '11 : t.- ty i ol: n. h\JlJt!ry? b. not C,·t.f.iJlt: '(I '11!;1i \." ""1,7 II. N.t:.!:D FOR SOLID 1. ',hen il b;t\,y (('111')111.111;) (:,:,'ris mor .. than;; mJthur roO) cnn pr[)dll':':, !.lit: In', t.1r, r c·~n: a. lII!"r S I, Ii i r~ m" n I j ll!~,' f t., . rr I ')' 'II ;:, n d '" Ve n i n g • h. fu,·rI Idrn :nlitl f,))rls rrl n'J,jl1 t.ime. ? Ikr;jl'" tIll' W, 'lflill!: ("(ld: f'1 ()1I r; mi 1 k ." Pr,-,], r" f)'lur (gl"1i1l ':nrl I :/.:umtes) "r v.·g.;l:·ble b. 1'(J III. IN'l'RODUC ING 1- Baby must L,'rn If) lik" nflW j·\:.or1s. NEil FOODS 2. M;,ke the ,;,r':111 thin, lik·, milk, elt first. 3. F ·,:d thl: \l by nnly 1 or ;) spnonf1l1 s t.ll(! fi ~st t~;!1i~. ·1· Gr:r1ur.lly tlri<.;f;·'ll lh •.. c·r,.,':! :'nd lrlcr"rlse th(~ nmount. 5. If Uk h:llly is nlill hUllr;-ry, hl·t;.1stf(:l;d (; fl'.r tIl>' (:.r.,"l). IV. ING REi;; .Hr G 1. "hon th·" b lj,y J .'!·rrl~' t·) lik,:: cc;r'::ll, gr"rlu LIly :::i"mol ina SOLID FOOD tur:c11 him l·) Jik,; v'·Cli;:bl.s (.;'n pl'IL.? Oflllot.h';r (~::rrot, FEGDINGS bn.JGstf"'L;r1) 1-l)t'I1.0, 2. Rlicipr; for e':r,','l 'UHf v I~,~t· bl,: puree. paT::;lcy,oil; [l • b 0 i 1 [) n d ::; ii, V (! V l! gt: t " b 1 (, S • s".1 t, !'['n, b. cook semol in:' in Vl;!",;i'lbJl? vl"t,t..;r. bnwl, knife c. arlo V(;g(~1.: l>ll! 1'1lrt:: •.J. sl'o',on. d. rrdd oil; S!llt. 3. 'r(J<1ch child to, orillk urr'II/;··· juice fr V. LE.llHNING TO 1- Sp()()nfe,~d It chi 1<1: ,~.: n';' 1 S i l'ur.'I.:, soups, III'ShHI Di BeUO!; i, ,n El\T ALOIJr~ eggs, 11':sh ,<1 I ,,/:,un,,; R , ch'II'l,,"<1 m 'll. ;> . ,,11f'n h,: r; (J ! j hrJld !', ".:j hi r:::;,. If'? :l • eu lJ hl ~, r rJ!' tj, ,11:, ill ~; fl" , I 1 Id ''':C~~. U • let him drink f 1',1fTI ; ~ g]":J:~ • - VI. VALUE OF \'h..:.'n .Y -dl (',' ,du' II y ill t. rndur;e f00rlS in this w:,y, y')u: rEACHING A 1- Insul'c Ul;,t ttl" eli i 1 d is not hungry II:) r IOGi lis weight. CHILD TO EAT 2. Cr.lll t i nue hr\~;1s t fel';) ill/, :lS ]()lle "S r·)s:~ibl·!. ) . T":ich ttw child t'l c::: t ( ~ 'If' ri e ty (If [(Juds. VII. \1 ill'1' IIIlV c'; 1- \Ill" t is tht' b,,:;!. f'lOel for b,dJi ,e s? iOU L~AHH~D? 2. ',:hr t el O,.S rn'JUlt'r do v;h ,'II II (' r " u'by itl Croy!i 19 L!s t 11,·3I'('ns.: ,"nJ Rnd nl"Jd s 11') r'.' t.o Gnt th:- II ht? r T!I i ] L,? din c: u !) S i ' I •• 3. \/h.v must y' )11 ill t.r(ldUCL~ new leods Gr::dually? 4. ,.hy mu:c;t you C'Hl ti IIUt: to bI'-" s fc<,d? •. hy 5· is it imp()rt',n t t.h'l t th~ child likl'? n v;:riety of foods? IMPORTANCE OF CARlllG FOH MOTII:;H 1,!l1.J CHILD LESSON 1-12 .- OUTLINt; MOlj l'rHH-:E ACTIVITIES Ti';lIC III ill; ,\ 1 [(i MOTH L· .:~; , ('1 1\' J T I ~ I. PREPARATION I- 'when must f1 WOln-lll bq;ill prl:P'! ri llg t18r br,dy fnr I:! d.h·,r- 1'.J~ t"r Ii .. !'! ,n::·' :.' ,j FOR hnod? Gj VI: I,X ,!mpl ': (If ;'hm.cd ' !l si8t..,r. -IJll:;I;d . l i :; ell:) !; i I' • 'J MOTHERHOOD '- . How '>lIl she du this? Giv<.! l:xnmpl(~ of Hachid's :::;is t ..:!" -H·.chid II. PREGNANCY "ih" t cnr III. IMPORT;,NCE I- If El womnn h l: com,s n T'.~gn" n t ng:·in s () ;)n Ilftcr (~ birth, It",:, l,nn!J· , n,j OF NURSltlG cnn sh·" h r..: n s t f e.:('1 Uw child '! y 'nr or l~O rt: ns shn sh.)uld? discu!l!lif·n. 2. ilhnt YI ill h:'l'l',:n to th..: child's w..:ight i!nd h(,if:ht? 3. If shu bn:.'lslf""'ri n bl: hy six t im:~s :1 d'l,Y from birth until gr" dUll 1 w "!nillg b'!gins (6 m'J) --:nd d 'JC rl~ iSL S the brenst fUL:ds 5 r du'dly, it is pos sib It.. tha t she won't become pr,:gnn 11 l so IJuickly. 'l'h<.! sucklill" ."1C linn of the chi] d Ci:uses hC!r buri,Y not to b,<. roe"dy for pr'Jcnitncy. !J • If she bUl:om.::s pI'ugn::nt, she should cf)ntinue to b rw' st feed the first child until he hus b',en gr:dun11y wenned. IV. NURSING \'lhat care must a WOl'l:.n take while she is nursing R':!f1p')nsc ;'.r.'J di"cu8}ii ,n. 1- to prot(!ct th(~ Lnby? 2. to pro tt'C t her hei!lth? V. IMPORTANCE 1. If n mothr:r hns repe2ted pragnr-:ncies, wh.'lt will h£'.ppen h,; S I,un s '" i lr"j OF CHILD to her hunlth? diSCllssinn. SPACING 2. Cnn she Cf"1 rt~ for her f~;mily 'IS she sh mId? 3· \1ill her body b~! ndequ'lte to form her:l thy babies? 4· Does your husb:-:nd underst"nn the importfmce of child sJ.lueirrg? - Rcs porl~~c : ,rlei ilHAT Hf,VE 1- '.'hen dO·JS JlTi; p:. r;! tj on for prl.!gni~ncy b~gin? VI. discussi·>!l. I YOU L~AmmD? 2. Cnn ,'} mot.hel"s body be re~dy fnr ~not'13r bab,Y in less thf.n It yuar? 3· How d08s br(;lls t fUl!d i ng help pI'(~v.Jnt pr ~gnr:~ncy? t !J • Huw fru4uently . tid how long must br,;;' 3 tfeEding i cr:mtj nue? i 5· iihy is ehild spacing import nt for you? ~ LESSON 1-1~ FAMILY M':.RKETWG OUTI,IlU': MONITRICE ACTIVITIES I. FOOD SHOPPING 1. i,ho does UI" ::;II"l':' i ng i [i .yr,u r f'tmi l.v? k,;~ ~")nB·.: Pllli 2. liow uft~ll du"s .YI'ur huJb',n,j sll"I'? dlSClJ!;fii,'r,. 3. !lOI:S he buy -, v"ri"ty ,-d' f'1l),jS lik,.' H"r:llid's fHtil,r? iJ. Can .v')U t'~c'ch ynur huslrnd Wh:lt YI)U h'tVl: lU'lrrlleri h~n,,'f II. CON3TRUCTOR A. M8nt ~nd eggs PO!] t" r FOODS 1. B1lY f'!'t1sh. -1":),)d (;re,ups 2. Buy smelll quantities. B. Legumos 1. Legum" s ,'1 Tl! i1 gl)od buy. 2. Buy legumes wi thou t insects. 3. Ll!gUr.ll"S C"II h.! bought in qU;Intity c:nd stored C. Milk lJr'lductll j. Buy milk whL,nt.:ver you cr,n. 2. v'h.ay, yogurt rnd ch"'l!se ker.!ll 1nngcy. ,. If p6ssib1u, nis2 ~ gOJt, sheep, cow ~r cnmc1 for milk. III. EN .;;HGY FOOD~j A. Oil nnd butt~r 1. Buy fresh. DiscussiJn. B. Gr~ins 1. Buy grFins without ins~cts 2. Grains cnn be bought in qunntity and st~l~d. C. Sug'1r 1. Buy oth8r foods first. Buy sugur l~st. IV. PRO'fECTOR A. Vegetcb1es Ditlcussion. FOODS 1. Find th<.: best buys ,;,'lch se,'son. 2. Buy fresh--not bruised n0r sp~tted. ,. Buy greens and tom<,tr;.,s in sm~~ll qunntitiGs. 1. P1~ntn gnrd~n 0f Gr~ens ;Inri t')ml~oe3. 5. Pi ck wi Id gruJ ns • 5. Tubers cnn hu star~d longer. E. Fruits. 1. Find the Llest buys le~ch 3"",S')I1. 2. Buy frosh--wlt bruis ~d nor spotted. ,. Pick wild prickly pei1rs. 4. Plant a fruit tree. LESSON 1-13 (Cont.) v,, RECIPES Vary your menus to encour:1ge your husbp.nd to buy n I''!rticipnt:'on. . variety of f00ds. ,/ho ;1 .l I- can give n",1'1 reei pe using L~gumas? 2. -- a neW sal VI. \,HbT RhVE I- '.. hnt fonds do you h.~ve ~t home nJ..,? Res(Jonsl! Ilnd YOU LE/.Rl~ED? 2. Do you hr!vu tuhers, gr~'ins or le~es stored? di!::!;:;ussit)n. 3. Do you r j 8e your ()wn eggs? 4· Do you hr!Vt.:1 a milk .::nimcl? 5· Do you ruise sm,~ 11 nnim r ls for I!I ~llt? 6. \Ihe. t would you like your husb:;nd t" buy on the next market day? - . - . -- .c· HOTHCRS' LESSON PLJiN3 SEC 0 N Dey C L E (~evised June 16, 197A) WSSOU 2-1 f.DVISE FOil Plrmurr ;:OTH -;.-(5 - OU"LIllY "OiHTRU-: -:; r::TIVrrJ --:; T ,: \QI I:IG r /I', lil l fli .---.J.t11V I TI 1. Consult the doctc~ 1. Do :;uu vi' it the II. SleeE habits 1. The pregn2nt l'oman needs plenty of sleep. Discl153ion. 2. Lf insomnia occllrs, a) pat 1 i ['ht suppers. b) oxclude co ffee and tea. c) tal~e a walle after supper. d) drink Hal':rI milk at b8dtime. glasfi 01 nilk Discussion III. Varicoso veins 1. Rest \lith legs e]evated. 2. To 11revent v V. '!eight gain Exce.ss ucir;ht go' in may mako delivery difficult. ------_.. _- . - --.---- .. --". -- - .-- f---- .. ------.. - VI • .!!:x:ercice .1., L,]k a half hour each day, 2. Don't Lft heavy loads-get help ______--____ -_0 ______.. ______L~SSON 2-1 '.fNIS:: .FOR PH :GIL'tlT t10m-R3 OUTLINE Hor'ITnIC~ f,CTIVITIES T~ ICllIlC r. IDS , II)TIi: J(:' i I;T rvITL;S VII. Edema 1. \latch for Slvell ing. --- 2. Visit the doctor if :nrelling occurs. 3. Exclude salt from the diet espocially after the seventh month. VIII. C6nstiEation Constip;)tion is common in pregnancy but can bo remedied. 1. Take exercico -- walk every ~Yr 2. i:',a t plenty of fruits and vegotables. 1 ~. :;:a t Hhole grain oread -- not whitB, IX. Hhat have :lou 1. 1~1Y is it, importrnt to visit the; doctor or midwife Hespon~o and learned? before co.oplications develop? discussiun. 2. 1fhy should a pregn2nt lIoman eat a variety of foods? 3. How do you remedy constipation? 4. 1'hy is it important to watch for SHelling? LESSON 2-2 fDVIS7 FOR THlE NIURSINlG HICUTWI OUTLIVE IiOII'!' 1R(7 ACT lVITI 75 T'.CiLCID;;II;TI 1.i.5 I CTIVIT. I. Introduction 1. Have you noticed that. ,reastfed Labies are healthier Discussin. .., hve fewer problims than non-breastfed thei, s? 2. How ranny of you are breastfending a baby-now' 3. l.ho will help us with this demonstration? II. Breastfeeding 1. -ash hands, doll -r baby Participation 2. Choose a comfortable and calm nlace, ard discussion. 3. Urn;rap baby and self. 11. Hold breast away from baby's noso to lot him breathe cirifortably. 5. Bagin with a dilflsrent breast each nursing. 6. Nlur',, on both side:. 7. Burp te baby. Nurse him longur if he wishes. 8. Clean ]),.-yh s face. 9. 1.sh breasts. 10. Cover each breast with a clean clcth. cloth III. Nutrition Needs 1. lire you more hungry than usual when you are broastj eeding? 2. Aow (do you inc~cse your food intake? Poster-food iRcsponse. 3. How do you increase -:our liquid intake? groups Do you get plenty oi rest? 5. Do you get some sunshimr. each day? IV. 1That have you 1. 1.hy do you cL, ose a comfortable place for breastfeeding? Response Tj. learned? 2. !!hy do you wash your breasts? c~ cussion. 3. A'hy do you burp the baby? h. Thy must you eat more than usual? 5. Why must you drink more liquidS? LESSON 2-3 IUF414T HYGIITE OUTLINE M1ONITRIC' LCTTVITIES T-i CiiiIi IIX, :.S iCi'VITII;S I. Introduction 1. How do you clean a new baby? nsp( nici and 2. When do you begin to bathe the baby? di,,c 1 it'll. 3. How often do you bathe the baby? If. Preparation 1. Arrange the materials needed. warm u.::tcr Particip,tion 2. Test water temperature. tabhle, ".::in, soap 3. Wash hands, have nrails cut. washcloth, towel, h. Play with baby before beginning. scissors, t]c, cotton, oil, c can clothes, Lrush III. Bathing 1. Ilash, rinse and dry hair. Participation 2. W1ash, rinse and dry baby. 3. Note--don't get soap in eyes nor cars. Don't let baby drink bath water. Use soft towel. IV. Lfter the bath 1. Dust baby with talc. Participation 2. Dress quickly avoid chilling baby. 3. Clean oars and nose. 4.Clip nails. V. Baby clothes 1. Display layette. Shirt, bib Discussion 2. Use mild soap for washing baby clothes, nightgown, 3. "aiten diapers in the sun. dress, cap, sox (A lesson on making baby clothes may be added.) diaper and VI. What have you 1. Why must you prepare for the baby's bath Response discussion. learned? before you undress him? 2. 1'hy do you change the baby's clothes after the bath? 3. How do you wash baby clothes? 4. Fhy is baby hygiene important? LESSON 2-4 INFANr FEEDING OUTLIi;E IO[ITIC :fCTIViTIS A,, X7.-T1 I. Mother's milk 1. What is baby's first food? Flannelboard Discussion. 2. Mother's milk is better for the baby than cow's milk. mother breast 3. It is clean and safe. feeding 4. Itis free and abundant. 5. It protects the infant from disease. II. Feeding time 1. The infants' stomach is small, Broastmilk digests Discussion. quickly. Therefore, breastfeed the infant short time (no more than 15 minutes) but often. 2. Feed him six times a day--morning, midmorning, noon, afternoon, evening, night. 3. Find e schedule thpt suits the infant and stick to it. III. Weaning 1. If the baby is breastfeeding six times a day yet Rosponse :'nd seems hungry and his weight slows down; it is time discussion. to supplement his diet with solid food. 2. There is no need to feed him solid before he is ready. 3. Don't wait too long to introduce him to solid foods or he will become thin. 4. Take time to teach the baby to eat from a spoon. 5. Continue to breastfeod while introducing solid food. What IV. have you 1. Why is mother's milk best from the point of view Response 2nd learned? of nutrition? discussion. 2 ..... of hygiene? 3 ...... of economy? 4...... of health? 5. How often and for how long should you breastfeed? LESSON 2-5 NUIIRITION DURING IENING OUTLINE MoV1ITHICE iCTIVITTES T.ri.T TI IDS I)rf*:C" ,.cCIv7Ti I. Weaning 1. How can you tell when your baby needs to oat more Firr.ioLoerdiles|,orc than mother's -nd milk? rither-Urctst- discussion. 2. It is important to breastfeed s often as possible fu, dinrg but to elso begin to feed solid foods. II. First solid 1. W/hen the baby seems hyngry (six months-morc or less), food cereal Discussion. begin to teach him to eat a little at the noon feedirg 2. Begin with a thin cereal. 3. Give only a spoonful or two the first doy. b. Breastfeed afterwards. 5. Increase the amount each day and be patient until he learns to like it. III. Juiec 1. Feed the baby juices with a spoon-orange, carrot, tcm orange to, grapefruit. juice 2. Lcter feed him with a glass. 3. Later he can hold the glass himself. IV. Feeding age breastfoedings supplementary additional sup Schedule feedings 6-12 months 5 me. plementary food eggs Discussion. 5 1 cereal, juice cereal 6 me. h 2 puree juice 7 me. 3 3 eggs, meat puree 8-12 me. 2 3 variety vegetables V. Feeding Preppre a portion of the family meal before the spices are 1-2 years added. LESSON 2-5 NUTRm~ION DURING 1-;NIING OUTLINE MONITRICE .CTIVITIES TE'CHIIIG AIDS K)Tif;LS ,CI'IVITILS Vj@ Recip::s Choose recipe ingrediunts and P2rticipation. 1. Wheat cereal matiriols for 2. Wheat cereal with milk recipe 3. Vegetcble puree h. Hashed potatoes VII. What have you 1. Why must a baby be introduced to solid food? Response -nd learned? 2. dhy do you have to teach a child to oct? discussion 3. lhy do you continue breastfeeding during weaning? it.Ihy do babies oat small amounts often? 5. How can you prepare the family meal for the baby? LESSON 2-6, V!,CCIJITIONS (UIItl lONITH-IC" .CTIViTiS T CllING .1IS iiTHLkS ,.CT1VIIiu I. WG 1. Uhich vczccint ion do you have to hrvc: to get a family 2. Do you know what the BCG book? csponse and 1 is for? 3. khy do you think discussion. you are required to have the b"?d I1. Do you kno anyone uho has tuberculosis? 5. lhat arc the symptoms? 6. Is it important that your children hove the BCM vaccination at birth? II. DPT AT three months your baby should have a DII' vaccination. It is Discussion 1.three. -iphtcria vaccirtions in one. I. The snptoms are fLver and e swollen throat with gray 2. Tho patchos child may suffocate and die. 3. tic should be taken 4. to the hospital immediately. If thurc is on epidemic of diphtlhmria, your child can easily catch it. 5. lle must have five vaccin-tions to Le fully protected at 3, and 5 months, one year later 4 and one and one half years later. The first 6. dose is not enough. Listen carefully to when the dispcnsary tells you to return for the other doses. 9. Whoopjng cough .U-Tno msyrp-s are a cold, fever, distinctive loss of appetite and a couph. Do you knoi what the 2. Take cough sounds like? your child to the clinic immediately. 3. It is butter to vaccinate your child than to lt him gct whooping cough. 4.Have him vaccin-tcd fit 3, 1, and 5 months, one year and later one and one half-ycars later. C. Tetanus T Tetnus is caused after a puncture uound, a cut or cutting the Umbilical cord. 2, The symptoms are spasms of the jaw cnd finally death. 3. Do you know anyone who has died from tetanus? 4. Itis important to have the whole family vaccinated against tetanus. 5. After the three doses at 3, 4 and 5 months, boosters are given to protect aga.inst tetanus. LESSON 2-6 ViCCIN TIONS OUTLIIE i1ONITRICE '.CTIVITf[-S IDS I -CTIVITIES III. Polio 1. Do you know anyone who had polio and died or became prlyzed for life? 2. The symptoms are variable--fever, Discussion. pain, mild cold or insta-nt paralysis. 3. It is too lete once the symptoms are sen. It is Letter to protect your children by vaccin, Lions. 4. Polio vaccinations are usually given with the DPT at 3, L and 5 months and one year with Loosturs afterw rds. IV. Smallpox 1. Do you know anyone who has scars from snallpox? Discussion. 2. Since people all over the world have begun getting vaccinations this disfiguring srrllpox or deadly disease is noarly wipod 3. It is important to have your out. child vzccinated at six months and every thrce years afterwards. V. NOasics 1. How many of your children have had measles? Discussion. 2. Havc any died from it? 3. Doc the clinic give a vaccination against it? )r.M'asles n,ed not bc P deadly di a.u. If your child strong is well and like hazchid, he may not become very ill with 5. Ho needs constructor m30sles. foods ,rnd orangu and greun leafy vgt,ables when hu has muslus. If he can't chew, pure his 6. KLep him warm and food. clean nd in bed in a room with low lighting. 7. Takc him to the clinic if'his fever bccom,;s high. VI. Uh,, hve you 1. What food aru vaccinations? learned? 2. Is there anyvinu in your house with Tb? Rcsponsc and discussion. 3. ,,ro all your children vaccinated? h. Do you hav, a record of' their vaccinations and 5. Why must you their boosters? make suru your children have their boost,.rs? LESSON 2-7 HUTRITIOIH FOR THE 2-5 Y2LR OLD SMCI 'TiflRs OUTLINE MPNITIICE ,CTIVITI1S TEACHING ADS LCTKViTIES I. Fooding your 1. Lt two ycars old thc child oats thrce m(-cls and 7 snack Iiscuaiion. Child each dry. 2. it is important thAt Lu e-t rcflularily. 3. Ho cannot choose the best foods for himsclf. Tch him to choose wisely. II. The Threc Food 1. U y docs the 2-5 yeor old neod constructor foods? RLspo-IsQ. groups 2...... protector foods? 3...... onergy foods? 111. Sa:mple menus 1. Bro kfst Flannclboard P:!rticipation -ccrual, milk, Put s,'Mple hrirza, brcadz, munus on the fruit, juicc fl_,nnclboard. 2. Lunch -vcgctrb]ls, mat, fish, eggs, legumcs, bread, oil, fruit 3. Srack -milk, broad, fruit t. Supper -hrira, broad, fruit, milk, pasta IV. Recipes 1. Hrir,- or vUgtablt soup 2. Snack of brood with spread or chooso. V. 11hat have you 1. How often should v 2-5 year old oct? R.sponse end learned? 2. How umany meals do you serve? discussion. 3. iThAt is a good snack for a child? 4.How con you t-ach your children to choose their meals wisely? LESSON 2-8 DEVELOPiIENT OF THE 2-5 YE&'R OLD OUTLINE 1101ITRICE ".CTIVITIES ._TEICHUr1G ..1DS iiTHItS i.CTIVITIFS I. Introduction A child develops physic-!ly, montolly, psychologicolly liscussiun. end sociolly. IL Phsicrl growth 1. This period of growth is slower than for th baby Discussion. 2. Uptch for weight loss duo to: a. ) worms. b.) not eating - vnri(;ty of foods III. Responsibility and Parents arc responsible for a ch ]d's development. Discussion. rclationship of Good development is rclated to a good r,17tionship parents with the child. IV. Education 1. How do you torch your children? Response. 2. M!hat do you tueach tnem? 3. Do you send them to Koranic schdol? h. Do you send the.m to p)rimary school? V. Slccp habits '.dequntc !rid regular slcep habits are important for Discussion. good mental and physical health. VI. Psychological 1. The child needs to explore, have hobbies. Discussion. 2. Find the causes, consequences and cures for ner growth vousness. 3. Understcand your child's fears. Help him overcome them. LESSON 2-8 DEVELOPI1,4T OF TIlE 2-5 YE-hR OLD OUTLINE MONITRICE ,.CTIVITIES T, CHING ',IDS MOTHIMS ,,CTIVITIES VII. Play 1. Friends, toys -nd gCrmes cre importrnt for the child Matcrir-l for Pa!rticipation 2. Domonstration of toym,-king-windmill, piper hat, toymaking stuffed toy. VIII. What hove you 1. 1!hose responsibility is it to toch children? Responsc -nd learned? 2. In whrt ways do children develop? discussion. 3. !Tho helps the parents with tho child's mental growth? 4. How crn you help social growth? LESSON 2-9 CHILDHOOD ILLNESS OJTIINE ONITRIC': ,CTIVITI,S TI.CHING ..Irs h(ITHL.S ,.CTIVrT. I. Responsibility of Keep an eye on mnd remedy minor illnesses b1,fore they cause pFrents complictions. II..Diarrhea 1. Duscriptiori of norm::l s+ool. Discussion. 2. Diarrhoa while teething. 3. Importonce of hygine and good diet. 4. llemndius--ricc wotcr, carrot soup, continue breastfeoding, plenty of liquids. III. Conot-ipition 1. Teach child to have regular bowel movem.ents. Discussion. 2. Imjiortancc of' varieO dict, 3. ltumudius--barley wrter, juices, fruits and vegetables. IV. Voriting 1. Check for othur signs--storw-ch pyin, fevr, dj .rrhea. Discussion. 2. fiupoztud vomiting iacy bc scrious, especially among small children. So doctor. 3. Givu plenty of liquids to ruhydrato. V. Dipcr Rash Diaper rash may be causcd by Discussion. IL i 1 (:r rriigh clothing, 2- Pl°!-+ic products. 3. Digcstivo upsets. 4. Cutting teeth. Remedies 1. Keep the child clean. 2. Use oil. 3. Do not use clorox nda harsh washing products on the child s clothes. LESSON 2-9 CHIII)HOOD ILLIESS OUTLIIE iONITRICE .,CTIVITrKS [3L.CHING .IDS kTHRS '.CTIVIT. VI. Ecr infcctions Ear inf'ctions -ru painful ord irwy bc scrious. Soc the doctor. Discussion. 1. Check for nosu or throvt infections or nIcaslos. 2. Sce thc doctor for fungrl infections. VII. Recipes Choosc rt:cipo. Engrcdicnts Particip-tion 1. Rico or c:'rrot witer for diarrhea. Ind equipmont 2. l3rluy or juices for constipation. .or rucipe. VIII. What havc you 1. 'hy is it importnt to clcar up minor illnesses quickly? Rosponsc lcarned? 11 and 2. hat ro some rrc the symptoms a child hms while teething? discussion. 3. !How should you trect err infections? 1.Ihy is n vcric;d diet including fruits and vegctables ilnporlLL nt? 5. Ulhy is rulydrAtion :_- vomiting? UESSON 2-10 GR;. INS jlID LEGUWhES IN TIE DIET OUTLINE i KOTHERS 'MHITR [C- .,CTIVITIiIS TU,CH!ir IiDS iCTIVITIES I. Constructor foods 1. Ilane tile constructor foods. Poster Participation 2. !lhy are they called constructor foois? - food groups and resp i ze. 3. They also help the body repair itself and fight disease. IL. Who needs construc 1. 1 hy does a pregnant woman need constructor foods? Response. toF~o~2 . nursing mother? 3...... children? III. Greatest need 1. 'Jhich members of your family have the [;ratest need for Response and constructor foods? Rspe n 2. If you have only one cEL, a little milk or a little meat, who should eat it? 3. How W,uld you preparc the 0 ,L:, milk, meat? IV. Constructor food . Find the two sources of constructor foods on the poster. - food Eroups Participation sources 2. Is it possible for you to buy or raise animal products? and response...... veretable products? . lhich of the two sources is cheaper? V. Combine [rains 1. Find the !grains in Group 2. - food groups Participation with lc[u.res 2. Find the le[:umes in Group 1. and 3. lhen you eat prains and legumes together you have a rich discussion. source of constructor foods. 4. Name some recipes you can make with grains and legumes. - hrira - coulscous - tagines of legumes with bread - IISB, CSB. LESSON 2-10 GRiINS ,ND LEGUi'S IN THE DIET OUTLINE HONITRICE ,'CTIVITIES TMCHIG j,IDS 1-OTHrES LCTIVIT. VI. Recipes Choose recipe 1. Flour bLinds of grains and legumes for baby cereal and ingredients bread, Participation and 2. Puree of grains and legumes for children, 3,.Taginus equipment of legumes and grains tor bread) for 4. Salads the family. ,and soup of cooked legumes served with bread. 5. Grains or legumos prepared with a small amount of eggs, milk or meat. VII. N-Jh!t hve you 1. Do your children need constructor foods every day in learned? order to grow? Response and 2. discussion. Whiuh source of constructor foods ia most econowical? 3. 1lhich source can be stored longer? I. If you prepare grains with legumes, can you be sure your family is getting the constructor foods it ncods? 5. 11ill you prepare more grains with legumes for your fmily this month? LESSON 2-11 MILK ,ND OTHER FOODS FOR STRONG BONES ..ND TFETH - OUTLINE - ONITRICE DTr "r ,CTIVITIIS TEi.CHING ',IDS ,CTIVITIES I. Need for milk 1. tqlht is the mest importr nt food for babies? Flannelboard Response 2. 1ilk is very important for forming strong bones and tecth; - glass of milk 3, D3 children need milk? 11hy? and discussion. II. Milk and milk 1. How; do you obtain milk? products 1ksponse. 2. If you raise it, is your animal well? 3. Do you buy it fresh, canncd, or powdered? b. Do you mako petit lit or yopurt? 5. Ifhnt do you do with the milk from the center? III. )vailcbility of 1. 1Iho eats milk products in your family? which products? ii-k pr-ducts Response. 2. Is it possibic to obtain them every day? 3. Is it possible to raise anials for milk h. If you have only a little milk, who shoud drink it? IV. Other foods Other foods hulp make strong bones and teeth. Be sure to ect beans plunty of these fiods. - eas, Discussion 1. Legumes ci peas, of 2. Dfied fruits ond nuts 3. V geta les- lentils 3. Vcge-tables figs, dates costave ilobility and It. Groun leafy vegetables raisinscs n almons' rocip, s for 5. Fish with bones sesamealmonds, seeds each - green beans, okrq artichoke - green leafy vegetables - sarjinjcfs _____ M2?SSON 2-11 IILK NJD OTHER FOODS FOR STRONG BONES JADN T,EH OUTITNE ICOAITRICE CTIVITIES T '.C1 IING 2IDS ITHES LCTIVIT. Y. Nunshinc Don't forpct thrt the body n.ds sunshine clso to imk-[un strong bones vnd teeth. VI. Recipes Choose rocipe In7rodionts and Perticipetion 1. Yogourt. equipment 2. Goat cheso. 3. Legume tngine. I. Dried fruit end nut recipe where economicel. VII. 11ht have ,ou 1. Vhy is milk importont for growing children? Response end learned? 2. '!ill yiu serve milk or milk products todey? discussion. 3. I!hat vill you serve if you don't hove milk? 4.Will you try this recipe during the month? LESSON 2-12 VEGETPBLES *.14D FRUITS IN TIME IET OUTLINE______OUTLINE MOTHEhS MONITR IC. ;-CTIVITIES T& C11ILM .IDS ,CTI__IT___ I. Protector foods 1. Nam the protector foods Poster 2. Hhy are they called protector foods? 3. 71hy - Food groups Particip;tion do we need to eat )rotector foods every d&y? and response. II. Vitainin 1. Some vegutcblihs and fruits are especially good Flcnnelboard for the eyes. Participation - eye 2. Name and response. thcsu foods that -ro good for the eyes. 3. I'lit color are these fruits - punpkin, carrot and vegetables? red pepper 4. Which are in season now? Ericot, tomto 5. |!hich ill you serve your fP'mily today? 6. lffh1n your greens, oga child is sick (espccially with measles), it is important to give him foods to prevent him from becomin,-, blind. 7. Which will you serve your family today? 8. Do you feed your children whon they are sick? III. Iron 1. Ife need food to make rich, red blood which carries rosy chocked energy to rll parts of Participetion the body. face 2. How can you and response. toll if a person h~s rich, red blood? 3. How do people act if they don't hve rich, red blood to carry energy? 4. Name these protector foods that keep onorgcetic. you strong and - green lcafy 5. 11hich of vegetables these foods do you prepare for you family? - legumes 6. Those foods are especially - dried fruits and nuts good for women. - artichokes - eggs IV. Vitamin C. 1. Hfo need protector foods to help our bodies prow, to protect - child playing Participation us from infections and to keep us from bruisin.- - green leafy vegetable and response orange, tomato, 2. Namo theuse protector foods. 3. Which are in season - cabbage, redand now? green b. 11hich ore most economical? popper - prickly 5. Do you peaer raise any of these vogetables or fruits? LESSON 2-12 VEGET. LES iND FRUITS IN THE DIET BUTLIME MONITRICE .,CTIVITIES TECHI 1 AIDS IO)THEhS ..CTIVIT. V. Green Lcafy 1. One vo utobl)c was put on the flnnulbord three times. - greon lcfy Rusponse VoTctnbles V!hat was it? -nd vcgetoblcs discussion. 2. Derk gruc, leafy vegtLbles ere the best protector foods. 3. I'hich ccn you buy ct this so.-son? h. 1 1hich c:,n you find in the fields? 5. Do you reise parsley -t home? 6. Do you rcise other green leafy vegetables? VI. Rccipes Choose c recipe Ingredients end Participetion. Saled or togine of fruit or vcgctebl, in seson, especially equipment 7 f[rcen lu fy vog,teblo. VII. l-,1,t have you 1. Show on the flennelboard which vegetables and fruits Prticipation, learned? '!rc good for your eyes. responsc and 2. Show which vegutnbles ond fruits mwko good, rich blood, discussion. 3. Show which vogutables and fruits holp protect you from infections end bruises. 4. Ihich vogetblc is the best for good heclth? 5. lhy are protector foods good for sick children? LESSON 2-13 HOMI FOOD PRODUCTION OUTLINE 1O4NITRICE ',CTIVITIES T 'CHING 'IDS MO2IIERS LCTIVITIES I. Importance of the 1. Do you htvo a frmily g.rden? Response. family g -rden 2. What do you grow? 3. Does hovinfg a garden help you savu money? II. Planning a garden 1. How large is your garden. Response. 2. How did you prepare it? - remove stones - sprdo - form canal system for water - pla nt - weed III. Gardens in pots 1. Plants may rlso be grown in Participation - tins, oil drums and discussion. - old tires - flower pots 2. Suitable plantj are - tometoes tina, pots - parsley plants - hurbs IV. Importance of small 1. Do you raise smll animals? Response vnirk l raising 2. hich animalsR 3. I'hrt do they produce? I. Does this holp with the family economy? V. Planning How much space, housing, food do you need to Response, r, i0o? 1. Sheep, goats? 2. rabbits? 3. chickens? It. pigeons? LESSON L-13 HO11 FOOD PiiODUCTION OUTLINE HIONITHICE ..CTIVITIES Til,CNIG ,.DS IUTIu.'6 ,.CTIVITILS VI. Demonstration Show mothers center garden, rabbits or demonstration on planting in tins. VII. What have you 1. How does having a garden save you money? Response and learned? 2. How does raisin C small animals save you money? discussion. 3. lho would like to try growingi a garden? lU. ho would like to begin raising small animals? "r| M 0 T H E h S' L E S S 0, P L A N S T H I R D C Y C L Ef (Hevis.jd April 25,1978) LESSON 3-1 BRESTFEEDI NG OITLI;E MONIThICE ACTIVITIES TEACHING JDII)5 MoTii t.; .C']V iTlE 1. ADVANTAGE OF List the advaritug-;s of breastfe ding. }usse and BU&ESTFEEDIG i1. Nutrition-bust food fur the baby di¢ussion. 2. Hygiene-clean and safe 3. o0iomy-saves [noriuy, Saves time 4. Immunity from disease 5. Makes baby feel secure, loved, ha?[y 6. Promotes geoc mother-child relati)nship 7. Means of family spacing II. ,HEN TO BEiIN Begin breastfueding one hour after Discussion. BREASTFEEDING childbirth. Advise from 1. The "first milk" is good for the baby mothers. - It is a good constructor food. - It protects the biby from disease. 2. It is good for the mother to begin breastfeeding immediately and frequently. - It keeps tha breasts from becoming engorged. - It establishes an adequate milk supply III. HOW TO BEGIN 1. To breastfeed immediately after birth it is most Discussion. BREASTFEEDING comfortabl; to lie on your side. Advise from 2. Touch the nipple to th, baby's cheek mothers. 3. Let the baby find the breost himself. 4- Make sure the nipple anc surrounding dark area are in the baby's mouth. 5. Begin each feeding with a different breast. 6. Burp the baby after nursing. IV. CARE OF TH.! 1. Before the boby is born, prepfre the breasts I. Demonstra- Participate in for suckling. tion. demonstration BREASTS - Pull out each nipple several times each day. - Squeeze out a little of the early nilk. 2. If the breasts become crncked: - Vash with water, no soap. - Apply oil. - Expose to the air frequently. LESSON 3-1 (cont.) IV.CARE OF THE - Feed for short-r periods but more frequently. BRE, STS (To stop the LL.)y from suckling, insrt a clean finger between thu bzby's gums to brea!c the suction or gCmntly squueze his nose). 3. If the breasts become engorged, red, )ainful, apply hot compresses frequently. if.CLRE OF 1. Tyke care of your health. YOUIISELF - Get plenty of slte,. Discussir)n. Ldvise froa - Rest during thu day. - Increase Advise your food intake, especially legumes and mothers. grejen leafy vegetables. - Drink more water and other liquids. - Get some sunshine each day. 2. The mother can produce more milk if her unergy is not used up by heavy work. Other members of the family shomi-d do tii heavy work. 3. 4ear comfortable clothing, ,hen carrying the baby on your back, do not tie the knot directly over your breasts. 4. Give yoirself time for nursing. 5. Talk with women who bre; stfzed successfully and who can encourage! you. VI. FR1'FEIICY 1. Feed the baby fr,querntly. Breastl'ud duringL the AND DIIRETION night. Discussion. OF 2. Continue Advise from to breastfeud when the child is sick. BREASTFEEDING 3. Continue mothers. to breastf.ud if you become pregnant. - Eat plenty of constructor foods yoursdlf. - Begin to wean the child gradually before the new baby comes. • Brestfeed as lontg as possible. - lit least ene y,:-ir. - Two years or more if possible. LESSON 3-1 (Cont.) VII. MEANS OF The suckling of the baby pre vjnts ovulati3n. FAMILY Discussion. .,dvise Chances of not bcoming pru,2Lnant are b~tter if you: SPACING from mothurs. 1. Bugin breast feeding iuuediately after birth. 2. Breastfucd the child whunever bt is hungry, day or night. 3. Do not give the baby othe.r foods nor liquids until six months or after. VIII. IUHAT HAVE 1. 'h1hy is mother's milk bust for baby? YOU LEARNED? 2. 'hen shoula bre-stfeuding Rusponsu :nd begin? discussion. 5. How can you prelare your breasts for breastfeeding? 4. Why should a sick child be bre:istfeA ? 5. How does bru-istfeeding prevent pregn-incy? LESSON 3-2 FOOD HYGIEN5' OUTLINE MONITRICE ACTIVITIES TEACHING AIDS MOTHERS ACTIVITIES I. INTRODUCTION Fresh foods properly properud,cl:Ln cooking and Discussion. eating utensils and pure w'ter are "ecesstry for your family's health. II. FOOD HYGIENE 1. Food selaction and criteria for freshniss of: Samples of Participation BEFORE - meat in fresh foods demonstration. COOKING - fish Pan of water - vegetEbles and fruits Eggs(fresh, eggs - old). 2. Washing foods: - meat - fish - vegetables and fruits - Soaking causesloss Fruit, of nutritivu value. vegetables. - dry lugumes- Sort and wash. Soak after washing Pan of water Use soaking water for cooking. Dry legumes Scrub 3. vagetables well. Peel very thinLy if Vegetables necessary. brush-Knife- Peeler 1II. UNCOOKED Wsh well. Discussion. FOODS Prepare salads and fruit juices just befoce serving to prevent loss ef vitamins. IV. FOOD HYGINEI1. Cover leftovurs and Ildc, out of the sun Discussion. AFTER and away from insects. Advise from mother COOKIEG 2. Prepare an adequ-ate amount of snpplemeitary food for the baby for each meal. Do not serve the bnby leftovers, especially in hot seasons. V. HYGIENE -OF Illness is caused by soiled utensils and by Discussion. UTEAS ILS spoiled foods. 1. Use clean utensils for cooking, servinS, eating. 2. Do not use rusty utensils. LESSON 3-2 (Cont.) VI. V,ATER IYGIENE I. Boil water for children to drink. 2. Add a few Javul (Clorox) Farticipatiri drops of clorox to water fjr in water dum.nstration. washing vegetablus and fruits. 3. Store water in a covered jar. VII. YOUijHAT HIV 1. How can you tell if a fish is frsh? 2. Why shouldn't you soak fruits Rsponse and and vegetables? discussion. LEARNED? 3. Vho can show how to scrub a carrot. 4. Why should you prepare the baby's food fresh for each meal? 5. Why do you sort and wash dry legumes before soaking thein? LESSON -3-3 COOKING FOODS OUTLINE MONITRICE ACTIVITIES TEjCHlNG 1IDS MOTHiC 1,CTIVITh.S I. lMPORT,;NCE OF Your family is nourishud by the food you serve PROPER Discussion. them. The way you prepore it has an eff ;ct on COOKING its nutritive value. METHODS II. COOKING METHODS i) Boiling 1. Boiling vegetables lose vitamins and minerals Pan- h.ater in the Participation in cooking water and by destruction by hjat. Vegetables - Cut dem-,nstr;ttijn. vegetables in l:rge, not small pieces. Knife - Put in boiling, not cold water. - Use small amount of water. - Boil a minimum amount 2) Steaming of time. 2. Steaming is a good method for cooking vegetablus 3 Roasting Steamer. 5. Some nutriants lost by roasting can be retrieved in the sauce. 4) Frying 4. The grease coating conserves nutrients but the Skillet. food might not be 5) Casseroles 5. This digestible. method of cooking is best. Nutrients are Casserole. lost only by heat. Do not overcook. III. PREPARi.TION 1. 1WJash mnat, fish, vegatabl~s and fruits but do FOR COOKING not soak in water. 2. Scrub vegetables or peel thinly if necessary. 3. Sort, wash well and soak dry legumes. IV. COOKING TIME Discuss cooking time of: Discussion. I. Meat-cook well. 2. Vat'a tablsrminimu m amount of time 3. Dry lo;umes-use soaking wat..r for cooking. Cook weLl. V. ,4HAT HAVE YOU i. How should you cut veg-tablds for b-iling? LEARNED? 2. 1,hat happens tonutrients £esponse and when veget Lbles are soakid? discussion. 3. iliy do you cook ve&getables a minimum amount of tigie? 4. Xhy do you cook legumes in their so:king water? 5. 1,hy is using a tagine dish a good cooking method? 1 LESSON 3-4 HOMi PRESERVATION OF FOOD OUTLIiE MONITRICE ACTIVITIES TEACHIlG J.IDS MOTiHERS ACTIVITIrZ I. INTRODUCTION It is to your advantage economically and nutritionally Discussion. to preserve foods rt home. II. METHODS OF a. Vegetabl,.s arind fruits to use: Vegetables Discussion. CONSMRV,TION - tuburs-potatoes and fruits 1. Short term - fruits-oranges for short - vegetablus-gruen toml-tos, onions term b. Choosd a storage plrce *'iwth fresh air and low storage humidity. If very dry, ploce a pan of water in thj room. c. Spread out on shelves (not piled up) vegetables and fruit to be kept -"week in these conditions. d. Vege tables ind fruits can be kept for longer periods in - sawdust - grapes - striuw - melrs, carrots - soil - potatoes - sand - citrus, ugts. 2. Canning a. Vegetables and fruits to use: Discussion. Tomatoes and most fruits are suitable for bottlin Vugetc.bles require gliss jairs, tight seals and a presure cannur to prevent food poisoning. b. Tomato juice rind purte Tomatoes, Participation in - wash and r movu bad spots salt demonstration. - simmer and sieve sieve - add 1 teaspoon salt/liter - reheat to boiling bottles,caps - fill clean bottljs to within 5 cm fron top. pan of - seal - place on rack in pan of water covering the bottles. - process in boiling water 10 minutes c. Fruit preserves. - weigh equal quantities of fruit and sugar - prepare syrup - lkg. sugar/ 1 cup water heat syrup to boiling Participation in - wash, peel, slice fruit fruit demonstrtation. - add to syrup, heat till concentrated LESSON 3-4 (Cont.) - place in jars -*snal jar with cellophanu and rubbarband or sealing wax. 3. Drying a. Most vegetables and fruits can be used. - blanch - cool rapidly in water - drain - place on mats in the sun, turning from time to time. - when dry, place in burlap bags ant store in a dry aerated place. 4. Brining a. Vegetables to use: - green peppers - gherkins - carrots, beets, tubers b. Prepare brine - 1/2 water, 1/2 vinegar Vegetables Participati)n - wash, cut vegetablis vinegar in demonstration - pack in jars water - fill with brine jars - seal airtight III. WIT HAVE 1. Which vegetables Pn fruits in season now A,s ponse 4n! YOU LEARNED? can be kept short term? discussion. 2. How do you store vegetables and fruits short term? 3. 'lhich fruits cand vagotabl.os available now are suitqble for drying? . hich fruits and vegetnblns are suitable for conning? 5. How do you can tomato juice? LESSON 3-5 STORING GRAIN A D LLGUMES OUTLINE M' NITRICE ICTIVITIES TEJHING iIDS MOTIth" jCTIVITILS I. SELECTION OF Select good quality grains and ljgume3 for storange Grains Discussion. GRAINS those not eaten by insects nor germiniting. II. METHODS OF 1. The sun is the best means of dryinK grains -!nd DRYING legumes. Leave them on the nlrnt until dry. 2. Grains -nd legumes can be dried on the rooftops. III. CONDITIONS Grains and legumes crn be stored for nonths, even Discussion. FOR DRYING years, undur good conditions: - Store fit low temp -rature. - Keep the store room *oer'ted. - Keep the store room clan. The groins will germinate in high hai_,U and humidity. IV. STORAGE 1. Above-ground silo. PLACE 2. Underground silo. 3. Storal-e room, stored in bags. V. STORAGiE 1. Excessive hint during storoge DJiscussion. CONDITIONS 2. High humidity - grmin-,tian and fermentation ALTERING 3. Insects at the best p).rt of the grains, NUTRITIVE VALUE leaving the hull. VI. IfHlT How HAVE 1. do you select gr:rins and legumes for Resp[,nso nnd YOU LEARNED? storage? 2. what ore good stor,g conlitions? discussion. 5. V-hat grains ond legumes do you store? 4. What strage methods do you use? 5. ',hat is the most economical means of drying grains and ltKgumes? LESSON 3-6 HOUSEKEEPI IG OUTLINE MONITRICE ACTIVITIES TEiCHIIG ,,II)S MOTHtfftS ,CTIVITI& I. INTRODUCTION We live, eat and sleep in our homes. G)d house keeping is important. II. CLEANIIG THE Clean the hous every day. Partici :ti.,n in HOUSE 1. Open the windows and doors to let in the sun to dcnnstr ti .n. kill germs. 2. Air the covers and sheets in the sun. 3. Sweep down cobwebs. 4. Clean under the beds and mattresses. 5. Sweep the floor, wnsh with water and disinfectant. 6. Dust the furniture. III. CLEANING 1. Cl,.an the kitchen every day. Participztion in THE KITCHEN - Wash the dishes Cover after every meal. - the dishes or store on shelves, hooks demonstr-tion. - Hang kitchen towels on hooks. i towel. towels,threqd - Hanger is e-'sy to mke. & needletwine IV. GARBAGE 1. Gnrb-ige attracts flies and rats. Keep grrbage Pnrticipati ,n in in a covered pail. A g'rba!g pail is easy dem,nstrition. to make. 2. City-put the garbrge pail out for picl-up Oil can, every morning, 5. Country-compost pliers, the kitchtn C',rbage ani burm haimner papers and bury the tins. V. LATRINES Feces contain ba:cteria that can be harmful. Discussion. 1. Use the toilet. - If there is no running watur, flush it with a bucket of water. - Clean with a brush nnd disinfectant. - Cover the toilet. 2. If there is no toilet: - Build a lItrine - Build it awvay from the house, well or otream. - Cover the latrine. - Clean it several times a year. LESSON 3-6 (Cont.) VI. LIMEWASHING To disinfect and mike the house look olean, limewash it, interior and exterior, tvico a year. VII. VMAT HAVE 1. Any do you air thd covo±rs in the sun? YOU LKANE? 2. Why do you clern every dqy? Response and 3. How do you make i towel rack? discussion. 4. How do you make a g-rbage pail? 5.How do you maintain toilet or latrine? 6. Why is limewashing importnnt? LESSON 3-7 WASHING CLOrHES OUTLINE MONITR-CE ACTIVITIES TEACHING iIDU MOTHe-hS ZCTIVITIh. I. INTRODUCTION One judges a motho: by her clenliness. Dirty and torn clothes indicz te l'ck of hygien, ind a negligent mother. Clothes well cared for lst linger. II. CHOOSING A 1. Choose a place "or washing clothes. WASHING ,ish basin, Disciuisi n 'n 2. Arrange materipls. soap,bleach AREA choice of scrub boErd washini, area. III. SORTING 1. Put dirty clothes in a clothes haimp~r. icker- Discussion CLOTHES 2. Separate clothes for washing. basket - Separate white from colored clothes. - Separate fine from work clothes. - Keep baby clothe.3 separate. - Keep clothes of 'The sick suparate. IV. VWASHING 1. dash fine clothe,,;. 2. Wash white cloth, s. 3. absh colored clothes. .1. Thrub grease spo ;s. 5. i-ash wool in cold water. Do not scrub. P:rticilwte 6. in Wash nylon in warm wa,t,?r to prevent yellowing. demonstri.tion. 7- *.1ash baby clothes sep ,iratu from the family wash. 4iby alothes. 8. Diapers -hould b,3 washed when they are soiled. 'sap Use soap and wara water. Remove stains by dater hanging in the sun to blench. fosin 9. Separate clothes of th sick and boil to destroy germs. ,il one h,lf hour in a bucket of soap and vn ( V. viHITENIIPI 1. Use bleach only on ,,hite cottons. U3! as little as possible and rinse clothes three times. 2. The sun is a better bleach -nd gives the clothes a nice smell. VI. RINSING Rinse well to remove soap. VII. 4VRINGING 1. Wring cotton clothes. 2. Do not wring wool nor silk. LSSON 3-7 (Cont.) VIII. DRYING 1. Dry white clothes on a lin:; in the sun. 2. Dry colored clothes on i line in th3 shide. 5. Shape woolens and dry flat in the sh.de. IX. MENDING Check clothes for mending-buttons off, hems out, Torn clothes Parti-iljtin irf tears. ncdlu, thread mu-ndiriU scissors dem( nstr'.tion. X. IRONING Iron clothes beforu puttinU them away. Ironing helps destroy germs; makes cl)thcs fold ensier, makes th ,rm look better. XI. STORING 1. Store clothes in a cle n place. CLOTHES 2. In summer, store woolen in moth bolls. XII. MAKING A A wardrobe is easy to ni~ke. I;irti:i.,ti ziin WIARDI{OB0 1. Put a sh,]f for linens. Shl f' n 2. Screw hooks under the shelf to hangt clothes. }{a),)ks,Scrcws 3. Store shoes on the floor. Curtain rod 4. H:ing a curtain in frnnt of the -ardrobe. Cloth XIII. HAVE WlHiiT 1. How do you choose a washing area? Respens :nd 2. '"hy do you separate baby's clothes? discussion. 3. W.hy do you boil the clothes of the sick? 4. When do you mend? 5. ',*hy is a wardrobe useful? Lz.SSON 3-8 WASHING DIS IES OUTLINE MON]TRIC',; ACTIVITIES TEIC} NG AI)") MOTHERtS ACTIVlTIZ I. PREPARATION 1. Scrap.- the dishces. FOR iiASHIING 2. Soiled dishes attract flies. If' you ion't hav , DISHES time to wash dishes, soak them in w: *er. II. WASHING 1. Fill basin with hot water. Hot water cleans Basin ParticiIp.tir in bett r helps cut grease. Cloth or DISHES dem nstr,-tipn. 2. Washing order: scourur - glasses Soap -Dishes - dishes and bowls Hot water - pots and pans 3. Don't let water get too dirty. Chang3 if necessary. III. RINSI!JG 1. Hinsu in a sep;trat,-- basin or clean ,ad rinse Pe!rticipcti)n in wash basin to uso for rinsing. demonstrhtion. 2. Rinse water should be hot, clear (no soap). - glasses - dishes and bowls - pots and pans IV. DRYING 1. Put dishes in drainer, basin or table Drainer Participation 2. Drying in in the air is easiest privided there Towel demonstrati, n. is not dust, insects nor animals. 3. Dry with towul in this order: - glasses - dishes and bowls - pots and pans V. STORING A cupboard is best. Otherwise, set on clean DISHES towel on table aid cover with a clean towel. VI. BABY DISHI S 1. W;ash baby dish,?s well. Remove all fool. Cluan th, corner. 2. Rins. well. LESSON 3-8 (Cont.) VII. DISHES OF 1. lash dishes olf th, sick in hot mt ,r. TIL, SICK 2. flinse in boiling wat,-. 3. Boil the dish:s of pursons with infectious dis.'ses. 1. Dry in tho air. 5. Keep dishes of the sick seplratu. VIII. WHiAT HAVE 1. In what order do you wpsh dishes? YOU LhARNED. 2. How do you w:ish !nd rinse dishes uen you hrve only on<: basin? 3. '.hat is th, bust vay to dry dishos? , "d 4. T-hy should ynu k-ep baby's dishes sdparate? dicussi-rn. 5. How do you wash dishes of the sick? LESSON 3-9 PURE WA rER OUTLINE MONITRICE ACTIVITIES TEACHING AIDS MOTHI:RS LCTIVITI, S I. IMPORTANCE You need water every day. How do you use water? List vt.;r uses. OF WATER II. IMPORTANCE water used for drinking and washing f)od must be OF PURE pure or you will get germs from the witer and become WATER ill (especially children). III. 'ATER SOUACES 1. City 1. Where do you get your w-,tir? 2. 1Where ziesponsu and dos th(, city gt the water? discussion. 3. 'hat does the city do to keep the Nater safe for its citizens? 4. Does the city notify you to boil the water if it becomes unsafe? 2. Village 1. Where do you tUet your 1,ater? 2. Who checks to s~e if the water is safe to drink? 3. If you do not have a saf water su)ply, ask your husbands to ask your village leade.s to help. IV. MAKINIG WATER If your city has a saf, water supply: SAFE 1. City 1. Make sure the person getting the w-Lter has washed his hands. 2. Make sure the water container is clean. 3. Boil the water for the young children. If you are notified tha:t the water is unsafe, boil the water. 2. Village If your water comes from a stream, well or cistern: 1. Let the dirt settle. 2. Bring the water to a boil to get rid of germs. Particip'ti,'n in 3. Fuel is scarce and exp,.nsive. B? cr reful with the demonstration. pure wat, r so you don't have to boil it again. 4. Put boiled water in a clian container. 5. A pottery jar is best because it keaps the water Pottery cool. jar LESSON 3-9 IV. (Cont.) 6. Wash the iar throughly jvury three iays and let Jar cover it air a few hours. Di pper 7. Keep a cownir on th,. jar. 8. Keep a dipper on top of the cover. 9. Do not let anyone sick drink from tie dipper. 10. Keep cistern water pure by addinp jELvjl (clorox). V. PREVENTION 1. Do ngt Lt anyone d,.fecate nor uriiate near OF DISE&kSE your water source. 2. Do not build the lntrine inear the wll. VI. 'iHAT HAVE 1. Is all vater s. .fe to drink ? YOU LER N;D? 2. How 1 can you makc wtor safe to drin? Rspnse and 3. How can you keep water s-f-. after y)u have disconn boiled it? 4. How do you kill the g,.2rms in a cist.rn? 5. Why shouldn't the sick drink from the common cup? 6. Why shotildn' t anyone defecate nor urinate near the water supply? LESSON 3-10 SANITARY BODY NAST3 DISPOSAL OUTLINE MONITRICE ACTIVITIES TE CjIIING AID53S MOTIHI[hS ,CrIVlII1:3 I. BODY FUNCTION 1. Hori does thu body gt rid of' wh:t ib doosn't want? ieo,. r, 2. The body also (,uts rid of worms and germs that disctssi,,. cause diarrhea, huriAtitis , typhoid ind chollera. 3. So feces and urine not only smell bid, they can be harmful to people. II. SPREAD OF 1. Watch th3 flannelb.yrd story. Flannelboard DIS:EASE BY pictur!s of FLIES 2. 14hat might happen to the person who eats the t-ilet-oln cooki, s? fly-cookies 2. Discussi.n 3. That th, story again. Toll hokv diarrhea could be pr,.vented at each step. a. open toilet open toilet 3-1. flush tc-il, ecv-r t il (')It, )f do. .', c,,v,..r with Atiit. b. flies like dirty, sticky and smelly things fly 3b. Keep t~i]ict, flies multiply in human feces and aiimal dung cloi, r,.r. V , aniinrl luni fr',, r r h-.r c. cookies cookies 3c. cv.wr f ods all foods keep house clorn d. If Ahmed cats the cnntaminated cookies, he Poster of might g-t diarrhea because his body is not Ahmed strong and healthy enough to fight Irorms. e. If Rachid eats the contaminated cookies, he Poster of might not get diarrhea because he is well- Rachid nourished and his body is strong and healthy enough to fight germs. LESSON 3-10 (Cont.) III. SPREAD OF 1. '%atch the flannelboard story. Flannelboard DISEASE BY pictures of CONTAMIATED FOOD SOURCE~S mintman in plants field 2. Thu man has hepatitis. I'h)t might happen to the person who drinks the tea? Tea glass 2. Discussion. 3. Watch the story again. Tell how the disease a man in field could be prevented. a. The danger of defecr.ting near food or water 3a. Do not disposu supply. of boly wastes near fcod or wat r su" :ly. b. Washing of mint. mint- water 3b. V',sh fruit -ind - fruits and vegetables faucet vegetables in pure water before catin,:. - aid a few drn)i3 of chlorine bleach to the water. IV. OTHER Wash hands afte2r using the toilet, bef-re ADVISE preparing food, before eating. V. WHAT HAVE 1. How does the body got rid of wastes? Response and YOU LZARNED? 2. How can body wnstes be harmful to human? discussion. 3. How do you keep your toilet clean? 4. if you d-' t hrve access to a toilet, what precautions do you take? 5. How can you keep foo . safe from flijs? 6. How can you help your children be h~althy enough to avoid many illnesses? LESSON 3-iI FEEDING DURING ILLNESS OUTLINE MONITRICE ACT1VlTIE,3 TEACHING tAIDS MOCi ,'TIVITIkS ]I.INTRODUCTION 1. An undernourished child is ill more often than 1ostersrcuo1, Uij a well-nourished child. 1Ldmembjr thu story -Ahmnd of Ahmed and Rachid? -fRachid 2. You con be sure your children are well nourished by: - Breastfceding as long as possible. - Gradual weaning. - Feeding adequate and v-!ried meals. I1. FEEDING During an illness a child needs food to fight L--rms. DURING 1. Milk is always an important food. If the baby won't nurse, milk the breast and feud him with ILL1NESS cup and spoon. 2. The sick child needs food, not just s ,ucjs and cooking juices. 3. lie may not fuel like chewing, but you can pre;pare his food sn it is easy to swoIlow. - make puree and soup with veg3tables. Chick peas. Partici-:iti)n - cook legumes well and mhash them well. 11aLrd boiled in dum.nstr7!tion - mash the eggs. egg. - chop the mreat in tiny bits. Fork, food 4. Feed him small -mounts of food froquently. mil. 5. If he has fever, givii him plenty of liquids. III. MEASLES Measles ne.:d not be a fatal dis;3aisu nor end in Discussion. blindness: 1. Prepare his food, as just discussed, so it is easy to eat. 2. Feed him plenty of vegetables that will protect his eyesight - yellow, orE.nge, red and preen leafy vge tables. 3. Keep him in bed. Keep him warm. 4. Protect his eyes from strong light. LESSON 3-11 (Cont.) IV. DIARRHEA 1. Lack of personal and food hygi !ne may cause diarrhea. What do you do for your child 'hen he has diarrhea? 2. If the diarrhea is very bad )r do.es not respond to your treatment, tak2 the child tD thD doctor immejia tely. Follow the doctor's advice. 3- It is important for diarrhea patients to have plenty of liquids to make up for the loss of water through diarrhea. V. .ORMS 1. 6orms may enter the body through the mouth. Discussion. - Always wash your hands before eating. 2. Worms may come from food. - Wash vegetablos well - Cook meat and fish until well done. 3. 'vorms may enter the body from the soil through the feet. - 'ear shoes. 4. Worms eat the food intended for the person. - Feed the patient well. 5. To get rid of worms, you must get melicine from the doctor. VI. 'HAT HAVE 1. How do you feed your child to make him well n,;urishod? YOU LEA161? 2. 'why must a sick child espns: and eat well? discussion. 3- How do you ])rojfLre food for a child vho does not want to chew? 4- How much and how often should a sick child eat? 5- Why must a child with diarrhea drink plenty of liquids? LESSON 3-12 CHILDIREN A1D ACCIDENTS OUTLINE MONITRICE ACTIVITIES TE&11t1JG ;.IDS- M0'1T1S i&,'1lVI TIt, I, INTRODUCTIO.I After each accident ono cr:n sU, ho' it. could hove been ,re ventad a lIok, an acti-n, n ;revrntirn sufficint :2specirilly with p3 ,lti..m) iittlft y-,ur children who ,are most vuln.,-rbl. [ivcuroi II. SUFFOCATION I. Keep ,. belts Iand straps out -of reach. 2. sliup Don't leave a baby alon- in i. lrge bd whre he can slip under the covers and suffocat. 3. Keep pins away from children. 4. Don't givk nuts t., small children. 5. Don't lot children 1lay with' plastic bags. III. CARBOI Charcoal stovts often five heidl'ch,2s ani may suffocate an Discussi--.. MONOXIDE entir family. POISONING 2.I. Cook out side on charcoal Dnn't put a charcoal burnerstovs. in the sleeping, room nor in a clos,,d r-cn. 3. Let air in the sl,;epinf room at night. 4. Air the houst, every dr-y. 5. Let air in a room ith ::hutL,,:iz burn3r. IV. POISO,,NI Children are curious ond put 'll things in thetir mouths. Discussi 1. Dint k. vu cl')rox, :n. -lcohol, ,et :r. t:t, medicine table on the or floor. Store poisans and mflicine out of reach of childr , 2. One movement prev.nts p-aisoning-rnis? your arms and place the poisns up high. 3. Don't put poisqns in s,,]',bottles. 4. Dan' t put machinc oil in veeta-tble oil bottles. V. BURNS 1. K(.e, children fr-,m !-v-n flaimes. 2. Don't lteave children Discussicn. home aloni wh.!r3 a flame 3. Keei; boilini: is burning. liquids out of reoach of children. 4. K ep match-s up high. LESSON 3-12 (Cont.) VI. CONCLUSIO1 Take tprccauti-ns but d,) not bl:. ov3r-protcotivc. Let children learn wlh' t thinfs are danrgurous. VII. VtHI T HAVE 1. 'hy are plpstic b:yas d,ng.,r)us? lhs,,onst !tI YOU LlABIIED? 2. 1her should ch!rcol st-v<,s b? us-A? liscussi n. 3. Why should y-)u let , little air in th(e sleeping room at night? A. Do you lj-.vu y')ur smrnll childrn homu alone? 5- thy shouldn't you b:, ovor-protictive? Apnendix 6 ATTENDANCE OF MOTHERS AND CHILDREN AT SELECTED SOCIAL EDUCATION CENTERS ( 6 Provinces chosen ) NAME OF PROVINCES NUMBER OF CHILDREN ATT.ONDING AVERAGE El Jadida 487 Casa.blanca ,t68 Ouarzazate 488 Tangier 492 Fignig i89 Meknes ;!15 2,839 473 (Monthly) Appendix 7 INSPECTORS VISITS BY CRS FIEILD PM-IOD NUMBER OF VISITS :.pril 1975 - October 1975 257 Octobcr 1975 - March 1976 78 i'pril 1976 - September 1976 156 October 1976 - March 1977 131 f,*pril 1977 - September 1977 168 October 1977 - March J.978 188 ,',pril 1978 - *',--ust 1976 92 September 1973 - November 1978 65 Totol number of centers visited 1.135 Appendix 8 BASELINE SURVEY A. BASELINE CENTERS In the Seven Economic Regions of Morocco PROVIECE CENTERS Northeast Oujda Jerada Oued Nachef Nador Ferk-hana North Rabat Oued Akreuck Tetouan iioulay Hassan Torreta Central Ben Slimcne Bouznika Casablanca Sidi Othman B. Moh,,.mmedia El Jadida Azemour North Central Taza Guercif El Hoceima El Hoceima Izmouren South Contral Meknes Azr-u Errachidia Jorf M'Deghrn Goulmina Meel ab Tensift Safi Sidi Abdelkriz Biada Essaouira SMB Essaouira Laa.ouj South Tiznit Ifni Goulimine Goulimine Ouarzazate Zagora Sidi Dacud 2 Anendix 8 B. P R E L I M I N A R Y S U R V E Y March-Anril 1975 There are only a few reports available on the sscio-ecornomic conditions and of dietary prectices and beliefs of the Moroccan mothers attending the Social Educati-n Centers. A study of the problems could help to develop the anpropriate. remedial educ-tional programs. For this purpose, baseline data including information on socio-economic status and of food h .bits we-e gathered from 42 participants at six centers in North, Cntral and South Mcrocco. This preliminary survey showed the need for a more extensive survey. The findings served as basis for the development of nutrition education curriculum and of evaluation tools. 1. Some useful information to be -iven consideration in develorment -f oduc: tin oro~rans for women: The average age of the interviewed mothers w~s 33 years, The average mother was pregnant every two years She had five children living - one ever l4 years of age She had one child deceased, usually before two years of age (75%) 20,1 of the mothers wor- outside the home There is only one full-time worker per household- usually of seven people The adult family members are illiterate The family living conditions are poor and crowded The f.ily uses a public water supply 33 of the families lack a latrine The resources are minimal - 1-2 Dirhams per person per day, with an average of 1 Dh There is little home production of food 40% of the children's weight is less than 90% of weight for age according to Harvard Standard 20% of the children's height is less than 90% of height for age according to Harvard Standard 3 Appendix 8 2. Health conditions There is a high morbidity among children, especially diarrhea, cold, fever, cough, worms and skin diseases. 20% of the mothers believe that sunshine is bad for the childi 3. ieaning practices and dietary habits W7eaning- immediate at the time of a new pregnancy - 50% - gradually as child matures - 25 % Late weaning preferred- there is no srecinl weaning diet Solid food given in the second year- n an average by the 15th month The mothers have little knowledge of the need for a good diet during illness. 50,7o of the mothers claim that they know that the diet is important for health. However 254 of the mothers eat only as much as a child. The common diet for breakfast for 66% of the children include tea, bread and oil. During lunch only 50% of the children have some protein food in their meals. 20% of the children had only tea, brecd and oil for dinner. The Ministry of Health dietary survey -f 1070 showed that the poor sectors of tha population were deficient in a number of nutrients. The average dietary intaL:e provided per day: Calories- 500-700 Protein - 20 g in urban areas 13 g in rural areas Calcium- 250-300 mg Vitamin A- 2,000 International Units Vitamin C- 20-45 mg Apnendix 3 4. To affect imnr-vemerits in dietary habits, there is need for: a) access to adequate amount of food, b) adequate storage facilities, c) knowledge of proper food preparation methods, d) consumption according to individual needs. 5. Program priorities based on the baseline information: a) emphasis on food of high nutritional value, especially foods rich in protein, c) how to obtain the maximum value from the food intake: - gradual w'_aning - controlling morbidity by immunization, proper hygiene and healthcare, - combining different protein sources to obtain required amino acids, - providing snacks on a regular basis to meet dietary need of vulnerable groups. 5 Apnendix 8 C. RESPONSES TO BASELINE SURVEY QUESTION"..IRE ADMINISTERED IN lQ75 AND AGAIT! IN 1978 -- Number of mothers responding to questionnaire 1975 - 8.5 mothers 1978 - 692 mothers 82/o of 1975 figure -- Language used: Arabic - 84% Berber - 1616 Berber was prevalent in Nador and El Hoceima in the Rif Mountains and in 3 centers in Ouarzazate and Errachidia south of the High Atlas Mountains. A few mothers in the Middle Atlas spoke Berber. -- Average number of children in family LIVING DECEASED 1975 5.16 1.20 1978 5.88 1.25 Eight older -and 2z younger (about 2%) of the baseline children died between 1975 and 1978. Causes were measles (6), diarrhea (3), whooping cough (2), unknown (21). One baseline mother died. -- Member of family who shops for groceries Fth r Mother Older Fumilv Mimb-r Eldest Child 1975 78% 17% 3% 2% 1978 69% 28% 1% 1% -- Eating order of family All tozether Father Mother Children Infants First First First First 1975 72% 5% 4% 15% 4% 2% 1978 76% 3% 2% 17% Appendix 8 6 Illnesses 3f children duriniz previous week comparison of older child in Summer-Fall 1975 with :roungar sibling in Spring 1978. The younger children had about 25/a less illness. Diarrhea worms fever cold sore ears skin prob. Older 1975 5," 32 .17 46 22 35 14 Younger 1978 22 6 17 16 8 21 Difference 32 26 30 30 14 -- 24 hours Dietary Recall of 2-5 year old (given by mother) TIMES PER DAY o______(_--o.oo3 -3 (P = 0.001) CONSTRUCTOR FOODS 0 .1. 1975 .13/ 'l-/ 15% 1% 1978 74 I 0 % (P= 0o o 5) 7EGZT1BLS -0 1 2 I3 1975 19/ 54 27! 0 1978 12A j 56/a , 31% i/ (P 0.001) FRUITLS 0 1 2 3 27 0.. 1975 82/ 15/ 17 1978 19.4 5 26,. 2 (P = 0.001) MILK PRODUCTS 0 1 3 1975 o/0 15% 2% 26A 1978 ,;% 254a 4.,-a Appendix 8 -- Times per week specific constructor foods were eaten TIMES PER WEEK LEGUMES 0 1 2 4A 5 6 7 1975 50% 20% 16% 7% 4% 1% 1% 1% 1978 1% 9% 29% 27% 13% 15% 3% 3% FISH 0 1 2 3 a 5 6 7 1975 44 24 14 8 5 1 1 3 1978 24 28 22 13 , 2 3 3 Fish consumption was greater in seven centers in four coastal provinces. MEAT 0 1 2 3 4 5 6 7 ------1975 11 38 24 2 6 2 1 6 1978 3 22 34 27 8 2 1 3 EGGS 0 1 2 3 4 5 6 7 ------1975 64 14 9 6 3 1 1 2 1978 11 21 25 13 11 6 lo 3 MILK PRODUCTS 0 1 2 3 A 5 6 7 ------1975 45% 6% 5% 5% 6% 3% 1% 29% 1978 3% 5% 18% 13% 8% 6% 3% 44% / Anpendix 8 -- !aning practices Abrupt Gradual Did not nurse 1975 91/ 5% 3% 1978 15% 83% 3% -- Hand washing before meals %ith soar 7ithout Soap Do not wash 1975 58% 34% 8% 1978 96% 4% 0% -- Boiling water for drinking Always For young During Never children illness 1975 5% 1% 15% 80% 1978 5% 1% 71% 22% References: 1. Jelliffe, D.B. The Assessment of the Nutritional Status of the Community, 'World Health Organization, Geneva, 1966. 2. A Field Guide for Evaluation of Nutrition Education Office of Nutrition, Technical Assistanc Bureau, AID - June 1975. A;)pendix 8 9 D6 BASELINE AND FINAL SURVEY RESULTS I. A'iTHROPO ETRIC ME,-SURE TS Table la. Number if children according tD Harvard Standard of weight for age Catagories arranged by age in six-month intervals. PERCENTAGE OF HARVARD STANDARD WEIGHT FOR AGE Age (vrs.) 91-100+ 81-QO 71-80 61-70 60- TOTAL ( 'ILDREN 0 - 156 25 8 7 2 198 - 1 92 70 36 24 5 227 1-li 64 34 56 20 11 185 li 2 42 51 48 26 6 173 2 2* 50 46 38 11 4 149 2j- 3 66 56 50 11 3 186 3 - 3A 63 85 46 14 1 209 3! 4 43 70 41 9 1 164 4 - 47 20 38 23 11 1 93 4 5 6 14 15 5 2 42 TOTAL CHILDREN 602 489 361 138 36 1.626 Table lb. 1978- Number of children according to Harvard Standard of weight for age Categories arranged by age in six-month intervals. PERCENTAGE OF HARV2,RD STANDARD WEIGHT FOR AGE Age (yrs.) 91-100+ 81-90 71-80 61-70 60- TOTAL CHILDREN 0 - 2j 0 0 0 0 0 0 2 - 3 33 30 16 1 0 83 3 - 5f 80 78 25 3 0 185 3-- 4 91 63 17 8 0 179 4 - 4j 53 74 15 7 1 150 4- 5 60 47 21 2 0 130 TOTAL CHILDREN 317 292 94 24 1 728* * 721 other baseline children had reached 5 years of age by 1978. 10 Apnendix 8 COMPARISON OF HARVARD STANDARD .7EIGHT FOR ,GE OF OLDER CHILDREN IN 1975 VITH YOUNGER SIBLINGS IN 1978, ARR!INGED IN SIX-MONTH INTERVALS Table 2a. 1975- PLRCENTAGES OF 819 OLDER CHILDREN IN EACH CATEGORY abe(yrss) 91-1O0O 81-90 71-80 0 60- TOTAL 3 0 -1 0 0 0 0 0 1 1+ 57% 14% 29% o% 0% 100% 1-_ 2 56 29 12 3 0 2 - 41 33 23 2 1 2 - 3 37 31 26 6 1 3 - 3 0 41 22 6 0 34 4 25 44 25 6 1 4 21 41 25 12 1 4+- 5 14 33 36 2 5 Table 2b. 1978- PERCENTAGES OF 6,6 YOUNGER SIBLINGS IN EACH CATEGORY Age(yrs.) 91-100+ 81-90 71-80 61-70 60- TOTAL % 0 - 2j 0 0 0 0 0 2i- 3 40% 36% 19% 5% 0% l00% 3 3- 43 42 13 2 0 34-4 51 35 10 5 0 4 -4T 55 49 10 5 1 4j- 5 41 37 19 3 0 Table 2c. COMPARISON OF PERCENTAGES OF CHILDREN IN EACH CATEGORY 819 OLDER CHILDREN IN 1975, 6,.6 YOUNGER SIBLINGS IN 1978 91-100+ 81-90 71-80 61-70 60- TOTAL % OLDER 1975 32% 37 24 6 0.9 100% YOUNGER 1978 43 40 13 4 0.2 100% 11 Appendix 8 1975-78 COMPARISON OF HARVARD STANDARD WEIGHT FOR AGE OF YCT,'GER SIBLINGS ARRANGED IN SIX-MONTH INTERVALS Table 3a. 1977- PERCETTAGES OF 815 YOUNGER SIBLINGS IN EACH CATEGORY Age (yrs.) 91-100+ 81-90 71-80 61-70 60- TOTAL 0 79% 13% 4% 3% 1% 100% - 1 40 32 16 10 2 34 34 30 11 6 1 2 17 17 32 18 4 2 2j 21 21 30 16 5 2 - 3 20 20 40 7 13 3 - 31 0 0 0 50 0 34- 4 75 75 25 0 0 50 0 0 0 0 Table 3b. 1978- PERCENT"GES OF 64.6 YOUNGER SIBLINGS IN EACH CATEGORY Age (vrs.) 91-19o+ 81-90 71-80 61-70 60- TOTAL % 0 - 2 0 o o o 2i- 3 1O % 36 % 19 % 5 % 0 % 100% 33-42 13 2 0 31- 4 51 35 10 5 0 4 4 35 49 10 5 1 4 5 41 37 19 3 0 Table 3c. COMPARISON OF PERCENTAGES OF YOU14GER SIBLINGS IN EACH CATEGORY - 815 IN 1975, 646 IN 1978 91-100+ 81-90 71-80 61-7o 60 1975 42 23 20 11 4 1978 43 40 13 4 0 Apnendix 9 SUR7EY OF DIETARY PRACTICES CONDUCTED BY PROVINCIAL DIRECTRESSES IN 40 CENTERS IN 20 PROVI1CES JADTUARY 1978 TO MAY 1978 A. ;,eaning practices 1. Wvhat is the best food for the newborn: mother's milk, other milk? January May Mothers' milk 87.3% 85% Other milk 10 % 11% Mixed 2.7% 4% 2. At what age do you begin weaning your child? January May 0-5 months 20.5X 9% 6-8 27.5% 28% 9-11 2.5% 2% 1 year or more d9.6% 30% 3. How long do you continue to nurse? January May 0-1 year 10.6; 44% 1-2 5.1.6% 24% 2 years or more 34.7% 32% 4. Do you wean: abruptly, gradually? January May Abruptly 46.4% 25% Gradually 53.6% 75% These four responses analyzed together are indicative of a common infant-feeding practice of breast milk as the sole nourishment until one year of age or more, then abrupt weaning. The MAy response s to question 4 indicate that the mothers may have heard the lesson on grodual weaning, but the responses to questiins 2 and 3 are disturbing. The first lesson of the 3rd cycle mothers' lessons are on effective breastfeeding. While bottlefeeding does not seem to be widespread in Morocco, this may be an area to watch as the country develops. 5. JANUARY QUESTION - *.hat do you feed your baby at weaning: cereal, vegetables, fruit, meat or eggs? MAY QUESTION - ,hat do you feed your baby at weaning? The responses did not differ greatly when the questions were posed in two different manners. About two-thirds of the responses included cerels and vegetables; one-half, fruit, and one-tenth, meat and eggs. 2 Appendix 9 Feeding the 2-5 Year Old 1. .,hat does your child eat for breakfast? January May Milk 52.2e 30% Caf6 au lait Dr coffee 31.7% 14% Tea 16% 3% The lower percentages in May are due to inaccurate reporting. The relative numbers were about the same. About 80% of the children eat bread for breakfast. About 15% eat a soup (legume soup or a gravy of flour with milk or water). 2. How many times a week does your child drink milk? January May 0-2 times 16.6a 5% 3-4 16.9% 14% 5-6 6 /- 10% 7 60.:.% 71% 3. ;that is the best drink for children: coffee, tea, milk, lemonade? January May Coffee 8% 10% Tea 16% 8% MAilk 72% 81:a Lemonade 4% 1% 4. How many times a week does your child eat raw fruit and vegetables? January May 0-2 times 25.2% 15% 3-4 37.3% 35% 5-7 37.5% 50% 5. How many times a week do you )repare legumes for your children? January May 0-2 times 53.9% 50% 3-4 37.2% 39% 5-7 8.9% 11% Lentils -49 % 54% ",hite bezns 13 % 42% Chick peas 14 A 14% Bread beans 17 % 17/6 Split peas 7% 3 Appendix 9 Health Practices la. Does your child get some sunshine every day? b. At what ag do ycu begin taking your child out in the sun? January May a) Yes 88.6% 97% No ll.4% 3% b) l4 - 2 months 25.5% 28% 3 - 5 46.5% 49% 6 or more 27.9% 20% 2. JANUARY QUcSTION Do you feed your child when he has measles? Yes 63.8% No 36.2% MAY QUESTION -- .hat do you feed your child when he has measles? A few mothers menrioned thnt they fed the child the usual diet. These special foods were mentioned. Milk products 15% of responses Organ meats 21% Honey 25% Fruits and vegetables 22% 3. JANUiRY QUESTIOff How many of your children are vaccinated? MAY QULSTION -- How many of your children are vaccinated? all of them vaccinated --- 55% not all of them --- 45% Cooking Practices 1. Do you use the soaking water to cook legumes? January May Yes 34.3% 71% No 65.7% 29% The responses indicate that the mothers had the lesson on preparing legumes. C4.THOLIC RELI F SMVICES-USCC Apnendix 10 EIVEIrr0RY OF PROPMTY PROCURED 'rITH OUTSIDE FUNDINGl Country Program: Morocco Project No.: FP.L/75 - 1 Date of Imentory: .'.ugust 31, 1978 C1T'RCT/GR,,NT No.: AID/NESA-G-1169 Funding Source: MID/NESA Property Nuraber Purchase Date of Number Description of Unit Price US$ PurchaCe Location 1169 # 1 1iinolta Hi-iatic FP Camera 842975 97.30 8/11/75 Marrakech Mocablitz Flash 215 L22CS 058088 58.o Nutrition School # 2 314 Overhead rojector Iarrakech Model 567 220 Volts 229 997 246.00 " Nutrition School # 3 311 Overhead Projector 229 998 246.00 " Uarrakech I Nutrition School # 4 Bell & Howell 16 mm 4243095 375.00 Marrakech Sound Projector Nutrition School # 5 Olivetti Manual dding 4arraiech Machine writh tapa 38415 90.75 " Nutrition School # 6 Dalite Projection Screen Classic 36.60 " arrakech Nutrition School # 7 Dalite Projection Screen Classic 36.60 Marrakech Nutrition School # 8 Dalite Projection Screen Classic 36.60 Marrakech Nutrition School ;# 9 'Dalite Projection Screen Classic 36.60 arrakech Nutrition School #10 Transformer 6K24 Ic 1005539 37.76 " Province of Settat #11 Transformer 6K24 VC 1005539 37.76 " Marralkech Nutrition Schoul Beni-MeJlla I/ z.lal #12 Transformer 6iC24 VC 1005539 37.76 Marrakech Nutrition School Province Figuig CATHOLIC RELDF SEVICES-USCC INV"E'TCRY OF -ROPERTY PROCURED "ITH OUTSIDE FUNDINGf Country Program: Morocco Project 'lo.: FAA/75 - 1 Date of Inventory: ,ugust 31, 1978 CCNTR CT/GPJ,1T No.: 1.ID/NES-G-II69 Funding Source: AID/mES; Property Number Purchase " Date of Number Description of Unit Price US0 Purchase Location # 33 Transformer 6K24 VC j 1005539 37.76 8/11/75 Province of Tanger # 14 Kodak Carousel Projector 3170128 90.00 Marrakech Nutrition School # 15 Kodak Carousel Projector 3170101 90.00 Marrakech Nutrition School # 16 Kodak Carousel Projector 3170093 90.00 Marrakecn Nutrition School # 17 Kodak Carousel Projector 3170103 90.00 Marrakech Nutrition School # 18 Welt Project-c-stand S.P-LCCK2C3 l.50 Marrakech Nutrition School # 19 Welt Project-o-stand SAFELCCK2C3 h150 Marrakech Nutrition School # 20 Welt Project-c-stand SLPEL0CK2C3 h.50 Mrrakech Nutrition School # 21 Welt Project-o-stand SPELOCK203 41.50 Marrakech Nutrition School # 22 Sony Tape Cassette 711692 63.00 Marrakech Nutrition School # 23 Sony Tape Cassette 711855 63.00 Marrakech Nutrition School # 24 Sony Tape Cassette 711693 63.00 Marrakech Nutrition School # 25 Sony Tape Cassette 711693 63.00 I Marrakech Nutrition School CLTIIOLIC RELF ZRVCES-USCC DW1EqrCRY OF PROPETY 'OCURED "ITH OUTSIDE FUNDING Country Program: Morocco Project No.: F,./75 - 1 Date of Inventory: A.7ust 31, 1978 CO!T,CT/Gr.'rr No.: AiD/NESA-G-1169 Funding Source: A3D/NESL Property Number Purchase Date of Number Description of Unit Price US. purchase Location # 26 8 mm Film Projectcr 4267356 90.00 8/11/75 Marrakech Nutrition School # 27 Olympia Typewriter 7-3-07847 302.20 i INrrakech (Irabic) Nutrition School # 28 Gestetner stencil 26-B-9374 1,372.50 10/24/75 Marrakech copy machine Nutrition School # 29 Calculator none 30.00 6/30/76 Marrakech Nutrition School # 30 7icwlex FilmsLrip Proj 75.50 8/11/75 Province of Fes "'ooden Case 8501666 11.97 Boulmane Transformer 750W 20.00 6/30/77 # 31 Projector - Case 8501670 87.47 3/11/75 Province of Transformer 750W 20.00 6/30/77 El Jadida # 32 Projector - Case 8501698 87.47 8/11/75 Province of Transformer 750' 20.00 6/30/75 Totouan # 33 Projector - Case P501691 87.h7 8/11/75 Province of Transformer 750W 20.00 6/30/75 'houribga # 34 Projector - Case 8501664 87.47 8/11/75 1,rrakech Nutrition School Province of Bcni-Me11al and ,,zilal # 35 Projector - Case 8501696 87.47 8/11/75 Province of Transformer 750" 20.00 6/30/77 Agadir # 36 Projector - Case 8501694 87.47 8/11/75 Province of Tr2nsformcr 750WI 20.00 6/30/77 E1 Kelaa C.;THOLIC RELF SZRVICES-USCC INV211TORY OF PROPT!MTY ROClED 'ITH OUTSIDE FUNDII% Country Program: Morocco Project No.: F,,,/75 - 1 Date of Inventory: August 31, 1978 COITR.CT/GRNT No.: ',ID/NES-G-1169 Funding Source: .,D/IESA Property Number Purchase Date of- Number Description of Unit Price US$ Purchase Location # 37 Projector - Case 8501686 87.h7 8/11/75 Province Casablanca Transformer 7501 T 20.00 6/30/77 # 38 Projector - Case 8501695 87.h7 8/11/75 Province Chaouen Transformer 750W 20.00 6/30/77 # 39 Projector - Case 8501701 87.h7 8/11/75 Province Settat # ho Projector - Case 8501689 87.h7 8/11/75 Province Tanger # h Projector - Case 8501669 87.47 8/11/75 Province Khenifra Transformer 7567 20.00 6/30/77 # h2 Projector- Case 8501669 87.47 8/12/75 Province Kenitra Transformer 750W 20.00 6/30/77 # 43 Projector - Case 8501702 87.h7 8/11/75 Province 1,eknes Transformer 750U 20.00 6/30/77 # h Projector - Case 8501680 87.L7 8/11/75 Provir.oo Safi- T Pronsforner 750, 20.00 6/30/77 Essaouira # 45 Projector - Case 8501656 87.h7 8/11/75 Province Nador Transformer 75GWT 20.00 6/30/77 # h6 Projector - Case 8501678 87.h7 8/11/75 Province Marrakech Transfcrmcr 750W 20.00 6/30/77 # h7 Projector - Case 8501678 87.h7 8/11/75 Province Tiznit - Transformer 750W 20.00 6/30/77 Tan Tan # 48 Projector - Case 8501688 87.h7 8/11/75 Province Khemisset Transformer 756W 20.00 6/30/77 # 49 Projector - Case 8501679 87.47 8/11/75 Province Figuig # 50 Projector - Case i 8501687 87.LL7 8/11/75 Province L1 Hoceima Transformer 750W1 20.00 6/30/77 C.'TOLIC .-CL=F SZRVICES-USCC IAVEORY OF PR.--RTY ,OCU2 D TITH OUTSIE FUNDING Country Prorrcm: Morocco Project No.: F..../75 - 1 Date of Inventory: ,upust 31, 1978 CO4Th.,CT/GR,,1]T No.: ,IP/!2,SL-G-ll69 Funding Source: ,,ID/!,rS, Property Number. Purchase Date of Number Dcscrintion c Unit Price US$ Purchase Location # 51 Projector - Case 5'03082 87.h7 3/28/76 Province Oujda Tr2nsfcrn.r 750'1 # 52 Projector - Case 3503080 87.47 9/28/76 Province Ouarzazate Trccnsformer 750J 20.00 6/30/77 # 53 Projector - Case 8503083 87.47 9/28/76 Province Zrrachidic Transformer 750WT 20.00 6/30/77 5L Projector - Case 8503081 87.47 9/28/76 Province Taza Tr, nsformer 750' 20.00 6/30/77 // 55 Chevrolet 1Llibu 1C35L68 Lj8g.2l 9/17/75 CRS/Rebat 38428 # 56 Transformer 75' 30.00 12/30/76 ,iarrkcch N'utrit ion School # 57 Transformer 7501! 30.00 3/19/77 Marrakech ;Iutrition School # 58 Texas Instruments 1963071 16.00 2/78 Hperrakech Nutrition School # 59 Siryer Filmstrip 132.00 5/30/78 irrakech Projector Nutrition School # 60 Charts 2CO,00 9h75oO 9/76 Delivered as needed to all centers