Nurturing Early Childhood Development: Inside the Malnutrition Centre of Excellence
Childhood malnutrition in the shadow of the El Niño drought
Nestled within the confines of Sally Mugabe Children’s Hospital, in the capital, Harare lies a colorful sanctuary. Freshly renovated, the playroom in the Malnutrition Centre of Excellence is a haven for laughter and rehabilitation for children who were close to losing hope.
The playroom, also known as the Early Child Development Centre, is key to the nutrition unit’s goal: discharging every child with a smile. This seemingly small detail speaks volumes about the holistic care delivered when treating children for wasting and severe malnutrition, reflecting not just the physical recovery but also ensuring the children's well-being.
Enthusiasm lights up Dr. Svitlana Austin’s face as she talks about the importance of the playroom in a child’s recovery. The pediatrician in charge of the Malnutrition Unit at the hospital and a member of the Pediatric Association of Zimbabwe (PAZ) emphasizes how crucial play therapy is in helping children heal both physically and emotionally.
Enhancing Child Development through Play Therapy
Many children suffering from wasting and severe malnutrition experience developmental setbacks and cognitive decline. Following the WHO's 10 steps for managing malnutrition, we blend emotional and psychosocial stimulation, including play therapy, to ensure their full recovery
To provide children with the best chance to grow and develop to their full potential, the hospital, and Pediatric Association of Zimbabwe in partnership with UNICEF, with funding from the Health Resilience Fund (HRF), is implementing various activities to enhance the unit’s capacity. This encompasses implementing a model to integrate play therapy and the promotion of early childhood development for the treatment of malnutrition, with the aim of replicating it in other locations.
The early child development phase, which encompasses the first 1000 days (conception to 2 years) and beyond up to school-going age (7 years) is a critical window of opportunity to shape a child’s development trajectory and lay a positive foundation for the future. Proper nutrition is an essential component of nurturing care for a child to reach optimum physical and cognitive development.
The playroom is equipped with UNICEF Early Childhood Development (ECD) materials and other toys and equipment and staffed with a designated play therapist to facilitate interactive play and responsive caregiving and teaching to caregivers is part of the treatment for wasting.
Weathering the Storm: Battling Malnutrition Amidst the El Niño Drought
As the El Niño drought takes hold, the development of millions of children is at risk. This crisis tightens its grip by compromising diet diversity and reducing household food security, leading to poor nutrition. The situation is particularly concerning among children, who are always the first to suffer as they are the most vulnerable to poor feeding practices.
According to Urban Zimbabwe Livelihoods Assessment Committee (ZIMLAC) 2024, overall, household food insecurity increased from 29% in 2023 to 35% in 2024, being highest in Bulawayo and Masvingo at 41% and 40% respectively.
Sibusisiwe Ncube, the hospital food services supervisor for the Malnutrition Centre of Excellence at Sally Mugabe Childrens Hospital, is a dedicated health professional with a multifaceted role. Amongst her duties is the responsibility of managing the Ready-to-use Therapeutic Food (RUTF) stock, a life-saving essential medicine that treats severe wasting in children under 5. Given the prevailing environment, she anticipates a rise in demand for RUTF.
"As the largest referral hospital, we are already receiving children with severe malnutrition from drought hotspot areas countrywide and expect a further increase. We are also seeing children from urban areas where water shortage and the cholera outbreak are rampant," she says.
The El Niño drought presents a complex humanitarian crisis in Zimbabwe, causing water and food shortages, both of which impact child nutrition. Poor harvests resulting from a shortage of water decrease household food security and lower diet quality for children in terms of both quantity and variety. The reduced water quantity and quality also raises the incidence of diarrheal diseases. The situation increases children’s vulnerability to malnutrition and compromises children's rights to education and protection.
Anticipating the devastating impact, UNICEF urgently appeals for USD 84.9 million to fund its emergency response, assisting children and women affected by the El Nino crisis. This funding will provide life-saving interventions to 1.34 million people, including 866,000 children.
The Malnutrition Unit at Sally Mugabe Children’s Hospital is providing comprehensive care including conducting diet counseling, outreach support visits to community-based groups that assist caregivers of children with disabilities and teaching feeding techniques and conducting screenings for severe wasting during visits. Furthermore, the unit is working to improve quality protocols for the treatment of wasting from admission to the ward.
Basking in the record achievement of reducing mortality rates among its in-patient caseload from 47% to 8% over two years, the Malnutrition Unit is living up to its reputation as a Centre of Excellence, highlighting significant improvements in hospital treatment.
Health Resilience Fund is a pooled fund coordinated by the Ministry of Health and Child Care, with financial contributions of the European Union; Gavi, the Vaccine Alliance; and the Governments of Ireland and the United Kingdom; and technical support of UNFPA, UNICEF and WHO.
