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Zimbabwe, April 2014: Community-based nutrition program helps reduce child malnutrition

© Richard Nyamanhindi UNICEF/2014
Village Health Workers are central in the success of the community-based nutrition program. They provide counseling on breastfeeding and complementary feeding at least once a month until a child attains two years

By Richard Nyamanhindi

April 2014, Zimbabwe – A “lead mother” from Buwerimwe village in Zimbabwe’s Manicaland Province, Mindmore Muuyandiyani is 24 years with two young children. Her first child was often sick and crying at night as an infant, but after learning about better feeding practices, Mindmore has changed the way she feeds her second baby, now seven months old and doing very well.

“Now with this child, I can sleep well because he is not sick,” Mindmore says. “I gave him colostrum immediately after birth and my breast within one hour of birth. I gave him no other foods for six months…Even when he is sick I will feed him because now I know it is important.”

This is in sharp contrast to Mindmore’s first experience with motherhood, when she fed her infant with fizzy drinks and porridge. “I often took him to the health centre, with abdominal cramping, diarrhea and vomiting,” she recalls.

This young mother is now an ambassador for better infant and child feeding practices in her village. Her husband also helps her to ensure that she has the right range of foods to feed their baby.

Significant nutritional improvements in a drought-prone district

Mindmore’s baby is among thousands of young children across Zimbabwe whose nutritional status is rapidly improving. Recent results from the Lot Quality Assessment in Manicaland show that overall child stunting rates in the province have declined from 38.1 per cent in 2010 to 36.8 per cent in December 2013 and Infant and Young Child Feeding practices have increased from 10.2 per cent in 2010 to 24.6 percent in 2013. Stunting is one of the common indicators of chronic malnutrition in Zimbabwe.

“This is significant progress in a drought-prone district with historically high rates of malnutrition,” said the Manicaland Ministry of Health and Child Care, Nutrition Assistant Pardon Binde. “It is a sign that Zimbabwe is making progress on reducing vulnerability among poor families, and enabling well-nourished children of today to help drive future economic growth and productivity as adults.”

Many factors could underpin the country’s recent progress: Greater resilience among low-income households thanks to better access to health, education, water and sanitation services, and programs targeted specifically at fighting malnutrition.

Community-based nutrition program reaches over 78,000 children

Such programs include the community-based nutrition program that trained Mindmore and other mothers in Buwerimwe village. With funding from the European Commission Director-General for Humanitarian Aid and Civil Protection (ECHO), UNICEF and the Ministries of Health and Child Care and that of Women, Gender and Community Development (MoWGCD) have partnered to reach out to more than 80,000 children under the age of two.

The community-based nutrition program began in January 2013 and targets 10 food insecure districts of the country located in four provinces of Matebeleland North, Mashonaland Central, Manicaland and Masvingo. It is one of the major components of the Government of Zimbabwe’s Food and Nutrition Security Policy.

With the program, fewer children are held back by poor nutrition

Julius Madhuweko, a voluntary community health worker in Marange where Buwerimwe is located has been regularly visiting sick or malnourished children in his community to see if they need higher-level medical care. Once a month, he has also been weighing children and counseling mothers on good practices related to child nutrition.

“Since I have been giving these messages, mothers have been practicing the actions and the weights [of children] have improved,” 38-year-old Julius says.

An evaluation of the community based nutrition program undertaken by the Ministry of Health and Child Care in Manicaland, shows that the program, as of February 2014, has indeed contributed to improved feeding and child care and thus to lower rates of stunting than seen earlier in these communities.

“The evaluation shows that the Zimbabwe program is working, and as we move forward, there are many things we can strengthen further,’’ said MoWGCD Community Development Officer, Gabriel Jaji. “If the improvement in children’s nutritional status continues at this pace, Zimbabwe will be among those countries in Africa that have tackled child nutrition problems head-on.”

Partnering with NGOs at the community level

The community nutrition program has successfully partnered with NGOs that are able to work at the grassroots level. For example, Plan International, an NGO that has worked in Manicaland and Zimbabwe for many years, has been implementing a community-based approach to manage acute malnutrition and improve feeding practices. This work is financed by the Norwegian Refugee Council and ECHO.

“We have seen many successes and some failures and our projects continue to evolve,” said Zvidzai Chidhakwa the Programme Support Manager for Plan International. “We understand the need to work in partnership and with a multi-sectoral approach if we want to strengthen the resilience of vulnerable Zimbabwean households and see their lives changed in a sustainable way. We are seeing very positive developments in nutrition due to effective collaboration between NGOs and the government.”

Working with NGOs, the program has helped to engage entire communities to foster social change. “There are big changes in the communities because almost all mothers are practicing better infant and young child feeding and care,” said Julian Kahwema, a Voluntary Community Health Worker in Buwerimwe Village.

Because the community nutrition program works closely with mothers, infants and fathers, and emphasizes rigorous training for health workers, pregnant women are also benefiting.

Nutrition, a key target under the Millennium Development Goals

Community-based programs have been effectively implemented in Zimbabwe and elsewhere as a platform for delivering health and nutrition interventions.

“We know that malnourished children are more likely to die,” said Kudakwashe Chiminya, UNICEF Nutrition Specialist. “By improving nutrition, children are more likely to survive, and achieving the Millennium Development Goal on reducing child mortality comes within reach, as is already the case in Zimbabwe.” 



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