FAO Regional Office for Africa

Afikepo: improving children’s nutrition in Malawi

©FAO

11 February, Chiradzulu district ­–  If it wasn’t for the intervention of the Afikepo nutrition sensitive agriculture (NSA) project, Estere Jailosi fears that she would have surely lost her daughter to malnutrition. In 2017, Estere was still breastfeeding her baby Jenipher, when she found out that she was pregnant. Soon after this discovery, her milk dried up, cutting off baby Jenipher’s primary source of food and nutrition. It was only through her encounter with cluster leader, Lydia Macheso, and her subsequent participation in and learning from Afikepo that turned things round.

Among its activities, the Afikepo NSA project, through community outreach, is helping to promote knowledge and practice of complementary feeding for children over six months of age and under under the age of two. This knowledge is critical for mothers in situations similar to that of Estere and Jenipher. With the assistance of an Afikepo-supported cluster leader Lydia Macheso, Estere was supported to improve her daughter’s health.

Cluster leader Lydia recalls: “It was during one of my routine visits to the ten homes which I support with nutrition education that I came across Jenipher. We were visiting Estere twice a week to check [in.]”

Given the need to track the nutrition status of under-five children, cluster leaders are empowered with screening skills to support early detection of malnutrition cases. These skills help communities to take control of health issues, where previously, deficiencies in children could go undetected. Depending on the severity, children diagnosed with severe forms of malnutrition are referred to hospitals for treatment.

In this case, Estere while now armed with nutrition knowledge through her cluster leader, was advised to visit her nearest health centre for assistance. At the time, her daughter was one year old and only weighed 4.4 kg. Unfortunately service providers at the health centre said that everything was in order. Estere, unconvinced, returned to cluster leader, Lydia, for assistance. From her, she learnt more about the six food groups required for optimal nutrition and food preparation. She learned how to prepare different types of foods and for an introduction to a variety of recipes that are appropriate for children at various stages.

“After they cooked everything they gave me a nutritious porridge to feed my child, but she still refused. The cluster leader helped me feed Jenipher, who finally started to eat. When I went back home, I prepared the same porridge, which she ate with no problem,” Estere said, adding that she also continued giving her different types of foods which she learnt about at the cooking demonstration. Recipes that she learnt included whole grain maize flour with vegetables, groundnut powder and fish powder which helped Jenipher thrive.

Cooking demonstrations are another platform that is being used to bring nutrition learning to communities. It is here that community members learn how to prepare food while retaining nutritional value; new recipes that ensure nutritious meals; as well as information regarding the six food groups. Estere was also advised to have a home garden and to be rearing small livestock for easy access of vegetables and animal products, which she took up immediately.

After a month Jenipher showed signs of improvement, and she continued on a diet in accordance with what her mother had learnt through Afikepo. Being an expectant mother during this trying period, Estere also improved her own nutrition, and would eat similar foods to what she prepared for her daughter. This improved her own health and that of her then unborn child, a little girl who weighed 4.6 kg at birth.

Project participants, cluster leaders, care promoters, extension staff, through the project have built trust with community members and with each other with a common goal in sight- improved nutrition. Such trust has become an essential ingredient for community behavior change and one which is key to saving children such as Jenipher from malnutrition.

Behaviour in Chiradzulu district is changing, according Agricultural Extension Development Officer (AEDO), Mphatso Kutama.  He observes that most people in the area where he works, Mombezi extension planning area (EPA), are following extension workers’ advice, adopting crop diversification and new technology combinations to improve nutrition status in their families as well as food and income security.

“Jenipher is a living example that eating nutritious food with all six groups can improve nutrition status of the family,” he says.  

Now three years old, weighing in at 13 kg, Jenipher is a healthy and robust little girl. Her favourite food is nsima with usipa (small fish), and pumpkin leaves. She eats a healthy diet thanks to her mother’s dedication to sticking with what she has learnt through Afikepo.

Under Afikepo NSA project, care groups, which have an average membership of 10 cluster leaders, are providing nutrition information and guidance to households. Each care group is headed by a care promoter, who leads on information sharing, whereas the cluster leaders such as Lydia, are subsequently responsible for passing nutrition information to different households.

About Afikepo nutrition sensitive agriculture project

Afikepo is a Chichewa name, which means “let them [the children] develop to their full potential”. It is being implemented with the aim of increasing and diversifying dietary intake of safe and nutritious foods to achieve optimal nutrition for women of child bearing age, adolescent girls, infants and young children in the 10 targeted districts of Chitipa, Karonga, Mzimba, Nkhatabay, Nkhotakota, Kasungu, Salima, Chiradzulu, Thyolo and Mulanje. The Afikepo nutrition sensitive agriculture project is part of the wider Afikepo programme which is funded by the European Union and is being implemented from July 2017 to June 2022.