Mothers, Community Volunteers First Line of Defense Against Child Malnutrition

Darla Silva, UNICEF USA’s Chief Program Officer, recently traveled to Karamoja, one of the poorest areas of Uganda, for a firsthand look at UNICEF’s community-based nutrition programs. Uganda is one of dozens of countries where UNICEF has been steadily accelerating malnutrition prevention and response measures. 

Nutrition critical for healthy development

Globally, there are 148 million children under age 5 who are not growing well because of chronic undernutrition; 45 million are suffering from wasting. 

These numbers are alarming, and point to a major global crisis fueled by many factors — from climate-driven droughts that are increasing food insecurity in the Sahel region and Horn of Africa to armed conflicts that trigger mass displacement of already vulnerable families.

For UNICEF, supporting child nutrition is a core part of any emergency response. But malnutrition is also a chronic problem among vulnerable children outside of humanitarian emergency settings. There are socio-economic and other factors, including a lack of knowledge and resources at the household level around the types and amounts of foods young children need. 

So nutrition programs aimed at preventing and responding to malnutrition and undernutrition are also a priority for UNICEF’s ongoing global program work.

A health worker in Karamoja, Uganda, shares information at a monthly nutrition community outreach session.
In communities without health centers, health workers hold monthly outreach sessions to provide mass nutrition screenings, outpatient treatment for malaria, prenatal care, immunization services and food/cooking demonstrations.

It’s easy to understand why. For every child, nutrition is the bedrock of healthy development. Good nutrition is necessary for a child to learn and grow and reach their full potential. 

And when a child is undernourished, it puts them at significantly higher risk of death from preventable, treatable causes — conditions like cholera or a respiratory virus. Being malnourished increases the frequency and severity of common infections and delays recovery. Nearly half of all deaths in children under age 5 are attributable to undernutrition. This is why UNICEF works so hard with partners all around the world to prevent malnutrition in the first place.

I was able to see firsthand the importance of taking a community-based approach to nutrition support — starting with mothers and caregivers — during a recent program visit to Uganda. Our group spent a few days in Karamoja, a sub-region in the northeast and one of the most socioeconomically disadvantaged areas of the country, where UNICEF interventions are making a real difference for children.

The sheroes of malnutrition prevention

Poor quality diets, services and practices are the main drivers of child malnutrition. Two-thirds of the world’s children do not eat a diverse diet, including breastmilk, grains, beans, dairy, meat, eggs, fruits and vegetables, at 6 to 23 months old — a time when the quality of a child’s diet is more important than at any other stage of life.

To address this, UNICEF helps develop and ensure delivery of a range of outreach services aimed at improving children’s diets and nutritional status, in partnership with ministries of health, local organizations and community health systems.

A community volunteer holds up a sign that teaches warning signs of malnutrition.
Training the community to recognize signs of malnutrition is done by volunteers who are part of their village health team, using posters that show signs of malnutrition. The volunteers we met spoke with confidence, and explained that when they saw signs in red, that is when they go to UNICEF for help. UNICEF is the largest provider of Ready-to-Use Therapeutic Food (RUTF), a treatment for severe child wasting.

Many measures are community based, and community driven, and emphasize family education, training and resources.Following this approach, UNICEF works with local partners to encourage and equip mothers and caregivers, with support from community volunteers — often mothers themselves — to play a leading role in ensuring proper nutrition for children.

That means being the first line of defense, by being aware of best infant and young child feeding practices, by knowing how to screen children for malnutrition and by being familiar with the warning signs and what they mean, so a child can be referred for treatment quickly if needed.

Simple, low-cost innovations help support child nutrition

While in Karamoja, I attended a cooking demonstration in Iriiri subcounty. Led by a UNICEF-trained health worker, the demo was a lesson in how to prepare a nutritious meal using items available in local markets.

Dozens of local moms turned up with their youngsters for the session, held outside under shade trees near the village center. Nearby, other services were being offered, including nutrition screenings using bands to measure upper-arm circumference and photos showing how to recognize signs of malnutrition.

Specially designed spoons and bowls — two of UNICEF’s simple, low-cost innovations to help reinforce nutrition guidance given — were provided. 

The visit showed the power of prevention actions to keep children healthy, especially when led by trusted community members.

A mother holds a feeding bowl provided by UNICEF that is specially designed to include reminders about what to feed young children to support good nutrition..
A mother in Karamoja, Uganda, shows a visitor the specially designed feeding bowl and spoon provided by UNICEF. This simple, low-cost innovation complements UNICEF’s other community-based nutrition support measures, including guidance on infant and young child feeding and other information shared during community cooking demonstrations. The bowl’s wide rim is printed with icons of eight different food groups; other markings indicate recommended portion sizes by age — half a bowl, three-quarters of a bowl, etc. The slots in the spoon help make sure food is not too watered down.Learn more.

Being in Uganda, seeing Karamoja community members coming together and working as a team to learn and support better nutrition for children, was a powerful reminder that building stronger, more resilient systems that kids need to survive and thrive must be done from the ground up — only through community action is a solution sustainable.

UNICEF cannot do this work without support from partners like The Church of Jesus Christ of Latter-day Saints, a major contributor to UNICEF’s nutrition programs and No Time to Waste campaign.

Other organizations supporting UNICEF’s global nutrition programs include the Bill and Melinda Gates Foundation, the Children’s Investment Fund and the Eleanor Crook Foundation.

UNICEF works with partners in over 190 countries and territories to create a more equitable world where every child can be healthy, educated, protected and respected. Support UNICEF’s mission with an unrestricted tax-deductible contribution today. Please donate.

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