Youth driving knowledge to reduce malnutrition in Djibouti

good nutrition in the early years of life is essential

Courage Nyamhunga
Fatouma waits for the gate to open at a house located in Hayabley
26 May 2019

It is mid-morning in , Quartier 4, Djibouti City . There is a slight breeze on this rather warm winter day. Fatouma aged 20 is a powerful ally in the fight against malnutrition in Hayabley.

Sitting under the shade of the shack Fatouma who is a member of the Community Management Committees under the National Union of Djibouti Women (UNFD) and receiving support from UNICEF, narrates how her day is like in identifying malnourished children in the community and referring them to health care centers.

Malnutrition is associated with more than half of all childhood deaths worldwide, predominantly a result of poor child-feeding practices, food shortages or poor access to adequate sanitation and healthcare. Malnourished children can struggle with lifelong consequences, including impaired physical and cognitive development. In Djibouti, about 68 percent  of children under five die before celebrating their 5th birthday. The high prevalence of malnutrition strongly contributes to this situation as it is estimated that about 35 percent of all deaths among children under five are directly or indirectly linked to malnutrition.


A MUAC strap is wrapped around undergoing malnutrition screening .
A baby undergoes malnutrition screening using the MUAC straps around her arm.

For every child, nutrition

Community Management Committees were started in 2008 as platforms to create dialogue on female genital mutilation. Since then they have evolved and now focus on broader thematic issues such as nutrition, child immunization, education, culture and environmental issues. Overall, these powerful groups have grown to reach 34 in Djibouti city and the remote areas.

Under this program, Fatouma is a specially trained volunteer under the Child Protection and Youth sub-committee who are sent out into communities to identify acutely malnourished children and refer them to local healthcare centers. After initial treatment is provided at the health care center,she trains community mothers on how to care for their children at home and preparing nutritional meals.


‘I learned to recognize the signs of malnutrition to better exercise my volunteer skills’.


Every day, Fatouma faces a mammoth task of sensitizing and identifying malnourished children, in a community that is very sensitive to strangers who come knocking on their doors. On a typical day if allowed to assess the health of a child, Fatouma uses a MUAC strap on small children and their tiny arms.

This simple plastic tape MUAC which measures the circumference of the upper arm can detect malnutrition, if a child falls in the red zone, they have severe acute malnutrition and they must act fast to receive help from the health care centers.

Fatouma tells the mothers how early detection could save a child’s life. That’s why UNICEF is giving technical and financial support to UNFD which trains volunteers like Fatouma to identify malnutrition as soon as possible


"I provide health education to mothers and show them how to prepare some meals, how they can avoid a relapse. There has been a big decrease on malnutrition in this community, now a lot of pregnant mothers know that they can be malnourished too during pregnancy’.

A group of mothers listening to Fattouma as she demonstrates proper feeding and cooking practices that prevent malnutrition
A group of older and young women go through a nutrition training facilitated by Fatouma. The Community Management Committees train community women on proper ways of cooking nutritional meals for their children and proper care of themselves during pregnancy.

Fatouma was trained on infant and young child feeding at the community level as part of the activities of the youth sub-committee under National Union of Djibouti Women (UNFD). She has in-depth knowledge on how to prevent malnutrition. The focus is also on educating parents on prevention of malnutrition through proper infant and young child feeding practices. Community theatre, radio messages and house-to-house visits by health workers and volunteers are all part of UNFD’s awareness campaign to encourage good feeding practices.

It is critical to screen pregnant mother against malnutrition: 1000 days is a critical window of opportunity. Good nutrition during that period sets the foundation for the rest of his life. Pregnant women’s access to quality care before, during and after pregnancy is a foundational investment in the health and well-being of children and society in its whole.

Our conversation with Fatouma continues as we try to have an in-depth understanding of her role as a youth nutrition champion. Fatouma never thought she would become an influential force in her community. Holding the MUAC strap as she prepares to assess a child she continues to narrate her knowledge on nutrition and her voluntary work.



A nutrition champion attends to a mother and her baby in Hayabley
Fatouma aged 20 is a powerful ally in the fight against malnutrition in Hayabley. As a member of Community Management Committees she was trained in identifying malnourished children in the community and referring them to health care centers.

‘Since I was trained, I know the signs of malnutrition, I send the child to the health center, where nurses can best help the child and treat the child if necessary. This is the best thing to do for the children. The mothers and other youths trust me that’s why they made me the leader of the Community Management Committee youth wing’


Through Fatouma’s work and influence there has been an increase in the adoption of recommended maternal, infant and young child health, nutrition and hygiene practices at community level. Her work has made a difference by promoting positive behaviors and providing counselling to young mothers and other young people. Since cultural beliefs and practices are deep rooted,Fatouma has managed to work closely with these communities, gain trust and continuously repeat the messages of proper care of infants and young feeding mothers.

What is UNICEF doing?

Thanks to the financial support from European Union and USAID, UNICEF and World Food Programe (WFP) are jointly working towards reducing malnutrition in Djibouti. In Djibouti UNICEF is the only actor that supports the management of severe acute malnutrition through supporting policy and strategy development, provision of national products (Ready for use Therapeutic Food (RUTF), medicines and equipment). It is also working with other partners to strengthen the capacity of health and community workers for quality care. In 2017 to 2018 UNICEF and its partners managed to provide essential supplies for SAM management services to cover entire SAM caseload in Djibouti territory including refugees, nomadic and migrant populations.