Mangochi community unites against malnutrition
Collective efforts to keep children healthy and strong
Hawa Alidi was heartbroken when her year-old baby was found with severe malnutrition at a village clinic near her home in Mangochi District, Southern Malawi.
The 24-year-old mother says it never even hit her mind that Latifa could be wasting.
“I took her to a village clinic following a sleepless night when she experienced a high fever. The community health worker screened her for malnutrition, and I was devastated to learn that her life was in danger,” she explains.
Latifa received 14 packs of ready-to-use therapeutic food from Adbester Banda, the health surveillance assistant at the village clinic, just a 20-minute walk from Hawa’s home in Mbaluku Village.
The clinic constructed by surrounding communities has saved them from long travels to Mkumba health centre, which take more than three hours by foot and costs K5 000 by motorcycle.
It has also improved the detection and treatment of malnutrition in children across the hills and valleys close to Liwonde National Park.
With funding from the UK’s Foreign, Commonwealth, and Development Office, UNICEF is supporting the Ministry of Health to improve the Community Management of Acute Malnutrition (CMAM). The assistance includes training frontline health workers and providing essential supplies, including RUTF and therapeutic milk.
Every Thursday, Hawa receives 14 packets of RUTF, the fortified peanut butter supplement for treating severe wasting in children under five.
“This is my sixth week to receive RUTF, which has boosted Latifa’s health. Her weight has risen from six to eight kilogrammes since she started taking two packets a day. She now plays and laughs with her friends,” says the happy mother.
She securely tucks the weekly RUTF dose in a handbag hanging on a wall beyond the reach of children.
Hawa is determined to see her daughter bounce back quicker and better.
“The HSA told me that RUTF is medicine, so I cannot sell or give it to a healthy child when my daughter needs it most. I don’t want her to relapse because someone is misusing her dose,” she explains.
And Latifa loves it too. She cried for some more after taking her morning dose on the sunny Thursday her mother took her to the clinic for routine assessments and replenishment of the lifesaving food supplement.
“She couldn’t eat but now has a healthy appetite. She couldn’t sit down but now plays with her peers. She was sickly, but it's three weeks since she last experienced a high fever,” Hawa bragged.
Such stories energise Jennet John, secretary of the village clinic committee comprising 10 volunteers.
The mother of five is one of the six women on the committee that unites health workers and community members.
Every morning, they mop the clinic’s interiors, sweep its exterior and mount a handwashing station at the entrance before clients arrive.
The clinic offers essential services, including nutrition screening, supplements, and counselling. Others include routine immunisation, modern family planning methods, and treatment for major killers of children, such as malaria, pneumonia, diarrhoea, and respiratory infections.
“As volunteers, we are energised by the change and smiles we see in children who have benefitted from the services on offer, including community management of severe acute malnutrition,” she says.
The village clinic, which started as a makeshift building in 2016, illustrates the benefits of putting health services close to where people live.
Policymakers in Malawi envision every person accessing quality health services within five kilometres amid the global push for no one to suffer financial hardships and deadly delays while seeking lifesaving services.
“The village clinic helps combat malnutrition-related complications and deaths. People no longer shun health services as did many parents when they had to walk over 14 km to access nutrition screening and supplements at Mkumba health centre,” says Janet, a mother of five.
Her committee stores RUTF “like any other medicine”, she states.
“The change in malnourished children confirms that RUTF is medicine. Our HSA usually brings just enough for the four children with severe wasting. In case of a remainder, we keep it in a drug box secured with two padlocks. The HSA keeps one key, and our treasurer Hadiya Saidi keeps the other,” she explains.
The two-lock system boosts transparency and accountability as the pair seals and opens the drug box every Thursday as all committee members look on.
Explains Hadiya: “The box with the two locks for greater security and mutual trust is part of integrating RUTF into essential drugs for child health. If a pack cannot be accounted for, we will summon the suspects and report them to the police. Anyone who steals essential medical supplies must face the law.”
The volunteers help the HSA weigh children, record the readings and measure the child’s middle-upper arm circumference (MUAC) using a tape. A MUAC reading within the green section confirms the child is healthy, yellow signals moderate malnutrition, and red depicts severe wasting.
Adbester Banda is happy that Latifa is now outside the red zone.
The HSA sees about 50 children every Thursday, including the four children who receive RUTF.
Community participation makes his job more accessible as the volunteers mobilise and follow up on children needing screening and treatment, he states.
The community health worker explains: “Mkumba health centre provides primary health services to a vast hilly setting with a population of about 23 000 that nine HSAs cannot adequately cover.