From hunger to hope: How communities come together to address malnutrition in Sierra Leone

Yoyema - At just seven months old, baby Festicia Gabesie is full of energy, her bright eyes watching her father closely as he gently rocks her on his lap. Her father, Festus Gabesie, brought her to the Yoyema Maternal and Child Health Post in Moyamba District, a small facility that serves as a lifeline for hundreds of children under the age of five in the community. Each year, the centre provides essential health services such as vaccinations and growth monitoring to about 600 children, some battling the silent but deadly effects of malnutrition.

“I want my daughter to grow up healthy and strong,” Festus says softly, smiling at Festicia, “That is why I never miss her visits here, especially when her mother is out of town. The nurses advise me on how to feed her, and I have learned a lot about what kind of foods she needs to stay healthy.”

Before receiving guidance from the clinic, Festus and his wife mostly fed Festicia rice porridge or biscuits, sometimes adding a little palm oil when they could afford it. Like many families in Moyamba, their meals are limited by what is available and affordable. “We thought giving her rice and biscuits regularly was enough,” Festus explains, “But I have learned here that rice fills her stomach but does not give her all the nutrients and vitamins she needs to grow well.”

Through the Infant and Young Child Feeding component of the programme, parents and caregivers learn about the importance of variety in children’s diet. Now, Festus and his wife are trying to introduce more local and affordable foods, like beans, potato leaves, groundnuts, and fish into her meals. “It is not always easy to find these foods every day, but we are making the effort. Even when we have only a small portion of beans or greens, we add them to her food. I see that she enjoys it, and I feel happy knowing we are giving her something better,” he says.

Festus’s experience reflects the broader reality of Sierra Leone, where malnutrition and food insecurity are pressing issues. According to the September 2024 Food Security Monitoring System report, 77 per cent of the population faces food insecurity, with 17 per cent severely food insecure. In Moyamba District, the situation is dire: 86 per cent of households spend over 75 per cent of their income on food, while dietary diversity for young children is critically low.

To address this issue, the Yoyema facility and 105 other health facilities, Community Health Workers, Mother Support Groups, parents and caregivers, and other community members are working with UNICEF and partners to implement a comprehensive package of nutrition services for children in Moyamba district. With thanks to the generous support of the Latter-Day Saints Charities (LDSC) through the United States Fund for UNICEF, the initiative has strengthened both the prevention and treatment of malnutrition since 2021, with services ranging from community health worker mentorship to nutrition screening and counselling, cooking demonstrations, and the provision of therapeutic foods for children suffering from severe acute malnutrition.

For families like the Gabesies, this support is eye-opening. Nurse Mamadi Kabba, the nurse-in-charge at the Yoyema Maternal and Child Health Post, explains: “Before, many caregivers did not understand how or what to feed their babies from the age of six months onwards. Now, through our cooking demonstrations and nutrition counselling, parents are learning how to prepare nutritious foods using what is available locally. We also screen children regularly so we can detect malnutrition early and treat it before it becomes severe.”

The programme has already delivered impressive results. Between March and August 2025, 37 per cent of children aged 6–59 months were screened for malnutrition on a quarterly basis, more than double the figure from the previous year. Treatment of severe acute malnutrition has also been highly effective, with cure rates at 99 per cent, exceeding global standards.

For Jestina Kamara, the District Nutritionist in Moyamba, these achievements show what is possible with sustained support. “Moyamba has long struggled with high rates of stunting and poor dietary diversity. However, with the support of trained community health workers and mother support groups, we are now seeing real progress. Parents are not just receiving treatment for their malnourished children; they are also gaining the knowledge to prevent malnutrition at home,” she noted.

Still, challenges remain. Food insecurity continues to drive poor diets, with many families consuming fewer than five different food items a day. This lack of diversity means children like Festicia risk missing out on essential nutrients critical for their growth and brain development.

UNICEF Nutrition Specialist, Brenda Kaijuka Muwaga, emphasizes the importance of focusing on community-based prevention strategies and combining this with immediate treatment and lifesaving support for children who are already malnourished. “Nutrition is not just about having enough food, it is about having the right kind of food,” she explains, “In Moyamba, we are working with communities to improve both access and knowledge. By strengthening the health system, training community health workers and linking them with Mother-to-Mother Support groups, and engaging families directly, we are building a foundation that will protect children now and in the future.”

For Festus, this knowledge has transformed how he and his wife care for their daughter. “Now that we know she also needs other foods to grow well, her mother and I make sure she eats a variety, even if it is not easy to find all the foods. We want her to have the chance to be strong and do well in school one day.”

As the sun sets over Yoyema, Festus prepares to take Festicia home, reassured by the care she has received and the guidance he has gained. His hope is simple but powerful: that his daughter will not just survive but thrive.