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Webinar: MAMI Care Pathway Experiences from Ethiopia & Colombia - Shared screen with speaker view
Sita Strother
16:34
Thank you all for joining! Please feel free to introduce yourselves in the chat. Sita Strother, Child Health Task Force Secretariat, JSI, DC, USA.
Ritu Rana
16:47
Yes!
MADU EZIOMA
17:01
yes
Marie McGrath
17:34
Hi All, Marie McGrath here, Technical Director of ENN and co-chair of MAMI Global Network with Marko at LSHTM.
MADU EZIOMA
18:48
Good afternoon All. Ezioma Madu, Federal Ministry of Health, Abuja, Nigeria
Ifaliako VOLAHAVANA
19:32
Hi All, VOLAHAVANA Ifaliako. Nutrition Team Leader, CRS MADAGASCAR
Ritu Rana
20:18
Hi, Ritu Rana, Asst Prof Indian Institute of Public Health Gandhinagar (IIPHG), Ex-GOALie- worked with GOAL as MAMI research advisor
Astrid Klomp
21:43
Hi all! Astrid Klomp here, MSc student Nutrition for Global Health and previously working with implementing MAMI care pathway version 2 in Rohingya refugee response, Bangladesh.
NATASHA LELIJVELD
22:24
Tash Lelijveld here from ENN :)
Andrew Beckingham
23:07
Andrew Beckingham. Snr Humanitarian Nutrition Adviser - Save The Children
Hatty Barthorp
23:24
Hatty Barthorp - GOAL. MAMI RCT partner with LSHTM, ENN and Jimma University, Ethiopia.
kalale patrick
23:26
Hello Everyone... Kale Patrick, from Kenya
Eilise Brennan
23:45
Hi all, Eilise Brennan, Nutritionist at ENN.
Kate Sadler
24:10
Hi All .. Kate Sadler .. freelancer and currently technical associate with ENN .. happy to see you all.
kalale patrick
24:47
Hello Everyone... Kalale Patrick, from SAVE THE CHILDREN INTERNTIONAL-Kenya. Health n Nutrition Officer Turkana County.
Kiersten Israel-Ballard
25:14
Hi - Kiersten Israel-Ballard, Team Lead - Maternal, Newborn, Child Health & Nutrition at PATH. Looking for intersections here in feeding of the small and sick newborn.
Sharon Tsui
25:30
Sharon Tsui, FHI360/ USAID's MCHN Activity in Uganda
Maimunat Alex-Adeomi
26:12
Hello everyone. Maimunat Alex-Adeomi, Global Neonatal Care. American Academy of Pediatrics.
Hatty Barthorp
27:59
Hi Everyone; This is Mubarek Abera, From Jimma University, Ethiopia. Researcher in Nutrition and Mental Health, Coordinator for Research program at Fcaulty of Medical sciences
Anthea L
28:00
Hi all, Anthea, Public Health Advisor at Red Cross; and Nutrition and Health Specialist
Anna-Marie Müller
28:40
Hello from South Africa. I'm Anna-Marie at the Grow Great campaign
Adriane Seibert
29:18
Hi everyone. I'm Adriane Seibert, Nutrition Advisor, Catholic Relief Services
Alexandra Beedle
30:14
Hi everyone, Alexandra Beedle, nutrition consultant
Sandra Remancus
30:57
Hi everyone from Sandy Remancus, Director of Alive & Thrive at FHI Solutions. Based in Washington DC.
Manjari Quintanar
31:16
Greetings! Hola! Manjari Quintanar, Senior Program Officer at PATH
ANDRIANARIVO Toky
32:05
Hi all, Toky Andrianarivo, CLTN Program Manager for CRS Madagascar
Tamar Chitashvili
33:06
What questionnaire is used to assess maternal mental health and how it is operationalized and monitored at community settings? How the stigma, associated with mental health assessment is being addressed?
Andrew Beckingham
33:55
Which languages are available?
Sita Strother
35:54
Please continue putting your questions in the chat and we will address as many as possible during the Q&A session.
Kathryn Beck
36:59
Are there training materials developed yet for how to use the MAMI toolkit that go along with the care pathway materials?
Hatty Barthorp
37:03
@Tamar - the MAMI Maternal Mental health SCREENING Q.'s have been developed based on the 'Patient Health Q'aire-4' (PHQ-4) drawn from part of the GAD-7 (generalized anxiety disorder scale) and the PHQ-8 (patient health Q'aire). The ASSESSMENT are based on PHQ-9.
Marie McGrath
39:05
The MAMI Care Pathway Package currently available in English. ENN can provide editable versions to help support adaptation and translation in different contexts. If anyone has capacity or resource to translate the package, let us know! Contact: mami@ennonline.net
MADU EZIOMA
40:24
Thank you Marko for the excellent presentation.
Hatty Barthorp
41:54
Thank you so much Marko for this thoughtful and interesting presentation !!
Marko Kerac
42:31
Thanks all for the opportunity to present. Please see here for MAMI CP (version 3!) - just launched today.
Marko Kerac
42:34
https://www.ennonline.net/mamicarepathway
Marko Kerac
43:22
WRT Mental health, after long discussion with MAMI Mental Health working group we use the PHQ9 tool. https://www.ennonline.net/attachments/3892/MAMI-Maternal-Mental-Health-Assessment-Guide.pdf
Evelyn Cherow
44:03
Marko, excellent framework for early identification and intervention. Could you please speak to the interface with inclusive ECD for those children identified at risk or with disabilities and any capacity building of specialist workforce at community levels?
Marko Kerac
44:16
We believe this will be appropriate for most settings - but of course it's up to each programme/setting to review and consider whether this is right for them.
Ayenew Negesse
44:21
Hi all, there is network interruption from my side. I trust It is now recorded and will be shared!
Sita Strother
45:55
Yes, the webinar is being recorded and will be shared along with the presentation slides later today or tomorrow with all those who registered
Marko Kerac
46:58
Thanks @Eveyln. ECD is VERY important - and especially so for small and nutritionally at-risk infants. Hence it's a "CORE TOPIC" which we expect to be discussed with all carers enrolled in the programme. Depending on what other services are available locally referrals for other support groups/services can also be made. THe "support booklet" contains some details of what can be done on ECD by way of start.
Marie McGrath
47:09
Regarding early child development, some content and links to key resources are included in the counselling cards and support actions booklet, p79-p82. https://www.ennonline.net/attachments/3888/MAMI-Counselling-Cards-(standard-version).pdf
Marko Kerac
50:25
@Kathryn Beck - training materials are in progress - but more are planned in future. For now, some of the "USER GUIDES" will help those doing training. https://www.ennonline.net/mamicarepathway
Marie McGrath
50:27
Content drawing on nurturing care for early childhood development framework and resources by WHO. The MAMI Care Pathway Package leverages what exists and build s on what is there wherever possible.
ANDRIANARIVO Toky
51:06
In the absence of the MAMI MUAC, can the weight-for-age index alone be used to identify the at-risk child in the implementation of the approach, and if so, does this not alter the methods proposed by the approach? Is there a choice between using the MAMI MUAC or weight-for-age?
Tamar Chitashvili
52:11
I would love to hear about interventions targeted to mothers with potential postpartum depression or other mental health issues.
Marie McGrath
53:17
Yes weight for age can be used alone; you do not have use MUAC. Evidence shows that it is good indicator to help identify small and nutritionally at risk infants under six months. It also has advantage of consistency with growth monitoring programmes as follow up is very important.
Ritu Rana
53:40
Thank you for sharing the experience from Ethiopia, Liya!
Pooja Panchal
53:44
Hi all, Pooja Panchal, Ph.D.- SRF, pursuing in Public Health Nutrition from Symbiosis International (Deemed University), India.
Marko Kerac
54:31
Great question @Andrianarivo. In systematic reviews we've done to look at which anthro indicator best idenfities high-risk of mortality, WAZ is actually best. SO that should be the priority measure - especially since it's already widely measured in many settings in GM programmes etc. MUAC is close behind - but there's more data from different settings needed to finalise cutoffs. WLZ is NOT good - not only does it take long time to do (hence it's not often done..) but it's poor at idenfiting high risk infants.
Marko Kerac
55:02
For others interested in the anthro admission indicators see here http://s3.ennonline.net/attachments/2615/MAMI-June-2017_Final-SHARE.pdf
Tamar Chitashvili
55:19
It is better than national average. Do you know the contributing reasons behind it?
Marko Kerac
55:38
(there's a systematic review/update of that paper in progress ...we hope that'll be out soon.
Hatty Barthorp
55:52
@Andrianarivo - please note that the use of anthropometry is only one element used to help identify risk of infant-mother pairs. There is the clinical ass' and also assessment of infant feeding and maternal health and well-being.
Marko Kerac
56:09
WHO are also commissioning a review on that question soon, to feed into the update of WHO severe malnutrition guidelines
Heather Stobaugh
56:57
Does (and if so, how does) gestational age play a role in either 1) identifying at-risk children <6 mos; or 2) the interventions/services provided?
ANDRIANARIVO Toky
58:34
thank you all for these precision
Ritu Rana
58:37
WHO wasting (<6m + <5y) guideline update questions can be accessed here https://www.who.int/news-room/articles-detail/call-for-authors-systematic-reviews-on-prevention-and-treatment-of-wasting
Sascha Lamstein
59:01
Hi All! Sascha Lamstein here from the USAID Advancing Nutrition project. This webinar has been great! It is also really helpful for us as we work to develop guidance on the development of a digital app for growth monitoring and promotion (GMP). I would love to discuss further.
Marko Kerac
59:44
@Tamar. Great question about mental health. For those with less severe issues just having the wider support is very helpful. As is the relaxation therpy. For those with more severe problems referral to local services is needed. There are lots of options, not just formal mental health services. e.g. the Friendship Bench model https://www.centreforglobalmentalhealth.org/the-friendship-bench
Manjari Quintanar
01:00:08
How long does the assessment and counseling take? How do HCP manage to fit it into their busy schedules? Or is it a dedicated HCP that only focuses on MAMI? Has it been fully integrated into routine care?
Marie McGrath
01:00:19
Dear Sascha, The app is very interesting development to hear about. Please contact us at mami@ennonline.net and we can discuss further.
sophie janet
01:03:06
Thank you for an intereseting presentation. This is a question for Andrea. Who is the staff doing MAMI in Colombia? Community health workers? How to mitigate the CHW workload? Any lessons learn to share? Thanks
Marie McGrath
01:04:03
Annexes 2a and 2b of the package have blank versions of the MAMI Care Pathway overview and 'who. what, where' so you can examine what services exist where you work that do or can carry out the different components of assessment and management.
Sascha Lamstein
01:05:24
Congratulations, Marie and Marko and team, on this new and improved version of the MAMI tool!!
Sascha Lamstein
01:05:38
I will definitely be in touch, Marie.
Andrea Garcia
01:06:03
Hi Sophie we have hired two MAMI counsellors and a MAMI officer, in Colombia the CHW is not an strong figure.
Patricia Jodrey
01:06:44
Thanks for this powerful presentation on the tool and pathway. The focus on the human component of the delivery addressing the needs of mothers and infant is evident. Congratulations!
Hatty Barthorp
01:06:55
@Sophie - In Ethiopia we use IYCF counsellors and nurses alike.
Gulnara Semenov
01:09:16
do you collect any indicators?
Tamar Chitashvili
01:09:25
@Marcus, Thank you. We used similar interventions as part of PSS support, which included interventions to manage stress (breathing and relaxation techniques), schedule worry time and etc and supported country teams to develop referral pathways
Heather Stobaugh
01:09:46
Thanks for the answer, Marko, on the gestational age question. That's really interesting and useful to better understand.
Marko Kerac
01:10:07
For other questions and for ongoing discussions do please post here and let's carry on talking https://www.en-net.org/forum/19.aspx
Marko Kerac
01:11:00
Thanks +++ to all for dialling in today. Look forward to being in contact. Do sign up to the MAMI global network to get updates https://www.ennonline.net/mami/globalnetworkmembership
Sita Strother
01:11:03
Thank you all for your participation! You can become a member of the Child Health Task Force to join future webinars and meetings here: https://www.childhealthtaskforce.org/subscribe
Marie McGrath
01:11:05
Ithttps://globalhealthmedia.org/videos/ is important to
Andrew Cunningham
01:11:30
Below is the link to the webinar on the IYCF Digital Image Bank, being hosted Tuesday morning, May 11th!https://www.advancingnutrition.org/events/2021/04/20/webinar-new-resources-iycf-programming-updated-image-bank
Mesrak Nadew
01:11:37
Thank you for your excellent presentations!
Ritu Rana
01:11:46
Thank you!
Ayenew Negesse
01:12:04
Thank you
Tamar Chitashvili
01:12:16
Thank you a lot for great presentations and responses.
Mai Abdalla
01:12:19
Sorry meant to sent that message to everyone - thanks for the webinar!
Harpreet Kaur
01:12:33
Thank you!
Andrew Cunningham
01:12:43
Below is the link to the webinar on the IYCF Digital Image Bank, being hosted Tuesday morning, May 11th!https://www.advancingnutrition.org/events/2021/04/20/webinar-new-resources-iycf-programming-updated-image-bank
Sandra Remancus
01:12:57
Great presentations! Thank you.
Mamadou DIALLO
01:13:06
Mamadou DIALLO Nutrition Supply Chain UNICEF.
Alexandra Beedle
01:13:10
Thank you so much for the presentations!
Hatty Barthorp
01:13:14
Re. time taken to assess and support infant-mother pairs. This is obviously a concern for any practitioners. However, it's useful to look at potential caseloads that health practitioners may be faced with supporting.
Sharon Tsui
01:13:16
Thank you!