While availability and access to food can be addressed through improved agricultural productivity and diversification of foods, education and knowledge dissemination on nutrition, food utilisation and improved family eating practices are required to improve people’s nutrition and health status now and in the long term.
According to the State of Food and Agriculture report 2013 two billion people worldwide suffer from one or more micronutrient deficiencies (a lack of vitamins and minerals), 868 million people are undernourished in terms of energy intake while 1.4 billion are overweight with 500 million of those being obese. Twenty six percent of all children under five are stunted and 31 percent suffer from Vitamin A deficiency.
In Malawi, official statistics for malnutrition are alarmingly high with most statistics showing very little improvement over the last 30 years. About half of all children under the age of five show signs of chronic malnutrition with an estimated 48 percent being stunted (too short for their age), 30.6 percent underweight (too thin for their age), and 11.4 percent wasted (too thin for their height). One third of the population is food insecure in terms of energy, resulting in further disrupted eating patterns and reduced food intake. A fourth of women aged 40-49 are overweight (only women are measured), and micronutrient deficiencies in both women and children remain high.
FAO, with funding from the Government of Flanders through the Flanders International Cooperation Agency (FICA), is collaborating with the government of Malawi in a project entitled Improving Food Security and Nutrition Policies and Programme Outreach (IFSN). One component encapsulates a comprehensive nutritional education programme targeting families with infants between 6-24 months to prevent malnutrition.
The nutritional education programme has a specific component focusing on the development of improved complementary feeding practices and recipes using locally available foods. This component operates at two levels, starting with the development of locally adapted messages and recipes using a formative research methodology called Trials of Improved Practices (TIPS), applied in a sample of households.
The TIPS process is based on trying out Infant and Child Feeding recommendations in the real home situation, establish what is feasible and practical to mothers, identify motivating factors and constraints to behaviour change and set interim targets towards ideal behaviour. After TIPS, the recipes and behaviour change messages are disseminated throughout the community as part of the nutritional education programme.
Impact on infants’ health
Naomi Tomoka, 28, of Yosefe village in T/A Kaluluma in Kasungu is one of the nine mothers whose infants are beneficiaries of the programme in Kaluluma Extension Planning Area (EPA).
During a routine meeting with fellow beneficiaries, she painted a gloomy picture of how life was when she gave birth to her first child before enrolling in the programme.
"My first child was often sick", confessed Tomoka, a lead farmer and mother of three. "I was constantly in the hospital with him and it was very depressing".
But all that is water under the bridge now. Last year, her life took a turn when her third child, Victor, registered in an “Infants and Young Children Feeding Programme” supported by FAO-FICA.
With training and support from Agriculture Extension Development Officers, Health Surveillance Assistants, and Volunteer Community Nutrition Facilitators, Tomoka is now one of the nine mothers who prepare nutritious porridge for their infants and feed them at regular times in a day, depending on the infant’s age.
The nutritious porridge is made out of three or four ingredients: 1) a starchy food such as mashed potatoes, cassava or maize flour (locally known as mgaiwa) mixed with 2) a high protein food such as beans, groundnut flour, fish or meat powder or goat milk, mixed with 3) a vegetable, for example pumpkins or green vegetables and 4) a fat such as oil or avocado. The dish is served with fruit. The idea is to make food for the infant that has an intake of recommended six-food groups by the end of each day.
"Life for us has now improved. Victor has never been in the hospital", said Tomoka. "There was a time in which our children in the village were getting sick often but now their bodies are healthy and are growing well", she added.
Victor’s Health Passport Book bears testimony to his mother’s sentiments. It now shows a dramatic increase in weight immediately after he begun to take the nutritious porridge.
"At his age, he also appears to be more intellectually developed than my other children who did not benefit from this programme", said Tomoka, flashing a motherly smile.
Soka Chitaya, District Project Manager for Kasungu, agrees that the programme has had tremendous impact so far on the health status of the infants because they no longer get sick as often as before.“There is great improvement in the health status of children following this programme,” Chitaya observed, during a visit to four nutrition project sites in the area.
About the IFSN project supported by FAO-FICA
The first phase of the project started in 2008 and was extended into a second phase in April 2011 for a period of four years until March 2015. The second phase is being implemented in six EPAs in the targeted districts of Kasungu and Mzimba.
The overall objective of the project is to contribute through policy and program advisory services to the achievement of the Government’s development goals in terms of improving the food security and nutrition situation of the Malawian population at large and more directly through direct grass-roots interventions to the improvement of the situation of vulnerable community members.
The project aims to reach out to 15,000 food insecure households and provide educational and training support to 31,500 households and 10,500 school children in all impact areas by the end of its life span.
Among other focus areas, the project has taken on board the promotion of livestock production; climate change, natural resources and environmental education; capacity building and institutional support; increased crop production and diversification; promotion of fruit production; soil and water conservation; potable water and improved sanitation, and other cross-cutting issues such as gender, malaria and HIV.