A significant proportion of Ugandan women of reproductive age and children under five years still suffer and die from acute and chronic malnutrition. Malnutrition in children is a life-threatening condition. Adequate nutrition has been recognised internationally as one of the key factors in human development and economic productivity. The resulting mortality, morbidity, and loss of productivity impede social and economic development.
Uganda Health and Demographic Survey (2011) puts the malnutrition rate at 14 per cent, a meagre drop from 16 per cent in 2006. The report further indicates that malnutrition cases are more likely to be high among illiterate women than the educated. This is attributed to failure by the latter to understand sensitisation messages that are embedded in several interventions geared towards fighting malnutrition.
Two salient efforts that can sustainably address nutrition challenges are Positive DevianceHearth, a community-based nutrition programme and the Integrated Management of Acute Malnutrition, which focuses on treating malnutrition at the facility level.
Positive DevianceHearth is a home-based nutrition approach targeting children who are at risk for protein-energy malnutrition. The approach identifies those culturally appropriate positive behaviours practiced by the mothers or caretakers of well-nourished children (Positive Deviants) from poor families. Such positive practices are transferred to others in the community with malnourished children. The “Hearth” or home serves as a focal point for demonstration of positive practices, education, counselling and rehabilitation sessions.
Proper child care practices and behaviours are identified among community members with well-nourished children despite not having access to special resources. This is buttressed on assessment of nutrition status, visits conducted by community volunteers to every household in the selected communities and encouraging high-risk children to be assessed for nutrition.
All children under five years are weighed during special growth monitoring sessions in their villages. Trained hearth volunteers then follow up the malnourished children in their homes and invite the caregivers to bring them to participate in a local Hearth cycle that takes 26 days. Caregivers learn to recognise malnutrition cases and treat them. In addition, children enrolled in hearth sessions are linked to the health centres within the locality.
This approach strengthens systems for the delivery of quality nutrition services to children below five years, pregnant and lactating women by promoting their use at both facility and community levels. This contributes to a reduction in maternal, child malnutrition and mortality.
A community approach to addressing malnutrition is appropriate in Uganda since most health facilities are not adequately equipped with supplies and trained staff to treat malnutrition. With limited facilities to provide nutrition services and inadequate referral systems, parents with malnourished children have to trek long distances to receive services. Most families cannot afford numerous trips to health centres. Using a community-based approach allows caregivers to remain in their homes and attend to their families. It also increases nutrition awareness by extending messages delivered by the community health worker beyond just the family of the malnourished child, but to as many other people in the community.
We must empower families and communities countrywide with knowledge and skills to fight malnutrition through appropriate, sustainable and easy to adopt strategies.
Mr Atuhura is a senior communications specialist, MSH-STRIDES for Family Health. firstname.lastname@example.org
SOURCE: Daily Monitor