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GMP programs in Ecuador.

Medina M
In: Growth Promotion for Child Development. Proceedings of a colloquium held in Nyeri, Kenya, 12-13 May 1992, edited by J. Cervinskas, N.M. Gerein, and Sabu George. Ottawa, Canada, International Development Research Centre [IDRC], 1993 Feb. 208-13.

Growth monitoring programs have been in place in Ecuador since the mid-1960s. UNICEF evaluated growth monitoring and promotion (GMP) programs in the country over the period November 1990 to March 1991 to review current GMP efforts and assess how they are affecting triple-a processes. This paper concentrates on the analysis of both community-based and clinic-based programs and lessons learned. The Ministry of Health Growth Monitoring and Development program is implemented nationally through the network of government health units, while other GMP programs are based in the community and implemented by different types of institutions and nongovernmental organizations (NGO). The study was conducted in 6 different areas of the country in which 3 communities each were selected. A total 810 mothers were surveyed, 18 GMP sessions observed, 18 focus group discussions held with mothers, and 37 in-depth interviews conducted with 37 nurse aides and promoters and 7 national officials. It may be concluded that the probability of program success increases in an institutional context which is supportive of community participation and enhancing the active involvement of mothers to make GMP successful; different approaches to implementing GMP activities have implications in terms of adequate coverage; every effort should be made to reach those most at risk; better ways of communicating with mothers should be developed; sharing experiences through joint exercises between the government health units and NGO projects will contribute to a better quality of program implementation; and the possibility of linking the weighing activities with income generation has been a significant contribution toward program success.

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