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Chad: growth monitoring and promotion

© UNICEF/WCARO/2008/Pirozzi

SAHEL - Percentage of under-fives who suffer from stunting (chronic malnutrition): 41%
Number of under-fives who suffer from stunting: 4 million

After losing her first-born son when he was only two, Seide Douta told herself that she had to go about things differently with her newborn daughter. But how could she save a child from malnutrition? It is a frightfully common condition in Djoukil-kili, a village nestled at the foothills of a mountain chain known as the “Queen of Guera,” 570 km north of N’Djamena.

Seide Douta was interested to hear that a woman in the village, a sister-in-law, had been chosen by nutrition workers from the CNNTA (National Centre for Nutrition and Food Technology) to take part in a community-based initiative. This mother was chosen for a simple reason: like many others, she had a malnourished boy and the CNNTA workers thought that he could be helped. They gave his mother guidance, which they asked her to follow closely: she should continue breastfeeding him and at the same time give him complementary food. In Djoukilkili, this food is made out of niébé (beans), sorghum, oil, sugar, sprouted millet flour and lemon (or tamarind) juice. These foods, readily available in Djoukilkili, are not usually given to children.

As a rule, children start eating out of the family meal dish from the age of six months. If they are given complementary food at all, it is, at best, a “porridge” made of flour and water with little nutrition value. By eating fortified “porridge” every day, the malnourished boy quickly got better. What’s more, village mothers said that the change was dazzling. Before, the child was batil (very thin), Seide Douta says in Chadian Arabic. After, he became guirgit (fat). This initiative, repeated in 128 other villages in the area, gave Djoukilkili the opportunity to establish a programme for monitoring and promoting child growth on a community scale. Seide Douta was won over by her sisterin- law’s achievements and wanted to get involved. So she decided to feed this fortified “porridge” to her youngest daughter. The girl is now chubby-cheeked and her mother says she is as fit as a fiddle – unlike her elder brothers and sisters, who often have health problems.

Seide’s success led the women in her neighbourhood to give her certain responsibilities: she was chosen to take part in a nutrition group made of five women who monitor and promote the growth of children in the village. That is why mothers sometimes ask Seide for her opinion. In Chad, community-based initiatives are helping villagers to monitor and promote their children’s growth.All of the questions are in a similar vein: is the effort worthwhile? Seide Douta tells them to just take a look at her daughter. The child is obviously in better health than many others. “At the start, some women didn’t believe me,” Seide Douta says. “But when they saw my daughter grow, they changed their minds.” To monitor the children’s growth, women from the nutrition group wind a tape measure around the youngsters’ arms every two weeks. By measuring arm circumference, they can detect cases of malnutrition. “There are children whose weight goes up and children whose weight goes down,” Seide Douta remarks. “In these cases we ask the mothers if their children have been ill. They often tell us that they have had diarrhea. So we advise them to go to the health centre.” More village women would like to give their children complementary food. Unfortunately, they do not have enough niébé. If someone in the village has any, the women sometimes offer to exchange it for millet. Otherwise, they have to buy it. But it is expensive: before the harvest, when niébé is hard to come by, the price can go up to 1,000 CFA francs (about 1.85 US$) for one coro (about 500 grams). To be able to afford it, Seide Douta works in nearby millet, peanut and sesame fields. Unfortunately for her, her farmer husband does not always make a contribution to what their children eat.

Like many other men and in keeping with local tradition, his responsibility is to ensure that there is millet in the family storehouse. “All mothers would like to give complementary food to their children, but they can’t,” says Zacharia Idriss, the general secretary of the village development association. “It is a question of means.” Due to the shortage of nutrient-rich niébé, only a minority of young children actually receive complementary foods. But the women in the nutrition group, who watch over the youngsters in the same way the Queen of Guera towers over their village, have no plans to give up.

by Michel Arseneault





Malnutrition in the Sahel


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