Moving the diagnosis of malnutrition to the family

By Zakaria Fusheini, Nutrition Manager

Benjamin and his mother visit Karinga Health Centre II in Nakapiripirit District for him to be able to survive. It’s been five months since the 2-year-old was diagnosed with severe acute malnutrition and enrolled on treatment at the health facility. 

Benjamin is among tens of thousands of children affected by malnutrition in Uganda. Nationally, an estimated 250,000 children are suffering from severe acute malnutrition, A Ministry of Health report from the routine Health Management Information System indicates that the number of severe and acute malnutrition admissions nearly doubled between January 2020 and October 2021. Worse still, a recent national report shows that nearly 6.9 per cent of the Ugandan population is food insecure, with infants and young children often bearing the brunt of nutritional deficiencies. Consequently, children’s brain and body development is being comprised, negatively impacting their cognitive potential irreversibly. 

Nutrition inspite of the COVID-19 pandemic

Government’s restrictions to control the spread of COVID-19, social distancing, school closures, trade and movement restrictions, and countrywide lockdowns disrupted the production, transport, and sale of nutritious and affordable foods, pushing millions of families towards nutrient-poor alternatives. It is estimated that only about one out of every ten children in Uganda consume a diet with the necessary food combinations for growth and less than 20 per cent of children who require treatment for severe acute malnutrition are receiving it. 

To protect children from and ensure treatment for those with severe acute malnutrition, it is important to ramp up public health efforts to support children and mothers in need while ensuring that the most vulnerable are not left behind. Globally and in Uganda, UNICEF remains a key partner of the Ministry of Health, in delivering high impact nutrition interventions aimed at preventing and treating child malnutrition in all contexts.  

Through UNICEF support, Benjamin and other children suffering from severe acute malnutrition are able to receive lifesaving ready-to-use-therapeutic foods also known as RUTF, an energy-dense food that is enriched with micronutrients. Other children suffering from severe acute malnutrition and other medical complications are also able to receive therapeutic milks and rehydration salts at supported health facilities in Uganda. However, tackling malnutrition requires collective effort, right from the family level and in a timely manner. 

Engaging the family in diagnosis and treatment of malnutrition 

Whereas prevention and treatment of severe acute malnutrition among children cannot be postponed, the COVID-19 pandemic continues to restrict the number of children who can be reached with these life-saving services. The Ministry of Health with support from UNICEF is implementing a new innovative approach known as the  ‘Family-Led Mid Upper Arm Circumference’ (MUAC), to support early identification, care and referral of children with malnutrition as well as reduce on the number of children presenting to health facilities late, resulting in poor treatment outcomes. The ‘Family-Led Mid Upper Arm Circumference (MUAC) approach' will be launched today in Karamoja and West Nile Sub Regions and will be scaled to the rest of the country.

Through the innovative approach, families and other caregivers are empowered to diagnose signs of malnutrition in their children using MUAC tapes, instead of purely relying on community health workers. These tapes are color-coded to enable mothers interpret the results, detect signs of malnutrition, provide appropriate care and seek treatment at health facilities early enough. Most importantly these routine checks can be done from home. 

Through a consistent regimen of ready-to-use-therapeutic foods the change is Benjamin is evident and he is alert and even playful!  Though Benjamin is on his way to a full recovery, there still are over children at risk of malnutrition in Uganda. Through the ‘Family-Led Mid Upper Arm Circumference (MUAC) approach, it is now possible for every family to monitor, and seek early treatment to ensure health, survival, growth and development for every child.