The organizing framework for HKI’s strategy to improve maternal, infant and young child nutrition is the Essential Nutrition Actions (ENA) framework which has been implemented in Africa, Asia and Latin America by many different field groups addressing the problems of malnutrition in low resource settings. The ENA framework provides an operational approach for advocacy, planning, training and delivery of an integrated package of interventions to reach the high coverage (>90%) needed to achieve public health impact. As such, partners are now promoting the framework to support the realization of scaling up nutrition objectives on the ground.

These training materials were developed through a joint effort by Helen Keller International and JSI Research & Training Institute Incorporated, with more recent up-dates and revisions supported by the United States Agency for International Development’s CORE Group and the Food-for-Peace Technical and Operational Performance Support (TOPS) Project. The most recent 2015 update of the training tools includes ‘essential hygiene actions’ (EHA) and gives attention to water, sanitation and hygiene actions, suggests homestead food production activities to improve access to nutrient rich foods, and provides practical exercises for negotiating with mothers and their families for behavior change.

A summary overview of the ENA/EHA framework is described in Understanding the Essential Nutrition Actions and Essential Hygiene Actions Framework (2015) [Français].

The latest ENA-EHA framework tools are available below in English and French.

• ENA/EHA Training Guide: Health Workers and Nutrition Managers (2015) [Français]
  This training guide introduces health professionals to the most up-to-date guidance on infant and young child feeding, adolescent and women’s nutrition, nutrition in the context of HIV, protocols for prevention of micronutrient deficiencies, integrated management of acute malnutrition, and relevant strategies for improving hygiene and sanitation. It emphasizes exercises to improve skills in counseling that support clients to adopt optimal nutrition practices.
• ENA/EHA Reference Manual: Health Workers and Nutrition Managers (2015) [Français]
  As an companion to the above ENA/EHA Training Guide for Health Workers and Nutrition Managers, this manual contains detailed technical guidance, including on how to deliver the right  nutrition support at the right time and in the right way to women and children at critical life-cycle contact points.
• ENA/EHA Training Guide: Community Workers (2015) [Français] 
  This training guide strengthens the capacity of community workers (from health, agriculture and community development among others) to deliver and promote the Essential Nutrition and Hygiene Actions. Taking into account literacy limitations, it simplifies technical content with hands-on sessions to practice counseling and negotiation, using role plays and field practice.
• EHA/EHA Reference Materials on Key Practices: Community Workers (2015) [Français]
  As a companion to the above ENA/EHA Training Guide for Community Workers, this manual contains job aids which cover key concepts for each of the nutrition and hygiene practices as well as some ideas on how Homestead Food Production (HFP) can be used to improve household dietary quality and diversity.