Saving children from malnutrition through bottom-up community mechanism.
Training communities and mothers to prevent and detect infant malnutrition from their houses.
“I am so happy. Youssouf is saved from malnutrition! He is now eating and playing without any problem, and he is feeling healthy.”
So speaks Fatime, a 36 years old mother of 6 attending the Outpatient Nutrition Unit (UNA) located in the Zafaye West Health Center, in N’Djamena.
Fatime lives in Zafaye, a locality situated in the northern outskirts of N’Djamena, the capital city of Chad. In Zafaye, the major part of the communities come from the surrounding villages, and access to health facilities is not always easy.
N’Djamena is one of the six priority provinces selected by UNICEF for the implementation of a nutrition project by UNICEF and the Foreign, Commonwealth & Development Office of UK Government (FCDO). These provinces were chosen based on the criteria of the high prevalence of global acute malnutrition and/or severe acute malnutrition in the 2019 SMART Survey. Aggravating factors such as food insecurity and/or movement of the population such as refugees, internally displaced people, and returnees were also among the selection criteria.
A few weeks back, Fatime found herself in a very painful situation for a mother. Her son Youssouf, 2 years and 5 months old, was very sick.
“Youssouf was vomiting and had diarrhea. He was losing weight, and I did not know what to do. I am a mother of 6, and Youssouf is my youngest child. As I had never experienced such a situation with the other ones, I was very afraid.”
This is the state of mind in which Fatime was found by a community volunteer during one of his daily community sensitization and door-to-door campaign, where mothers are educated and encouraged to follow-up the nutritional health of their children.
Organized by the Zafaye West Health Center with support from FCDO and UNICEF Chad, the activity is part of a larger project aiming at strengthening the prevention and treatment of severe acute malnutrition in six provinces in Chad.
As he was presenting the signs of acute malnutrition, Youssouf was identified and enrolled in the Health Center. He thus became a beneficiary of the project, and his mother was given drugs and therapeutic foods popularly referred to as “plim plim”.
“Apart from the drugs and plim-plim that have been given to me, I have also learned to make the porridges of Youssouf with local food such as potatoes, carrots, banana, and other products. I learned this during sensitization campaign at the health center”.
Youssouf is only part of the around 80 patients who are declared malnourished and treated in the Health Center each week, following door-to-door campaign during which mothers are taught to detect malnourished children and to bring them to the health center.
As there are not a lot of health centers with outpatient nutrition units in or around their neighborhood, this strategy allows the mothers to be educated on the importance of a balanced diet for infants and children, what they usually ignore or do not easily accept.
Questioned on the added value of this strategy, Haoua Hassan, a community volunteer answered: “Going to the mothers often allows us to bypass the shame that some feel about letting others know that they are not able to feed and care for their children well. By going to every home, it is easier for us to detect sick children, but also to give nutritional advice directly to their parents.”
In the same vein, Alifa Prosper, another community volunteer, also testifies: “Generally, the mothers of malnourished children follow and respect the instructions we give them because they can relate to our advice and they want their children to recover health.”
Haoua and Prosper are part of the 100 Community health workers trained on interpersonal communication and sensitization to raise awareness on Essential Nutrition Action as well as mass screening, referral, and home visits for Severe Acute Malnutrition cases, with support from UNICEF and FCDO in the province of N’djamena.
In Zafaye, they move in the surroundings from Monday to Friday each week to inform the communities on the existence of the project, but mainly to sensitize and educate mothers in good nutrition practices, be it in their houses or at the health center.
During another door-to-door sensitization, Aicha, 2 years old, was found malnourished. After days of treatment following the advices and drugs received in the Zafaye West Health Center, the little girl recovered her health. Like the other mothers sensitized by the project, Achta Bichara, her mother, was trained in how to detect malnourished children, as she proudly testifies.
“When the community volunteer came in my house weeks ago, he used a kind of bracelet to detect that Aicha was suffering from malnutrition. I was also given this bracelet at the health center and I was trained on how to use it to detect malnutrition, which I already know.”
Procurement and distribution of nutrition kits to health facilities as well as support to training and sensitization are just part of the numerous activities carried out as part of the project supported by UNICEF and FCDO. Alongside, WASH in Nut kits where also provided to improve good hygiene and sanitation practices within health center, including preventive measures against COVID-19.
As of June 2021, 43,000 children were saved from severe acute malnutrition in the target provinces, thanks to UNICEF and FCDO support. Now, Youssouf, Aicha and all the other former patients of the outpatient nutrition unit of the health center can walk and play around like normal children, as they have recovered their health.