Managing child malnutrition in communities

Community management of acute malnutrition

By Penelope Kakhobwe and Jack McBrams
HSA Sam Mpatula visiting Margaret and her son during a household visit
UNICEF Malawi/2020/Nyirenda
18 December 2020

When she looks at her one-year-old son Maynard, Margaret James is grateful as she reflects on the last three months when she watched him struggle with severe malnutrition.

“The fact that he can now play, sit up and function normally seems like a miracle as he could barely undertake these activities,” she utters. “I initially noticed that apart from exhibiting signs of underdevelopment, Maynard was constantly ill and he had swollen limbs and pale hair.”

Sam Mpatula, the area’s Health Surveillance Assistant (HSA), disclosed to Margaret that her son  weighed 8.6 kilogrammes, his Mid-Upper Arm Circumference (MUAC) was 9.3 centimetres and he was suffering from oedema.

The MUAC measurement was also in the red zone, which meant that he was severely malnourished.

It is at this point that Margret summoned her wits; she strapped the baby on her back and undertook the 30-minute walk to the Machinga District Hospital under the sweltering sun.

HSA Sam Mpatula holding a packet of ready-to-use-therapeutic food (RUTF) provided by USAID BHA
UNICEF Malawi/2020/Nyirenda
HSA Sam Mpatula holding a packet of ready-to-use-therapeutic food (RUTF) provided by USAID BHA

“At the hospital my son was assessed and referred to Liwonde for further treatment where he was placed in the Nutrition Rehabilitation Unit (NRU) to get his body weight to normal upon which he was discharged the following week,” Margaret says.

As part of Maynards treatment, Margaret was taught how to prepare nutritious food for her son for him to eat along with ready-to-use therapeutic food that he was prescribed.

She was also encouraged to join care groups that focus on Community-Based Management of Acute Malnutrition (CMAM, and members are taught about the different food groups and how to prepare diversified foods for growing children, such as peanut butter and soya porridge. Caregroup members are also trained in the timely monitoring of children’s weight to detect malnutrition.

Margaret watering her vegetable garden, an initiative she learnt from the care groups
UNICEF Malawi/2020/Nyirenda
Margaret watering her vegetable garden, an initiative she learnt from the care groups

These CMAM interventions are being implemented with support from USAID's through its Food for Peace Programme. About $2,800,911 was provided to UNICEF and the Government of Malawi improve access to and utilisation of life-saving nutritional services for vulnerable children in the drought-affected districts such as Machinga.

The project aims to reach 21,704 children under the age of five years old with the treatment of severe acute malnutrition through life-saving therapeutic foods.

 Maynard required constant supervision during his illness, leaving Margaret unable to assist her husband in their garden, where they grow tobacco as a means of livelihood.

However, she says that help the family received from the HSAs and from the hospital aided in the child’s full recovery. 

 “I never knew that a child could be this healthy and happy after what I experienced,” says Margaret as she observes her now healthy grandchild.