A package of health and nutrition services to help children fight malnutrition
Integrating health services into nutrition programs to improve outcomes for children in GPAA.
It’s early morning in a remote and conflict-stricken part of South Sudan. A group of women with babies on their backs or in their arms sit in a large tent set up as a nutrition center, waiting to be screened for malnutrition. Among them is 2-year old Anna-Baba and her mother Mary Lokoli.
Anna-Baba and Mary come from Lekuangole cattle camp, in the Greater Pibor Administrative area, and were admitted to Lekuangole Outpatient Therapeutic Programme when Anna-Baba was identified to have severe acute malnutrition. Mary approached the nutrition center after Anna-Baba became sick with fever, coughing and was losing weight.
Years of conflict and recurrent flooding in South Sudan have severely impacted people's health and nutrition on top of impacts on many other parts of their lives. In the Greater Pibor Administrative Area, some health facilities have very poor services, increasing malnutrition prevalence among vulnerable children and adding to the vulnerability of thousands of families who have exhausted their resources fleeing from one place to another after losing their livelihoods.
Infants and young children like Anna-Baba with severe acute malnutrition are more likely to experience weakened immune systems which can make them significantly more susceptible to contracting diseases such as malaria, diarrhea and other childhood diseases.
Often mothers must cover long distances to receive care for malnourished children who require medical care for other sicknesses to attend clinics and nutrition centers in different locations. The long distances coupled with a lack of money and resources can prevent women from accessing needed health services when their child is suffering from acute malnutrition. This often leads to health deterioration in health status and, in some cases, the death of children.
In the Greater Pibor Administrative Area (GPAA), UNICEF supports 37 static, and 5 outreach sites through partner, ForAfrika. Fifteen of those sites have fully integrated into health facilities while 22 are nutrition standalone centres.
Tackling malnutrition is one of the most important ways to improve health and reduce the burden of diseases and death among young children. However, preventive nutritional interventions geared toward the GPAA have had limited success in curative care due to gaps in dealing with other nutrition determinants such as health, water, sanitation and hygiene.
The integration of other elements such as malaria testing and treatment with the distribution at the household level of mosquito nets and water treatment tablets to treat turbid or unsafe water increases the chances of survival for children with severe acute malnutrition.
UNICEF in collaboration with the South Sudan Ministry of Health, UN agencies, and civil society organizations has initiated a shift in addressing wasting in children, by moving away from primarily treating children suffering from acute malnutrition to prevention and treatment, through the integration of Water Sanitation and Hygiene (WASH), Health, Education, Food Security and Livelihoods (FSL), Protection and Gender Based Violence (GBV).
The integration of Malaria testing and treatment for children with Severe Acute Malnutrition is happening at all nutrition facilities whether standalone or fully integrated given the availability of the RDTs and Antimalarial treatments. Partners have been able to provide additional healthcare services while improving the quality of treatment outcomes for the nutrition programme. In addition, the only medical theatre in the Primary Health Care Center (PHCC) in Pibor was refurbished and equipped to help curb mortality rates in Pibor County. ForAfrika has deployed competent medical staff who have safely delivered over 40 babies at the facility over the last year.
In 2022, 8,943 children were tested for malaria in GPAA nutrition centers, 1,429 were positive and were treated or referred to a nearby health facility or Boma Health Initiative (BHI) program.
With thanks to generous support from USAID/BHA and the World Bank, UNICEF and partners such as For Afrika are supporting families in GPAA through a package of health and nutrition services including malnutrition screening and treatment, medical check-ups, treatment and referrals, diarrhoea management, Aqua tabs and health and hygiene education.
I have learned a lot of things during our stay in the nutrition center. As well as care for my sick child, we were trained on purifying drinking water, proper breastfeeding and nutrition, and good hygiene
This improves health-seeking behaviour among the community and reduces complications and mortality among children with severe acute malnutrition. With this integrated package of services, mothers will no longer need to move to several locations for health and malnutrition treatment.