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Partnership between Canada, UNICEF and Ghana Health service to reduce malnutrition

CMAM
© EBaddoo
Khadija and her son Rakeem

Khadija and her son Rakeem live in Tolon a town 30 minutes by road from the regional capital of the Northern region of Ghana. When Rakeem was 14 months old he became ill and lost a lot of weight, according to their belief system his mother treated him with traditional herbs.Two months later, he wasn’t getting better, so Khadija sought help from the health center where he was diagnosed with Severe Acute Malnutrition. 

Rakeem spent 2 months in rehabilitation on a treatment of therapeutic foods and was discharged weighing 7.2 kg. Two months after Rakeem’s recovery, he may have to return to the treatment center as he has relapsed and his weight is dropping. Malnutrition is not unusual in that part of the country but what makes it dangerous is that often, it is not considered a medical condition but rather, it is tied to a belief system – that it is a ‘curse from the gods’. 

Malnutrition is also a result of ignorance, poverty and lack of food, and even after rehabilitation, some families are not convinced that changing the way they care for their children will permanently relieve the children of their condition. Kadija and her son’s situation is not unusual, but they were lucky to have been told about Community Management of Acute Malnutrition programme, (CMAM), which is supported through a grant from DFATD-Canada to UNICEF-Ghana. Through this programme Rakeem’s rehabilitation was made possible. 

When Rakeem was discharged, his mother was counselled on how to care for her son as well as how to improve 

“I was told to give him green leafy vegetables and to include beans and groundnuts in his diet.”
 
 the complementary  foods that she feeds Rakeem.  The CMAM approach includes counselling of caregivers on new feeding practices. However, Khadija is unable to sustain the recommended practice because her husband who lives in the south supports her minimally with 20 Cedis a month (about $8). 


Khadija who does not work and lives with her son’s great grandmother is unable to afford the new ingredients required to fortify Rakeem’s meals. Even though poverty is a challenge in that household, grandma who is the head of that household still believes that there is more to Rakeem’s illness than malnutrition and so does not prioritize the recommended care for Rakeem. The CMAM programme is timely and has brought relief to many families but there are still children like Rakeem who have successfully undergone rehabilitation but lapse because caregivers are unable to sustain the care recommended. 

“I want my son to live a healthy independent life and become successful” that’s the future Khadija wants for her son but the continuum of care is broken partly because of the social system.

CMAM is an innovative approach to managing severe acute malnutrition in children 6-59 months of age. The programme is run by the Ghana Health service. The components of the programme include searching for cases in the community by health workers, and the involvement of the community in the detection and referral of cases for treatment. With technical support from UNICEF, health workers and community volunteers have been trained to identify and refer cases they find in their communities. It was on one of those community case searches by health workers that Rakeem was found and sent to the health center for rehabilitation. Since 2011 when the programme was introduced in Tolon, data available from the DHMT shows that there has been over 75% recovery rate for children who were enrolled and successfully recovered from their condition. Previously diagnosis and treatment was only at the facility level out of reach of many caregivers. But now CMAM is practiced at the doorstep of community members making it more accessible. Again, more children have been identified and treated because of effective monitoring by health workers and volunteers.


 

 
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