Reducing malnutrition in Malawi

Reducing malnutrition in Malawi

Tiferanji Vizyalona, a member of the Concern team in Malawi, has contributed this piece on a new programme being conducted in Nsanje district which has been successfully reducing the instances of malnutrition.

Concern Malawi are piloting a community based programme, Positive Deviance Hearth (PD Hearth), aiming to reduce the number of malnourished children under the age of five. PD Hearth is based on the idea that solutions to community problems already exist within the community. Its overall goal is enabling communities to independently address the problems of malnutrition in their young children. Parents and caregivers are not simply trained to rehabilitate their malnourished children, but also assisted in sustaining the rehabilitation on their own at home. Families are encouraged to use indigenous knowledge, lessening dependence on outside resources.

Assessing needs

In conjunction with the Ministry of Health (MoH) and the Ministry of Agriculture and Food Security (MoA), the PD Hearth programme has been up and running for less than a year in Ligobwa village, Nsanje district. Ligobwa village was selected for the programme as it was sending more children to out-patient therapeutic programmes than any other community in the area. A nutrition assessment revealed that there was a malnutrition rate of 47% among children under five years of age.

To establish why there was such a high rate of malnutrition in the village, and find solutions to this, Concern arranged and facilitated focus group discussions with all members of the community. It soon appeared very little education had been provided about nutrition, good hygiene practices, HIV and AIDS and the importance of monitoring the growth of their children.

In order to address this, Concern staff trained members of the community to be volunteers. These volunteers are now conducting all of the practical and information sessions in the village. It is predicted that the programme will benefit no less than 200 children in the area.

Nutritious meals

One way of addressing the malnutrition problems faced by the community is to teach parents and caregivers to cook nutritious meals with locally available produce. Cooking demonstrations were held. As well as showing the community how to prepare porridge based on the main staple of maize. A porridge based on sweet potatoes has also been developed ensuring the community has the knowledge to diversify when one of the main ingredients is scarce. In addition to the cooking demonstrations, volunteers routinely carry out home visits, giving additional support in preparing nutritious meals for each family in the programme.  

The Village Health Committee and volunteers have been conducting monthly growth monitoring sessions, where the children in the community are weighed and measured. Parents and caregivers are now able to monitor the progress of their children and identify health or malnutrition problems earlier. This limits the amount of children developing more severe and acute health and nutrition problems.

Information sessions have been held with the community to discuss key issues such as hygiene, breastfeeding and HIV and AIDS. These discussions have opened the door to previously ignored or feared subjects, and promoted a sense of ownership and responsibility for those living in Ligobwa. Some women in the village have devised songs which contain messages about HIV, nutrition and breastfeeding.

The prevalence of malnourished children has now reduced from 47% to 27%. Joseph Njanje, a father of one of the children in the programme expressing his happiness at this success, said “This year the gods have smiled at us. You do not know how much good work this programme has done to our children. In the past years if there was a funeral it was of a child, but this year we have not had any.”

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