Philani Child Health & Nutrition Project
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THE OUTREACH PROGRAMME

"I had been abandoned by those who know me. Philani became my mother and my father..."
Busiswe, mother of twins

The Khayelitsha Health and Nutrition survey (UNICEF, 1994) showed that the children most at risk of malnutrition, neglect and abuse were from socially and economically marginalized families. To reach these children Philani started a house-to-house visiting programme in 1995. This has been further developed into a comprehensive outreach programme, which is now our largest and most far-reaching programme. Women from the local communities who have well-nourished and healthy children despite poverty, so-called 'positive deviants', are identified and trained in order to advise and support other women in the community regarding child health and child care issues. Together, our Outreach workers and mothers identify resources and coping mechanisms developed in the community and use these to improve the quality of life of mothers and children. About 50 per cent of the children admitted to the programme are rehabilitated and another 25 per cent see significant improvement.

We currently work with more than 3,500 children and their families through our Outreach programme.

The Outreach philosophy

The Philani Outreach Programme aims to identify every child at risk of malnutrition, neglect, HIV/AIDS, abuse or exploitation in our local communities and intervene to protect those children. Philani is the only community-based outreach programme supporting and monitoring families receiving HIV treatment. The philosophy behind this programme is one of finding and building on knowledge and experience present in the community, recognizing and developing women's resources and facilitating women's support of each other in protecting the healthy mental and physical development of children. The Philani Outreach Programme has developed after the internationally established 'Hearth Model', adjusted to South African circumstances.

Outreach workers

More than 70 Outreach workers operate within this programme, all volunteers, receiving ongoing training and a monthly stipend for their work. The programme is managed by two Outreach coordinators, a Senior Assistant coordinator and four Assistant coordinators (volunteers), all of whom are out in the community five days a week, running the programme in 10 areas. The Outreach workers' method of working is simple: they walk around their delegated areas - usually the communities in which they live - knocking on doors, seeking to identify malnourished children and their mothers. Many mothers are so sick themselves or otherwise bound to their homes, that, in the majority of cases, Outreach workers are welcomed for their support and care.

Continuous professional training is an essential aspect of the Outreach workers' involvement with the programme. They are trained in child health and nutrition, HIV/AIDS, counselling, TB, child neglect and abuse, resource mapping, community home visiting, in the field growth monitoring, and many other areas. In April 2004 Philani was asked to take over the management of a community programme previously run by the Western Cape Department of Health, called Integrated Management of Childhood Illnesses, and integrate that programme with our Outreach Programme, which we have done successfully.

Medicals and evaluation

Weekly clinics with the Philani Medical Doctor are held at each Philani Nutrition Centre, to which children on the Outreach programme in need of extra medical attention are referred. In 2007, a programme of field-clinics, held in houses in the local communities, has been initiated, with the aim of all children on the Outreach programme being checked regularly by a doctor. It will only be possible to achieve this aim and make it sustainable, however, with extra medical staff.

There is a strict regime of monitoring the programme and children's progress and measuring outcomes. Outreach workers' clients records are checked reguarly and data captured and analysed for evaluation purposes.

MOTHER'S STORIES

 
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