18-month-old Natalie is now healthy after receiving treatment for undernutrition at Kaya Regional Hospital.
By Priscilla Ofori-Amanfo
OUAGADOUGOU, Burkina Faso, 21 September 2011– Recently nominated Nutrition Advocate for West Africa, and President of Cape Verde from 1991 to 2001, Mr. António Manuel Mascarenhas Gomes Monteiro has ended a three-day visit to Burkina Faso ahead of his participation at the UN High Level Meeting on Nutrition in New York on 20 September 2011. In his new role, Mr. Monteiro is engaging with senior government officials on the importance of investing in nutrition not only to reduce the burden of undernutrition and child mortality, but also to increase economic development throughout the region.
In Burkina Faso, the first country Mr. Monteiro has visited as Nutrition Advocate, data provided by the National Nutrition Survey in 2010 show that 35 per cent of children under five are suffering from chronic undernutrition and 11 per cent are suffering from acute undernutrition.
A proactive stance
The government of Burkina Faso has been proactive in responding to nutrition challenges, and in 2002 the National Directorate of Nutrition was created within the Ministry of Health. Then, in 2007, the “Three-Ones” were launched – one multisectoral coordination framework through the national nutrition council; one national nutrition policy and one monitoring and evaluation system. Aware that scale up of its response can only be achieved through partnerships, the Ministry of Health signed agreements with civil society organizations in 2009 to boost community based nutrition and health interventions and has intensified its engagement with development partners. As a result of these efforts, rates of undernutrition have been decreasing since 2009.
Accompanied by the Minister of Health and the Governor of Kaya, Mr. Monteiro began his field mission at Kaya Regional Hospital, in the centre north region of Burkina Faso. The hospital’s capacity to treat undernourished children has significantly increased since Save the Children and UNICEF began providing financial and technical support. As Dr. Coumbo Boly, a paediatrician at the hospital explained, “In 2006 we looked after 30 undernourished children. The following year this number had risen to 130. By 2010 we were able to treat 282 children and this year we have already received 380 new admissions. Save the Children covers all the medical fees for these children and that encourages mothers to bring their children here,” she said.
Nutrition Advocate, Mr. Monteiro holds a child treated for undernutrition at Kaya Regional Hospital.
Providing basic training
Despite the fact that much needed support is being provided, the hospital continues to face problems including a lack of some medical supplies and qualified medical staff and is unable to follow up on the nutrition needs of women who have travelled alone from distant villages.
Nurses explained to the delegation how children are treated with therapeutic milk or ready-to-use therapeutic foods (RUTF) provided by UNICEF and demonstrated the use of image flipcharts in interpersonal communication sessions during which women are advised on what to eat during pregnancy and while breastfeeding, and the nutritional values of food.
This knowledge has made a big difference in the lives of 18-month-old Natalie and her guardian, Augustine Ouédraogo. “When Natalie arrived at the hospital 13 days ago, her whole body was swollen because she was so badly undernourished. She was very weak and sick. First we treated her with antibiotics and then we gave her therapeutic milk before moving her onto ready to use therapeutic paste,” explained nutrition assistant Ms. Mamounata Balima.
Natalie lost both her mother and father and was already undernourished when Ms. Ouédraogo became her guardian. “I didn’t know how to make Natalie better, but the nurses taught me how to add sesame seeds I have at home to the porridge I make for her. Now she is walking and talking again because she is well,” Ms. Ouédraogo said.
It is precisely this information on how to enrich foods using locally grown cereal and grain that is gaining important ground within communities. During the second part of his field mission Mr. Monteiro travelled to the village of Weotenga in central Burkina Faso, to see nutrition interventions led by civil society. Mr. Monteiro met with women from the community and the non-governmental organizations supporting them -Association Chants de Femmes, International Baby Food Action Network (IBFAN) and their local branch in Burkina Faso which are all supported by UNICEF.
Mr. Monteiro met with Prime Minister Luc-Adolphe Tiao to discuss Burkina Faso’s nutrition challenges and progress.
Engaging the community
Against the backdrop of a lively song about exclusive breastfeeding and complementary feeding (composed by Burkinabe musician Dim Jeremy with support from IBFAN) played to welcome Mr. Monteiro, the NGOs explained how they are working together to make a difference in nutrition at community level. The NGOs conduct a five-day training and sensitization course for community based organizations (CBOs) on early initiation of breastfeeding, giving colostrum (first milk) to babies within the first hour after birth, exclusive breastfeeding in the first six months of life, nutrient-rich complementary feeding, consumption of iodized salt; hand-washing with soap, and safe hygiene practices including the construction and use of latrines. The CBOs in turn share this knowledge at the grass-roots level.
Mr. Monteiro heard from women who had participated in the training sessions. “I used to feed my babies traditional liquids and water because I thought it would make them strong. Now I know that babies only need breast milk for the first six months of life and then we can start giving them food such as porridge mixed with the cereal we grow. It is good for our children to eat nuts and sesame seeds because they contain oil. We do not have a lot of money, but we have everything we need here to keep our families strong and healthy,” one woman said. Another woman proudly presented her 14-month-old son to Mr. Monteiro, explaining that he had been exclusively breastfeed until six months of age and that he had never been admitted to a health centre due to illness.
Sharing a vision
Back in Ouagadougou the following day, Mr. Monteiro met with the Prime Minister. In the presence of the highest authorities of Burkina Faso, he stressed the importance of a shared vision and a concerted effort by all partners and stakeholders in achieving sustained results in nutrition. He also met with the Directorate of Nutrition and some of its partners including bilateral and multilateral organizations such as the World Bank, European Union and USAID; NGOs Helen Keller International, Plan, Red Cross, Terre des Hommes, MSF, APAIB, Association Chants des Femmes and Action Against Hunger; and UN organizations including the World Food Programme, WHO and UNICEF. The technical meeting consisted of an overview on the government response to nutrition, presented by Dr. Sylvestre Tapsoba, Director of the National Directorate of Nutrition and a presentation by development partners on the support provided to the government, presented by UNICEF.
At the closing of the meeting, Mr. Monteiro congratulated the Government of Burkina Faso for its concerted efforts in responding to nutrition challenges. “My role as Nutrition Advocate is to convince authorities to do more to address undernutrition. Development partners are important, but Governments are primarily responsible for improving the nutrition situation of their populations. They need to take the necessary steps to achieve this important goal. In Burkina Faso, the authorities have already embarked upon important initiatives. What the Government is doing in the field, with support from partners is truly remarkable. Burkina Faso is an example for other countries in West Africa,” he said.
Mr. Monteiro’s visit ended with a press conference where he reiterated the good progress made by the Government of Burkina Faso in tackling the nutrition challenges. “Investing in nutrition is a way of breaking the vicious cycle of poverty; improving human capital and ultimately accelerating economic growth”, he said.
In 2010 the Government of Burkina Faso requested that the country be included as an “Early Riser” country in the Scaling Up Nutrition Movement (SUN), which emphasizes the importance of improving nutrition from pregnancy up to a child’s second birthday. Mr. Monteiro’s visit to Burkina Faso has provided him with information on the country’s challenges and progress and has also given him an opportunity to see first-hand the importance of coordination and partnerships to provide an effective response.
Mr. Monteiro travels to New York a few days after his departure from Burkina Faso upon formal invitation from the UN Secretary General to deliver a speech at the High Level Meeting on Nutrition. He will bring the experience from his field mission to this meeting.