Hearth curriculum

By Marion Wells,2014-05-20 13:57
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1. Discuss importance of keeping children healthy (so they grow well, can play and learn and be healthy, strong adults). 2. Learn how and why to feed a sick




    1. Define a balanced diet by identifying different food groups

    2. Learn the importance of 1. diet variety, 2. feeding frequency (importance of snacks) and 3. food

    volumes for children of different ages

    3. Learn how to make economical food choices in the market

    4. Learn that marissa is a bad food, especially for women and children


    ? Children should have a good mixture of foods in their diet

    ? Why? - food groups (square/bowls) and what each group is good for

    ? Variety means the child will be interested to eat enough to be healthy and grow well

Frequency and Amount

    ? What is a meal? (example what we are using in Hearth affordable and available) ? What is a snack? (example what we are using in Hearth affordable and available) ? Young children need to eat little and often because they have small stomachs ? Babies less than year should breastfeed before eating and need to eat less often

    ? As children grow increase the frequency of eating and the amount at each meal ? Young children should eat 5 times a day 3/4 meals and 1/2 snacks ? What foods are not good value for money? Very sugary foods like sweets. Good alternatives are:

    (nutritious snacks) sugar cane, tamia, bread and tahania, bread and honey, zalabia, sweet potato

    mashed with milk/oil, bread and milk or fresh fruit juice, groundnuts, dates, mangoes, lentils and

    sugar, beans and oil, rice and milk/honey/sugar, boiled wheat with milk/honey/sugar, simsimia)

    ? Marissa is a bad food for women (especially breastfeeding women, but all women who have to

    care for children) and should NEVER be given to children. It is like a poison for a child

     Teaching modes and aids:

    ? Make a food triangle with example foods for 1. growing (proteins = all animal foods MILK is

    important for children who are not drinking breastmilk, and lentils, beans and peas), 2. fighting

    infection and staying healthy (all fruits and vegetables, although the best are red, orange, yellow

    (mango, watermelon, tomato) or dark green leaves (kudra) because these contain lots of vitamin A)

    and for 3. energy (for playing, working, learning) (cereals = millet, sorghum, wheat, bread, rice)

    ? Use the picture of the child to describe how having a small stomach means he must eat often

    ? Use the picture to show how to make neisha/medida protein rich: add oil AND

    daqua/lentils/milk etc

    ? Discuss Hearth meals and snacks



    1. Learn what Active Feeding is and why it is good

    2. Learn how to make sure the child gets enough food

    3. Discuss how to make sure the child eats well if the mother has no time

? Active feeding includes: mother should sit child on lap and feed a young child with her hands or a

    spoon; mother should talk to the child and encourage him telling him what the foods are for, playing

    games, etc

    ? How to make sure the child gets enough food: younger and older children should have their own

    bowls; mother should take time to feed the child (he has a small stomach); if the child won’t eat

    mother must encourage/play games/talk/play/take time. Mother must not accept refusal unless she

    is sure the child must be full!

    ? Dealing with refusal offer the child his/her favourite foods, try different tastes, textures, colours,

    combinations, make meal times happy, not hurried…

    ? How to make sure the child eats well if the mother has no time: other carers should be given these

    same instructions; other carers should be adults or older children that are responsible and love the



    Teaching modes and aids:

    ? Practice during session

    ? Discussion of poster



    1. Reinforce the importance and reasons for supervision of young children and discuss ways to do this

    2. Learn the benefits of playing

? Child should be with mother all the time and breast feed on demand until 2 years old. If he is left

    with another carer he might not get enough good food to be able to grow well and stay health. He

    also needs breast milk all the time until he is at least 2 years old ? If the mother leaves the child, he should be cared for by and adult or older sibling who should

    be given clear instructions on hygiene, feeding and caring ? Children under 5 must be supervised at all times and taught what is right and wrong

    ? Children need to be played with to make them grow well and be happy

    Teaching modes and aids:

    ? Show the mother a picture of breastfeeding and discuss the importance of breastfeeding until 2

    years old

    ? Group discussion on UNICEF pictures of playing

    ? Make some small toys for use while the mothers are cooking use everyday ? Get mothers to teach each other mothers some good games to play with their children /sing songs

    ? (Use appendix 7 and 8 of management of children with severe malnutrition for guidance on age

    appropriate psychosocial stimulation)




    1. Define what is food hygiene and why it is important (relate food contamination with disease-


    2. Identify methods of blocking food contamination (from food storage to preparation to cooking

    to serving to the next meal)

? Hand washing at critical times: hands should be washed with water and soap before preparing food,

    before eating and after the latrine

    ? Raw foods should be washed

    ? Foods should be stored well (airtight containers / away from animals)

    ? Foods and drinking water should be covered from flies

    ? Foods should be kept clean and children supervised to eat (no eating off the floor)

    ? Cooking and eating utensils should be clean and dried on a dish rack

    ? Left over food can be eaten if it has been covered and heated through again until it is very hot

    ? Recap on WHY we must do these things



    1. Define what is personal hygiene and why it is important: identify diseases related to poor

    personal hygiene (diarrhoea, skin infection, eye infection) and identify methods of

    preventing diseases related to personal hygiene

    2. Illustrate how dirty hands are a source of diarrhoea and emphasize importance of hands

    washing at critical times

? Hand washing at critical times: hands should be washed with water and soap 1. before preparing

    food, 2. before eating and 3. after the latrine

    ? Nails should be trimmed and clean

    ? Bodies and faces should be clean, wash children when they are dirty

    ? Recap on WHY we must do these things




    1. Define what is home hygiene and identify diseases related to poor home hygiene

    2. Key needs for good home hygiene: latrine (and proper care and use), rubbish pit, dish rack

? Every house should have access to a latrine, all faeces must go in the latrine, children should be

    assisted and taught how to use the latrine, including washing hands with soap and water after use

    ? Animal faeces should be disposed of and the child should not play near them

    ? Use a dish rack for drying cooking utensils

    ? Dispose of rubbish in a pit

    ? Recap on WHY we must do these things

    Teaching modes and aids:

    ? Discuss Oxfam picture handouts

    ? Discuss UNICEF pictures

    ? Practice all relevant behaviours during Hearth sessions pointing out when they happen and

    discussing them

    ? Tell older children / show older children how to do these things hand washing etc



    1. Learn the meaning, importance and benefits of EXCLUSIVE BREASTFEEDING until 6 months of age

    2. Discuss good first foods for baby (meals for children 6-8 months old)

    3. Discuss how to feed children from 9 months of age until 2 years old

    4. Discuss the best time to stop breastfeeding: children need breast milk until they are two years


    5. Learn how to wean in a way that will mean the child is not in danger 6. Discuss the benefits of breastfeeding even if the mother is pregnant 7. Discuss important foods for a child not drinking breastmilk

    ? Babies only need breast milk from birth to 6 months of age. They do not need water to drink or

    foods to eat. This helps the mother stop from getting pregnant and is best for the child’s health

    too (he is less likely to get sick and stop growing well)

    ? At 6 months, baby needs good foods to grow well and stay healthy (what foods? Recap on lesson one,

    discuss good meal ideas, e.g. asida/medida/neisha AND groundnut/simsim paste/oil/sugar /milk/

    mashed fruits or vegetables/fruit juice/beans). Before this time is too early and the child is at risk

    of getting sick (not being able to digest the food and eating dirty foods). Later than this the child

    will not be getting enough goodness from milk alone and might be difficult to feed new foods. Take

    time and patience and try different soft foods

    ? From 9 months to 24 months baby needs to start eating more and more and greater variety until he

    eats all the family foods

    ? Babies need breast milk until 24 months but they must be weaned slowly. This means the child

    needs to be eating more good and different foods and having less breast feeds (stop night feeds

    last) slowly slowly (over months) until he is happy eating foods alone no breast milk. He must

    not be sent away to a relative as this will make him unhappy, he will not eat, he will lose weight

    and will become sick.

    ? A pregnant woman can breast feed her baby without harm to herself, or her children. Most

    children in Mornei become malnourished BECAUSE they are weaned too early. Stopping

    breastfeeding early puts the child in danger of sickness from contaminated food and water and

    from malnutrition and death. Diarrhoea is caused by dirty foodor water and not breast milk.

    The mother must eat well, drink well and both children will grow well and be happy. Breast

    milk is a growing food which also helps the child fight infection and have energy to play and

    learn. It is 100% clean and safe and an important food for children up to two years old.

    ? A child no longer drinking breast milk NEEDS other growing foods milk is important in the diet

    of a weaned child, but other growing foods are lentils, samak, loubeh, CSB,

    Teaching modes and aids:

    ? Pictures of breastfeeding and weaning group discussions on what they mean




    1. Discuss importance of keeping children healthy (so they grow well, can play and learn and be

    healthy, strong adults)

    2. Learn how and why to feed a sick child

    3. Remember how to treat diarrhoea

     Knowing when to go to the clinic 4.

     Learn the importance of vaccinations 5.

? Sick children need MORE foods and MORE drinks and continued breastfeeding even though they

    don’t have an appetite: this is to fight the infection, repair the body and keep growing. Neisha

    is good but needs to have added OIL/SUGAR and a growing food, like daqua or milk

    ? A child with diarrhoea and/or fever needs to be taken to the clinic early, and before the Fakhir.

    Diarrhoea is 3 or more loose stools in 24 hours. Other danger signs and reasons to go to the clinic

    are: convulsions, lots of vomiting, the child is not drinking anything or breast feeding, the child is

    sleepy/unconscious. Medicines should be taken as the doctor says and if they do not work you

    should go back to the clinic.

    ? Children should have all their vaccinations at the clinic before they are one year old to ensure they

    are healthy in later life

    ? NEVER harm a child by cutting them or pulling out their teeth. This has no benefit.

    Teaching modes and aids:

    ? Discuss ORS making picture and how to make at home, discuss vaccination pictures etc


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