In Madagascar, integrating play into malnutrition treatment
Ready-to-use-therapeutic-food (RUTF) carboard boxes are being transformed into fun toys for children to accompany pediatric services and malnutrition treatment
It’s a difficult afternoon for five-year-old Fifaliana who has been suffering from seizures for the past week. She is being treated at the pediatric unit at the Befelatanana hospital, in the city of Antananarivo. Her caregiver, 21-year-old Mialisoa Francine, is by her side trying to comfort her.
“I’ve been taking care of her since she was born”
Mialisoa then reaches for a box that once stored packets as therapeutic food known as PlumpyNut that is used to treat severe malnutrition in children. The box grabs Fifaliana’s attention. She’s eagerly trying to reach at them and starts to play all by herself. She’s playing with a puzzle – which aims to improve the child’s cognitive development – that she resolves with ease. Fifaliana spends almost 30 minutes playing with the toys. She’s playing with all the different types and doesn’t want to stop.
“It’s the first time she’s playing with this type of toys, she only plays with teddy-bears at home. I’m quite surprised she’s having no difficulty because she’s not in school yet,”
Globally, UNICEF delivers thousands of tons of ready-to-use therapeutic food (RUTF) every year. The sachets contain a nutrient-rich peanut that is given to children under five suffering from severe acute malnutrition (SAM). In 2023, some 7.5 million cardboard boxes used to transport RUTF were dispersed worldwide and almost 70.0001 of them across Madagascar.
Through the “Project Play” initiative, five categories of games including 20 types of toys have been developed by the Lego Foundation and the UNICEF Supply Division that give a second life to the empty RUTF boxes. The activities include:
- Toys aiming to foster exploration
- Musical toys
- Toys to improve cognitive development
- First person toys – which let the child play as if they are the main character – and third-person toys – that allow the child to control or watch a character or object from the outside.
This initiative has a long-term objective of integrating play stimulation into malnutrition treatment, and to address climate change by managing waste through sustainable procurement.
“The children enjoy the toys. They allow them to escape the reality of their sickness for a while when they play with them. But, we still have difficulties in encouraging parents to use them with the children,” says Maminiaina Ranaivoson, a doctor at the hospital for the past 16 years.
The toys have been tested for a week now at the pediatric unit of the hospital, with 20 children being given a chance to put them to the test. Five doctors in the hospital have been trained on how to use them and how to include the parents and caregivers in the process. A pilot will be launched soon in four districts of the south-east and southern regions of Madagascar. The toys were designed to be inclusive, with contrast colors, tactile features, easy grip, ensuring all children can play with them.
Play enhances healthy childhood development, helping them to develop cognitive, social, emotional, and creative skills.
1-68.417 of RUTF cardboxes were dispersed across Madagascar in 2023
