The place of early childhood development in national policies – Interview with Dr. OKA of the National Nutrition Programme

Dr. KOUAME Oka is a medical doctor (MD), and nutrition public health specialist with extensive expertise in policy, field epidemiology and monitoring-evaluation. In this interview, he tells us about the National Nutrition Program of the Ministry of Health and Public Hygiene (MSHP) of Côte d’Ivoire,  which he leads since 2017 as the Director-Coordinator.

Can you explain to us what is the National Nutrition Program and what it consists of?

R: The Direction-Coordination of the National Nutrition Program (PNN) was created in 2001. This unit is responsible for the implementation of the National Nutrition Policy and all relevant strategies specific to nutrition as part of the MSHP’s contribution in the fight against malnutrition in Côte d’Ivoire. The PNN implements three strategies, they are: the strategy for the management of malnutrition for children under 5 years old, the newborn and young child feeding nutrition strategy, and the nutrition strategy for people living with HIV and other chronic diseases such as diabetes and hypertension. PNN also implements activities that contribute to the fight against micronutrient deficiencies for which it has developed several guidelines and protocols. We are currently scaling up key nutrition interventions accross the country. These interventions are part of the overall framework of the National Multisectoral Nutrition Plan led and coordinated by the National Council for Nutrition, Food and Early Childhood Development (CONNAPE), in which specific guidelines are defined for the fight against malnutrition.

In this regard, the Multisectoral Nutrition and Early Childhood Development Project (PNMNDPE) emphasized the convergence of intersectoral community actions that are sensitive or specific to early childhood development. This approach reflects the Government’s commitment provide holistic services to young children and increase human capital in Côte d’Ivoire. In this context, we have been active since the start of the initiative targeting children’s first 1000 days since 2017.

How do you include early childhood development in your field activities? What works and what doesn’t?

R : As I mentioned earlier, we opted early on for package of care for nutrition that integrates other early childhood development (ECD) aspects. We chose to take these ECD aspects that go beyond nutrition, into account, in the “baby-friendly hospitals” initiative package that promotes breastfeeding. We are satisfied with the enthusiasm of the beneficiaries. We now need to improve the knowledge of the volunteers.

What has been your experience with TRECC?

R : Our experience with the TRECC program has always been very satisfying. Our first intervention on ECD benefited from the technical and financial support of this program.

What is striking and innovative for us is TRECC’s working method, which I can describe as unique. This methodology allows us to benefit from a learning process for scaling up while ensuring sustainability. We are also pleased with TRECC’s confidence promoting the government’s leadership. I would like to note the dynamic negotiation process which is always participatory, and which reinforces our sense of responsibility and ownership. The benefit is twofold: capacity building and sustainability of interventions through national ownership. TRECC’s approach, from the pilots with independant evaluations, to the adjustment phases before scaling up, reminds me of the saying: “He who wants to go far, spares his mount.” To say that by taking the time to learn from our shortcomings, we give ourselves the chance for greater results.

This working method also includes the support of Innovations for Poverty Action, which reassures us, because as an independent observer, their experience improves the quality of our interventions. 

How do you envision strengthening ECD parenting skills over the next 5 years?

R : Today, we are committed to full coverage of one health district, the Lakota Health District comprising 113 villages. For us, this will mark the beginning of the integration of Essential Nutrition Actions integrating ECD into the community care package. I mentioned earlier that this theme is integrated into the training of health workers for the establishment of more than 1,000 health facilities as part of the “baby-friendly hospitals” initiative.

Our approach is to strengthen the skills of fathers, mothers, or caregivers in nurturing care for the adoption of good practices from the first contact with a health center. Then, provide community support through community health workers or volunteers. We are working hard to integrate our actions into the vaccination program and the national mother-child health program to seize the opportunities offered by these activities and to increase our synergy of action.

“The PNN implements three strategies, they are: the strategy for the management of malnutrition for children under 5 years old, the newborn and young child feeding nutrition strategy, and the nutrition strategy for people living with HIV and other chronic diseases such as diabetes and hypertension. PNN also implements activities that contribute to the fight against micronutrient deficiencies.”