Polio campaign helps identify malnourished child
Community management of acute malnutrition
On a good day, Ramisa Jester is a bubbly child. But for large parts of July and August, she was anything but as she was under enormous pain and cried constantly.
But her mother and her aunt insist it could have been worse.
A health surveillance assistant (HSA) who was conducting the polio mass vaccination probably saved Ramisa's life when he visited her in August.
Ramisa's mum had, at that time, been admitted to a traditional healer's home for treatment when the young girl, who was born in October 2020, developed sores in the mouth, would not eat properly, and also showed signs of oedema.
"She cried all the time, but it was worse at night. She had developed sores in the mouth and was struggling to eat," says her mother, Hajra Masha.
While a visit to a health centre had failed to bring about any change to Ramisa's health, the visit of the HSA from Malukula Health Centre turned her life around.
"A health worker from Malukula Health Centre was conducting a polio vaccination when he heard about the baby. When he saw her, he recommended that she be given ready-to-use therapeutic food (RUTF), so he asked us to go to the health centre. My daughter went with my sister to the hospital where they were given RUTF," Masha says.
It had been five days since Ramisa had been admitted for RUTF, but Masha already saw the light at the end of the tunnel: "To feed her porridge is a struggle, but she asks for RUTF and eats it without challenges."
Ramisa still cries at night, but the swelling has improved since, explains Masha.
Through the Ministry of Health, the Government of Malawi is implementing the Out-patient Therapeutic Programme in public health facilities to treat cases of severe acute malnutrition (without medical complications) in children.
With support from USAID/BHA through UNICEF, the children admitted to the programme are treated with RUTF and antibiotics.
UNICEF also supports the Ministry of Health in capacity building and technical support to improve the skills of HSAs and community volunteers in nutrition assessment and management of cases of severe acute malnutrition.
Monica Linyanja, an HSA and the nutrition focal person for Malukula Health Centre, explains that the polio campaign made them visit every household and also allowed them to assess other health challenges, such as the case of Ramisa.
"When the child was identified, she was swollen all over," she explains.
Door-to-door nutrition screening, commonly known as active case finding and referral, is one of the components of the Community-based Management of Acute Malnutrition (CMAM) programme, explains Chifundo Rambiki, who is UNICEF Nutrition Field Monitor for Mangochi.
"The exercise is critical in the early identification of cases of acute malnutrition and ensuring that the identified children are referred to health facilities for reassessment and possible admission into one of the three CMAM programmes. The exercise involved routine screening of all children 6-59 months at least once a month. It is carried out by HSAs, community volunteers, and care group promoters within their catchment areas," Rambiki says.