Website: <www.accioncontraelhambre.org>
Contact person(s): Nuria Salse at [email protected]
Introduction and background
In terms of school health, the objectives of Acción Contra El Hambre (ACH) Argentina are to know the food and nutritional situation, the access to health services and the maturing development of schoolchildren to develop integral projects on health and nutrition (i.e. iron supplementation, healthy eating, physical exercise, health coverage and school vegetable growing).
It is required to establish integral intervention strategies which put together nutrition, health care and stimulation actions driven towards children, along with working together with families in order to improve living conditions, quality of relationships and upbringing standards.
ACH Argentina does not formally promote or support the FRESH framework.
Activities and programmes
The project is based in the province of Santa Fe situated in North of Argentina. It has a population of 3,000,700 inhabitants. During 2005 ACH Argentina performed a nutritional and cognitive development survey to a representative sample of school and preschool children. The results showed that even though this population reported to have access to health services the quality of medical attention provided was poor. The main nutritional problems found were anaemia, growth retardation and obesity. The outcomes of the cognitive development assessment were associated to social family problems and growth retardation. Over the 54 schools and 43 preschool centres selected for the study, 27 institutions were chosen to develop integral projects on health and nutrition.
The main areas of work were identified together with teachers which were:
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• Iron and folic acid supplementation.
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• Healthy eating.
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• Guidelines to improve the quality of meals.
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• Physical activity.
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• Coordination with health centres to improve health check-ups.
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• School vegetable growing.
Furthermore, ACH Argentina is involved in reproductive health education, teachers and parents training and the distribution of education material to schools i.e. videos and booklets, as well as the development of nutritional guidelines and nutritional software.
Education materials are developed to be included in different school subjects. In this way, healthy eating and school-based programmes on how to grow vegetables are included in subjects such as biology and mathematics.
The project provides technical support to improve the quality of children’s diets offered at the institutions. This is done using the PAHO software ‘Planut’. With this
software, as well as evaluating the nutrient content, allows taking into account the cost of the meals.
Weekly micronutrient supplementation comprises 200mg of ferrous sulphate and 60mg of folic acid. This activity also involves training teachers and parents on anaemia and administrating tablets to 42 schools of the province of Santa Fe.
Physical and leisure activities were combined with promotion of a safe school environment. Teachers and children were involved in removing weeds and litter from school surroundings to gain space for this purpose. Referral to health services for vaccination and health check-ups also takes place at project schools.
Topics on policy and advocacy work
Topic Topic
Human rights, discrimination and stigma reduction
Services for students with special
needs ✔
School feeding programmes ✔ Violence prevention
Immunization, vaccination ✔ Gender and sexual diversity Ethnic and religious diversity Environmental concerns Skills-based health education including
reproductive health/HIV&AIDS prevention ✔
Access to safe water Tobacco, drugs, alcohol prevention Promotion of adequate
sanitation/latrines Health and nutrition services, including
deworming ✔ Partnerships and participation Promotion of a safe school environment ✔ Malaria care and prevention
Work place issues Other: Growing vegetables ✔
Partnerships, advocacy, research and participation
Schools were selected after the nutritional survey. At that time regional and provincial health and education authorities were already informed of the project. Afterwards, school authorities were visited to coordinate activities. A meeting with teachers interested in integral projects was held to determine the areas of work. According to the areas selected, community partnerships were identified. Health services were always contacted, but other programmes such as ProHuerta − a government programme that promotes home food production − were only included if the school was interested.
At regional level the programmes promote partnerships with Universities as: ’Fundación del Gran Rosario’; and UNICEF; State programmes as ‘ProHuerta’ and ‘Programa Social Agropecuario’; and other organizations as the ‘Rotary Club’, ‘Argentine Agricultural Federation’ and the ‘City Council Emergency Centre’.
The key actors to the projects were teachers; therefore they have been involved during the entire process i.e. choosing the topics according to the school needs and integrating the activities with the school curricula.
The project is carried out by ACH Argentina in collaboration with UNICEF Argentina, the Spanish Agency for International Cooperation, Santa Fe Health and Education
Ministries, ProHuerta Programme, Rosario City Council, local NGOs such as ‘Línea Verde’ and ‘Equipment Production and Construction Alternative’.
The information obtained from the surveys is used to promote awareness about the situation of children in different ways such as: technical publications; presentations in scientific meetings; and meetings with decision-makers.
ACH Argentina began to work in Santa Fe after the floods in June 2003. The first project aimed at strengthening the nutritional surveillance system. Within this project a nutritional survey to children aged 6 months to 6 years was carried out in the most affected area of Santa Fe. The results showed that anaemia was highly prevalent not only for infants but also for schoolchildren.
The learning capacity and school performance of the same schoolchildren were assessed using a simple questionnaire that was completed by teachers. These results were then associated with anaemia.
A strategy to tackle anaemia was proposed to the local health authorities and 14 schools affected by the floods initiated a weekly supplementation with iron and folic acid. As a result of the supplementation the prevalence of anaemia was reduced from 23.7% to 16.8 % among this population.
As a consequence of the lack of information regarding the nutritional cognitive development status of the school population, ACH Argentina decided to perform another survey in 2005. This time the sample was representative of the total of the state schools of Santa Fe province. The study included nutritional and cognitive development assessments. The anaemia levels found were similar to those found in 2003 in the 14 schools of the flooded area. As regards to the cognitive assessment all tests showed poor performance, however, the most affected were related to environmental stimulation. In the same way, poor performance was associated with the level of instruction from the mother. Another variable linked to all the cognitive tests was growth retardation.
Future plans
The experience carried out in Argentina will be capitalized with the possibility of implementing these activities in other countries where ACH Argentina is working, for instance in Colombia, but adapting the activities to the context.