Tackling the scourge of malnutrition among the most vulnerable children in Zambia

Practical cookery classes encourage a healthy diet at home under the MDGi programme.

Simon Ingram, UNICEF Communications Consultant
Nutritious food displayed on a tray during a cooking demonstration
UNICEF/Zambia/2019/Siakachoma
22 August 2019

It’s lunchtime, and a jostling queue of hungry children waits impatiently in the yard of St Francis Xavier Catholic church. Guarding the entrance to the church hall -- which serves as both classroom and canteen -- is the senior cook who is meant to ensure that only those children registered for the church’s free lunch programme are allowed inside. But as she explains with a sigh, it’s hard to turn any of them away.

Two-year-old Beatrice Mubanga is one of the smaller children who are soon wolfing down large bowls of fish stew and nshima (a dish made from maize flour and water that is a staple food in Zambia).

We had met Beatrice earlier at the nearby health centre where she had been brought by her 14-year-old aunt, Rebecca. Beatrice was brought to the centre a year ago showing clear symptoms of Edema, a form of malnutrition caused by a lack of protein in her diet.

“Her stomach and limbs were swollen, and there were sores on her head and body,” recalls Benedicte Kapinda, the Safe Motherhood Action Group volunteer who has been following Beatrice’s case. The child’s condition has improved but there is still cause for concern, she adds.

Hunger has long blighted the lives of many Zambian children. While stunting levels have been reduced in the past twenty years, the country still has one of the highest rates in the region, with more than one million under 5 children suffering from stunting at any time. According to a household survey conducted in 2013-2014, just 7 per cent of children eat what could be considered a minimum acceptable diet.

Practical cookery classes encourage a healthy diet at home

The Ministry of Health’s MDGi programme, supported by the European Union through UNICEF and UNFPA in Copperbelt and Lusaka provinces, has made boosting nutrition a priority. Volunteers like Ms Kapinda are critical to MDGi’s success in preventing malnutrition before children need referral to health services.

Volunteers are trained to teach families the health benefits of everything from exclusive breast-feeding for infants, to the protective value of Vitamin A supplements and immunization against communicable diseases like measles. Over the MDGi programme’s duration, nearly 11,000 volunteers have also been trained in how to promote positive infant and young child feeding practices, as well as the special procedures needed to help more severely malnourished children.

The value of such efforts was becoming clear by the end of 2018, when data showed a 29-point increase  in the number of children accessing the specialised Out-Patient Therapeutic Programme (OTP) sites supported by MDGi for treatment of acute malnutrition. Moreover, the proportion of health facilities offering severe acute malnutrition (SAM) services achieving a recovery rate above 75 per cent rose from a baseline of 50 per cent to 81 per cent by the end of the MDGi programme.

Cooking demonstrations are a key part of this approach. Every day, volunteer Lydia Kalala holds a demonstration at her local MDGi-supported health centre on the outskirts of the capital Lusaka. A group of around a dozen mothers, some with young children in their arms, sit on wooden benches and listen to her explain how healthy, nutritious meals are possible even on a minimal budget.

Behind her, a number of ingredients are spread out on a table. Familiar produce such as sweet potato, avocado and banana are laid out alongside baobab tree fruit (chibuyu), pumpkin leaves and even ground caterpillar.

“You don’t need expensive food from shops to feed your children well, and help them avoid malnutrition,” Mrs Kalala declares.

She cites a series of examples such as kale porridge, avocado and sour milk. The caterpillars make good porridge too, she says, when added to pounded maize.

“We encourage them to start a garden,” says Mrs Kalala. “So, if they can’t afford to buy healthy ingredients they can grow them instead.”

Snacks and sweet drinks are discouraged: “Instead of buying a fizzy drink, buy a banana and mix it with milk,” she says. “It’s much healthier.” Heads nod in agreement.

There are messages, too, about the importance of exclusive breast feeding for children under six months of age.
Judging by the lively discussion that follows, most of the attendees feel they’ve learned some useful tips.

“Even with a small budget these ideas are doable,” says 40-year-old Contrida Ngoma approvingly.

You don’t need expensive food from shops to feed your children well

Contrida Ngoma, 40
This avocado fruit is a nutritious key feature during cooking demonstrations in Zambia
UNICEF/Zambia/2019/Siakachoma
Lydia Kalala displays the Avocado fruit as she explains to mothers and families its nutritional benefits in a child's diet during a cooking demonstration at George health centre in Lusaka, Zambia