Therapeutic feeding programme turns the tide in the battle against malnutrition in Uganda

Identifying, treating and preventing malnutrition among children

By Robin Giri
UNICEF Uganda/2019/Francis Emurot
13 May 2019

Amid the cries of young children and the gentle cooing of mothers in the Zebra Ward, 22-year-old Rachel Nakasita gazes lovingly at Natasha, her seven-month old daughter. Rachel’s wide smile belies the harrowing struggle of the past two weeks that she and little Natasha have been through.

“I couldn’t breastfeed because I got an infection in my breast and I was feeding her cassava porridge, but she just kept getting worse and her body started swelling,”

says Rachel.

Upon arrival, the medical staff at the Mwanamugimu Nutritional Unit assessed little Natasha with severe acute malnutrition which was further compounded by her illness.

In-patient therapeutic feeding
“When a malnourished child is diagnosed with a medical complication, we immediately admit them here for treatment and therapeutic feeding,” says Julian Eyotaru, the Senior Nursing Officer, who has been overseeing this department for the last decade.

Initially, little Natasha was so weak she could barely eat and all she did was cry. She started on a diet of F-75 every two hours, and then little by little over the next few days she got better and started taking Ready-to-Use Therapeutic Food (RUTF).

“She has improved a lot and now she is happy like before. Now, I know how to mix the required types of food to make my child healthy,”

says Rachel.

Rachel will be discharged in a day or two, armed with the knowledge to prepare the right foods for her child.

UNICEF Uganda’s nutrition section works closely with the Ministry of Health to support capacity building of health staff and provision of vital therapeutic foods such as F-100, F-75, ReSoMal and RUTF to help turn the tide against malnutrition in Uganda.

UNICEF Uganda/2019/Francis Emurot

Out-patient Therapeutic Feeding
About 20 metres away and separated by two smaller buildings in between, a group of about three dozen mothers and young children are assembled under a large open shed with a wide roof to keep out the sun. They are here for the Wednesday Clinic, which is routine. This is where children who are being treated for malnutrition at home are assessed weekly by the team of medical staff, and then provided therapeutic foods for the next two weeks, including an appropriate number of sachets of RUTF that they will feed their children over the next two weeks.

Zabina Nabiroje, the Public Health Nurse, stands next to a table laden high with food: various kinds of beans, nuts and legumes, plantains and yams, fruit and meat.

“These are the foods that are available in our communities and knowing the right mix and proportion when preparing food, will help you keep your children healthy,”

she says.

Zabina has a very reassuring tone and the women listen attentively, and many understand the implications of a varied diet, rich in nutrients, that will help keep their children healthy and nourished.

After this session, the children are then weighed and measured, and their progress is monitored in each child’s individual health diary. Based on the weight gained compared to the previous week, the medical staff then provide each mother with sachets of RUTF that they need to feed their child for the next 14 days.

“My child is healthier than last week, and I can see that he has gained some weight. Now, I also know how to prepare nutritious foods, and will also feed him this,” says Laira Annette, showing the sachets of RUTF that she has received for the next two weeks to feed her son, Etolim.

Undernutrition is one of the leading health problems as 29 per cent of Ugandan children aged 6-59 months are stunted (2016 Uganda Demographic and Health Survey). Prevalence of wasting has been mostly stagnant at 4-5 per cent between 2011 and 2016. The battle to cure and reduce malnutrition is a core component of the country programme of cooperation between UNICEF and the Government of Uganda.

UNICEF Uganda supports the Ministry of Health by providing medical and nutritional supplies, and training to health staff to identify, treat and prevent malnutrition among children under five. UNICEF is able to do this with the generous support of donors like the United States Fund for UNICEF.