title: Delivery of nutrition services in health systems in sub-Saharan Africa: opportunities in Burkina Faso, Mozambique and Niger.
abstract: BACKGROUND
  In sub-Saharan Africa, underweight and micronutrient deficiencies account for an estimated 25% of the burden of disease. As the coverage of national health systems expands, increased opportunities exist to address the needs of children and women, the most vulnerable to these deficiencies, through high-quality nutrition services.
  
  
  OBJECTIVE
  To assess health providers' knowledge and practice with regard to essential nutrition services for women and children in Burkina Faso, Mozambique and Niger, in order to assist the development of a standard guide and tools to assess and monitor the quality of the nutrition services delivered through national health systems.
  
  
  RESULTS
  The three surveys reveal the extent of missed opportunities to deliver nutrition services during routine prenatal, postnatal and child-care consultations for the prevention and treatment of highly prevalent nutritional deficiencies.
  
  
  CONCLUSIONS
  A commitment to improving the quality of facility-based nutrition services is necessary to impact on the health outcomes of women and children 'covered' by national health systems. Rigorous assessment and monitoring of the quality of nutrition services should inform health programme and policy development. Building on the lessons learned in these three assessments, Helen Keller International has developed a standard Guide and Tools to assess the quality of the nutrition services delivered through national health systems. These tools can be adapted to assess ongoing nutrition services in health facilities, provide a framework for nutrition programming, inform the development of pre-service as well as in-service nutrition training curricula for providers, and evaluate the impact of nutrition training on providers' practices.
authors.affiliation: Helen Keller International, BP 8150 Ouagadougou 04, Burkina Faso. rhampshire@hki.bf
authors.forename: Rachel D
authors.initials: RD
authors.lastname: Hampshire
authors.forename: Victor M
authors.initials: VM
authors.lastname: Aguayo
authors.forename: Hamani
authors.initials: H
authors.lastname: Harouna
authors.forename: Julie A
authors.initials: JA
authors.lastname: Roley
authors.forename: Ann
authors.initials: A
authors.lastname: Tarini
authors.forename: Shawn K
authors.initials: SK
authors.lastname: Baker
mesh_terms: D000328:Adult; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006296:Health Services; D006302:Health Services Research; D006801:Humans; D007223:Infant; D007229:Infant Welfare; D007231:Infant, Newborn; D008297:Male; D008429:Maternal Welfare; D008430:Maternal-Child Health Centers / Q000458:organization & administration*; D009035:Mothers / Q000193:education*; D009073:Mozambique; D009313:National Health Programs / Q000458:organization & administration*; D009548:Niger; D009748:Nutrition Disorders / Q000517:prevention & control*; D052756:Nutritional Sciences / Q000193:education*; D011247:Pregnancy; D011314:Preventive Health Services / Q000458:organization & administration