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Massive scale-up targets malnutrition in Angola

By Luca Solimeo

A new report by UNICEF to be issued on 15 April reveals the high prevalence of stunting in children under 5, but also outlines the tremendous opportunities that exist to make it a problem of the past.

CAALA, Angola, 10 April 2013 – When Eunice brought 1-year-old Marilia to the therapeutic feeding centre in Caala, Huambo Province, the baby was in critical condition. She had swollen legs and hands and was refusing all food, including breast milk.

© UNICEF Angola/2013/Solimeo
A community health activist measures the arm circumference of a child affected by moderate acute malnutrition in Longonjo, Huambo Province, Angola. Between December and February, more than 2,000 such community health activists screened 248,000 children under 5.

The doctors told Eunice the baby was affected by severe acute malnutrition, mostly caused by a poor-quality diet and inadequate feeding practices, worsened by the nutrition crisis. 
Had she been left untreated, Marilia might have died.

Scale-up of inpatient and outpatient facilities

In Angola, mothers like Eunice who live in rural communities often rely on traditional healers or untrained nursing staff to take care of their children. This practice is dangerous, in the case of severe acute malnutrition; appropriate therapeutic treatment must be initiated immediately to prevent further damage and death. In fact, when Eunice brought Marilia to the village health worker, the therapy did not work, and the baby’s condition deteriorated.

Child screening has been possible thanks to the scale-up of an integrated response to the 2012 nutrition crisis. Over the eight months since the joint Government–UNICEF–WHO–FAO response to the nutrition crisis was launched in June 2012, the Government of Angola opened 27 inpatient facilities across the country. During the same period, 307 outpatient treatment centres were opened in 10 provinces.

The Caala therapeutic feeding centre is one of seven health facilities specialized in managing severe malnutrition in Huambo Province. Over the past three months, 44 per cent of children screened for malnutrition through community outreach in the municipality of Caala, – 2,700 cases – have been identified as affected by either severe or moderate acute malnutrition.

© UNICEF Angola/2013/Ferreira
A mother has brought her child to the Bailundo therapeutic feeding centre, one of seven health facilities in Huambo Province specialized in managing severe malnutrition.

Making a difference with community-based treatment

To extend the reach of the programme to the rural population, an outreach programme addressing acute malnutrition at the community level was launched in November 2012. The programme – the Community-based Management of Acute Malnutrition programme – targets families living more than 3 km from health centres.

Volunteer community health activists were identified and trained in the four most drought-affected provinces by the Ministry of Public Health. The training was conducted in partnership with UNICEF and international NGOs including World Vision, Africare and People In Need – and now with the support of the European Union, which recently funded a 4 million euro project on nutrition and food security in Angola.

Between December and February, more than 2,000 community health activists trained under the  programme were able to screen 248,000 children under 5. They identified 32,174 cases of severe and moderate acute malnutrition – 12.9 per cent of the screened cases. Including the 15,328 children admitted to therapeutic feeding centres and outpatient treatment centres, a total of 47,502 children have already benefitted from the programme.

Support for tackling malnutrition

UNICEF Representative in Angola Koen Vanormelingen discusses the reach of the programme and future plans: “UNICEF support significantly contributed to expand the coverage of therapeutic and health centres, and community response in the four most at-risk provinces. We are now promoting, with the Government, the expansion in other affected provinces, such as Huila, Benguela, Cunene and Moxico, where malnutrition prevalence was initially underestimated.”

“Chronic and acute malnutrition significantly impairs brain and cognitive development of young children, and is the single greatest contributor to child mortality,” says European Union Ambassador to Angola Javiel Puyol. “The European Union is keen to support the Government of Angola and the communities affected by the 2012 drought in improving food security and substantially reducing child malnutrition in the country.”

After the diagnosis, Marilia began treatment with therapeutic milk. In less than one week, the oedema had progressively diminished, and the baby had started accepting breast milk and therapeutic food.

She started interacting with Eunice as she had not done for several weeks.

“She was turning her head to me again when I called her. She started looking everywhere in the room again. She wanted food. I was so happy, I can’t say how,” says Eunice.



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