SPRING worked closely with the Ministère de la Santé Publique et de la Population (MSPP) to strengthen the nutrition assessment, counseling, and support (NACS) approach. The NACS components comprise a nutrition continuum of care:
- Nutrition assessment: a critical first step in improving and maintaining nutritional status. It involves measurement and classification of nutritional status by gathering and interpreting anthropometric and clinical information.
- Nutrition counseling: an interactive process between a client and a health provider or counselor that uses information from the nutrition assessment to prioritize actions to improve nutritional status.
- Nutrition support: includes both clinical management of malnutrition at facility level and ensuring clients have access to prevention and follow up services at the community level.
NACS was already being used when SPRING started working in Haiti, but the MSPP was concerned with how well and how consistently the approach was being applied in health facilities. There was a need for standardized nutrition assessments, job and counseling aids, trainings, equipment, expansion of nutrition services, and support for supportive supervision. SPRING focused its interventions to address these areas and this drove our collaboration with the MSPP and other stakeholders.
To build the capacity of the health system to support NACS scale-up, we invested in formative elements of the NACS approach to define the standard of care for NACS; finalized the NACS and IYCF training packages, job aids and counseling materials; and revised the national supervision tools for nutrition. FANTA led the development of the NACS training package, and SPRING supported the document’s finalization and MOH approval process after FANTA closed. The complete NACS training package and IYCF training package were validated by the MOH in August 2015.