Early screening keeps children in shape at Thandizo CBCC in Thyolo

Trinia Chigwanda, a cheerful health surveillance assistant at Kathawire Village in Thyolo district, southern Malawi, is a regular visitor of Thandizo Community Based Childcare Centre where more than 70 children gather to learn and play.

When she arrives at the preschool facility, the atmosphere swiftly transforms into that of a clinic. Some children stay calm while others start crying after seeing her as they associate the presence of health workers with injections. But Chigwanda, with smiles on her face, greets the children and leads them to singing and dancing to reassure them.

Parents carrying their children’s health passports, also join to see their children receiving health and nutrition services that Chigwanda brings.

“I come here on Thursdays to check children who are younger than five years old,” says Chigwanda. “I make sure I am here by 8am so that when parents come to drop off their children, I also ask them about how the children are feeling,” says the health worker.

After arriving at the centre, she first goes around the centre’s facilities to check the state of water, hygiene and sanitation to ensure the environment is clean and safe.

Since last year, Chigwanda has increased the number of her visits to the centre to screen children for malnutrition and check their overall health. This is because the village is among those badly impacted by El Niño-induced food insecurity that has increased the risk of malnutrition to children.

The village has more than 1,200 people. Out of these, about 200 are under-five-year-olds who also face the risk of malnutrition in times of food insecurity.

“In this case, early screening for malnutrition is very important to these children. I don’t want anyone of them to develop a serious malnutrition condition because I fail to detect it early,” explains Chigwanda as she coordinates the centre’s caregivers and parents to help the children form a line to be screened.

She says cases of admission of severely malnourished children to the nearby Lomola Health Centre have been rising due to food insecurity. Luckily, she adds, no child from the childcare centre has been admitted recently to the health facility for severe acute malnutrition, thanks to her mass screening efforts.

“I am really delighted to see that these children are growing up well. They look healthy and fit,” says Chigwanda.

When she is at the preschool facility, she also delivers health talks to parents, encouraging them to have backyard vegetable gardens and give their children diversified meals using locally available foods.

“I follow up with the parents by visiting them in their homes to check that they are feeding the children well despite the difficult food insecurity situation,” says adds.

Chigwanda says she likes her job because it enables her to create relationships with people in the village: “I chat well with the community. They don’t reject the services I provide to benefit the children. I tell them that I also come from this village and, therefore, cannot give their children harmful things.”

Doreen Kamoto, caregiver and mentor at the preschool facility, praises the integration of nutrition and health services with their early childhood development work.

She says, in December last year, the health worker identified three children who were moderately malnourished at the centre and the children have been receiving corn soya blend to improve their conditions.

“When a child is found to be malnourished at this centre, it’s easy to follow up with parents so that the child gets the needed treatment. Further, our parenting sessions now include lessons on how to prepare diversified meals, which was not the case before,” says Kamoto.

Thyolo District Council has strengthened the integration of nutrition, health and child protection services at Thandizo and other childcare centres in the district with support from the EU-funded UNICEF project, as part of the El Niño emergency response. UNICEF's emergency response, due to the impacts of El Niño, has reached 5.7 million people with life-saving services in Malawi.

Thyolo District Nutritionist Kafere Noel Banda says the assistance has enabled the council to conduct mass screening campaigns in the whole district, using about 600 community health workers and reaching about 126,000 children aged 6-59 months.

“We see the benefits of the mass screening in our hospitals. When we have identified malnourished children early through mass screening, they don’t overstay in our treatment programmes at the health facilities,” says Banda.

He notes that they are now identifying more child malnutrition cases before they are worse, adding such cases are easier to manage and give health workers a greater chance of saving the children’s lives.

As Chigwanda concludes the mass screening at Thandizo childcare centre, Banda witnesses the strong bond the health worker has formed with the children. A scene of happy children surrounding Chigwanda unfolds as the health worker packs her tools, including the mid-upper arm circumference (MUAC) tape used to assess children’s nutrition status, in her bag.

“We will not rest until every under-five child in this district is screened. Our goal is to ensure that no child suffers from severe or acute malnutrition when we have a clear chance to prevent that through the mass screening campaigns,” says Banda.