UNICEF boosting children’s nutrition to prevent stunted growth in Zimbabwe
By Richard Nyamanhindi
At the age of four, Tapiwanashe Tiripano weighs just 10kg and, at a height of 84cm, is not much larger than a baby. Fed on Sadza (thick porridge) and breast milk since she was born, she is now receiving treatment for malnutrition at Chipfatsura Rural Health Centre, about 80km from Mutare, the third capital in Zimbabwe.
Part of this treatment involves training her mother, Chipo Tiripano, on how to prepare the right foods for her child and introduce her to Ready to Use Therapeutic Food being supplied to all health centres by UNICEF. “I will try to mix Sadza with beans, kapenta (Tanganyika sardine) and soup, so that it is softer. Maybe that will help her to gain weight,” she said, adding that Tapiwanashe does not like to eat fruit and vegetables.
“We teach these mothers that children need to eat from the three different food groups, but it’s difficult to change their habits,” Rita Mare, a volunteer health worker at the centre said. “Sometimes, they will follow our instructions for a while, but then they go back to their own ways. So we have to repeat the same message over and over.”
The result of under-nourished babies is children who never grow to their full potential. Children who are stunted are at greater risk of illness and death and impaired cognitive development, while a 2010 World Bank study found that stunted adults earn 10 per cent less over the course of a lifetime.
A report on child malnutrition released by Save the Children in 2013 entitled A Life Free From Hunger: Tackling Child Malnutrition puts the number of children affected by stunting globally at 170 million, and notes that if current global trends such as volatile food prices, climate change and economic uncertainty continue, more than 450 million children will be affected by stunting in the next 15 years.
The Zimbabwe Demographic Health Survey 2010-11 found that stunting affects more than 30 percent of all Zimbabwean children under five, one of the highest rate of stunting in the world. The problem is especially prevalent in ten districts located in the four provinces of Matabeleland North, Mashonaland Central, Manicaland and Masvingo.
At the launch of the Zimbabwe Food and Nutrition Security Policy in 2013, the government noted that malnutrition currently accounts for more than 25 per cent of deaths among children under the age of five.
Poverty is a major factor, particularly with more and more people losing their jobs to the economic crisis that began in 2006. The Zimbabwe Monthly Economic Review for February 2014 notes that more than 70 per cent of Zimbabwe’s population live below the poverty datum line and spend more than 80 per cent of their income on food.
But the country’s high rates of stunting also have much to do with the people’s obsession with Sadza. Although many children consume enough calories, they have trouble growing because their diet consists almost exclusively of Sadza, to which relish and salty soup may be added and, if the family has enough money, some meat. “We found that the highest occurrence of stunting is sometimes due to the lack of knowledge about the type of foods that children should eat. Most households just give their children porridge in the morning and Sadza for the rest of the day,” said says Mildred Chikukwa a nurse at Nzvenga Clinic in Marange in Mutare district.
Poor food is not the only culprit. At Zimunya Clinic in Mutare Urban, village health worker Sally Murezvo battles all kinds of harmful feeding practices. “We tell women to exclusively breastfeed for the first six months, but they often feel they don’t have enough breast milk. So then they give the babies tea or sugar drinks as a supplement,” she said.
Murezvo noted that some mothers simply do not feed their children enough. “During the day, the mothers are busy working in the field. The children just play around the village. Sometimes the mothers will leave some cold Sadza with a child minder to feed the children at noon, but often they get no food at all until night time. This is especially a problem with breastfed babies - they need to drink eight times a day, but often only get fed two or three times.”
The most critical period for stunting is from conception until a child reaches two years, but in Zimbabwe, the problem does not stop in early childhood.
To help reduce the number of stunted children, UNICEF and its partners with financial support from the European Commission Director-General for Humanitarian Aid and Civil Protection (ECHO) is reaching more than 30,000 children with Infant and Child Feeding Services and has set up more than 3,000 community nutrition sites, where babies are weighed monthly and mothers receive information about child feeding. The Chipfatsura Rural Health Centre alone is visited by more than 300 mothers with over 300 children under five every month. Community workers at the centre teach mothers how to grow fruit and vegetables that can be added to their children’s diet at little cost. “I have seen how children change. You can see that the children become stronger and will not get sick easily,” said village health worker Murezvo.