No longer for the poor
Nebbi district’s integrated approach to nutrition governance is challenging traditional beliefs about vegetables
Communities in Nebbi never wanted to eat vegetables. They thought vegetables were for the poor.
“Vegetables are considered food for the poor who cannot afford any other diet,” Olley Ben Robinson the Chairperson of the district nutrition committee explains. This negative perception, among other poor nutrition attitudes, is one of the key reasons for malnutrition in the district. In 2011, Nebbi had the highest stunting rates in the West Nile subregion with nearly 4 of every 10 children stunted and wasting rates three times the national average. However, a nutrition governance initiative is changing these statistics.
With funding from the European Union, UNICEF, through the Development Initiative for Northern Uganda (DINU) is spearheading a nutrition governance programme aimed at increasing access to and utilization of nutrition interventions as well as create an enabling environment for such interventions. A 2019 situation analysis of children in Uganda primarily attributes under nutrition to poor academic performance and economic productivity later in life.
“UNICEF is intent on promoting practices that ensure that children have a great start in life and that their families adopt sustainable nutrition solutions,”
Under the programme, primary schools are the entry point to school children, their parents and then the community. Each of the 132 participating schools in Nebbi is required to have a demonstration garden and at least one parents group comprising 30 parents with a lead father and lead mother. The lead father doubles as the lead farmer and is responsible for modelling good farming practices among group members. On the other hand, the lead mother is responsible for promoting home gardening, good infant and young child practices and group savings. The sub county nutrition committee trains each group on good nutrition and agronomy practices, provides agricultural inputs and is responsible for integration of nutrition in all sectors especially gender, health and education.
Nutrition in education
The primary schools grow micronutrient-rich foods such as orange-fleshed sweet potatoes, green leafy vegetables and iron-rich beans on a demonstration farm run by the parents and students in the upper classes. The school feeding progamme also runs on food from the school farm and contributions from the parents. “Before this initiative, the food we collected from the parents was never enough, but now we even have a surplus”, David Coothembo, Head Teacher of Owilo Primary School in Erussi Sub County reports. Each school also is attached to a health centre that supplies iron and folic acid tablets to adolescent girls, to boost their iron levels during menstruation.
Nutrition in homesteads
At Mernyayo Anyong parents/ farmers group in Jupazuba Village, Erussi Sub County, one father testifies that because he fed his three children on fish and meat only, he thought they were bewitched when each time they visited the hospital, the doctor said their blood was not clotting enough. “We were placed on a diet of beans, fruit and vegetables that I thought was a sign of poverty, but after one month there as a noticeable improvement.” He has since planted a kitchen garden for vegetables and ensures that vegetables are a mainstay on the daily menu. By implementing improved farming methods taught by the nutrition committee, the farmers also are able to harvest crops two to three times annually.
Nutrition in health
Nyaravur Health Centre III which serves a population of over 22,000 people in Nyaravur Sub County and beyond, has integrated nutrition into all health services especially for mothers and young children. During a visit to the health centre, we witness the nurse conduct nutrition checks by measuring the circumference of the middle upper arm. None of the measurements fall in the red category, which is an indicator of malnutrition. Since the health facility started nutrition health education and more families adopted vegetable growing, there was a big drop in malnutrition cases which were prevalent among children with teenage mothers and elderly caregivers.
On a monthly basis, the facility conducts health outreaches, targeting hard-to-reach areas with comprehensive health services including immunization, antenatal care and nutrition education.” The outreaches often include cooking demonstrations that illustrate how to cook the nutrient-rich foods. Willy Ringtho, In-charge of the health centre notes. “Our greatest challenge is the negative attitude towards some nutrition practices, especially consumption of vegetables, but this is steadily changing.” In October 2019, the facility registered no single case of malnutrition among all the patients.
Improving economic livelihoods
At Jupazuba village in Erussi Subcounty, the parents who belong to the farmers group attached to St. Joseph’s Italia Primary School not only feed on the produce from their gardens, but also sell the surplus. Ricard Ofungi, the lead/model farmer has a clear record of earnings from his demonstration farm since March 2017: UGX 8.92 million. His spreadsheet also indicates expenditure on school fees, garden tools, purchase of goats, land, iron sheets and food for his family. In Angal Ayila Village another model farmer Odongo Chris Jacob who started off by hiring land for farming in 2018 now expects to earn at least UGX 2 million from his extensive vegetable crop.
Though the programme is beset by challenges including erratic weather patterns and land fragmentation leading to common land conflicts, the greatest challenge remains community mindset towards best nutrition practices. “Attitude change is a process, not just towards continually eating vegetables, but also modern methods of farming that require greater organisation and more work in taking care of the gardens,” the district planner concludes, “But we are committed to continuing this process to boost the health status of children, families and communities in Nebbi.”