Maternal Newborn and Child Health

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AIDS Education Group for Youth (AEGY) in partnership with Mennonite central committee is implementing the Maternal, New-Born, and Child Health in Bugulumbya sub county Kamuli district. The project aims at improving maternal, new-born and child health in the community through improved utilization of high impact interventions and improved nutrition using “Ekitobero” in Kamuli district.




The Outcome

Malnutrition has become a major health concern in the communities where AEGY is operating. Malnutrition accounts for about 35% of deaths among children under five years of age around the world. Stunting, severe wasting and growth retardation are the major problems associated to malnutrition and especially among the under-fives. Malnutrition is a major cause of morbidity for all age groups accounting for 11% of disease burden globally. Child malnutrition in Uganda remains largely a hidden problem, micronutrient deficiencies are similarly difficult to detect. Malnutrition remains one of Uganda’s most fundamental challenges for human welfare and economic growth. It’s against this background that AEGY supported the nutritionist to train pregnant, lactating women and caregivers of children under 5years on maternal, infant and young child nutrition and good hygiene and sanitation practices.
The training was focusing on the first 1000 days which are key in the growth and development of a child. This is the period from the time of conception up to two years of age. This is a very critical period where the brain grows and develops (cognitive development)

AEGY has been conducting training aimed at  enhancing the knowledge, attitude and practices of pregnant and lactating women and care takers of children under five years on appropriate feeding and dietary practices to ensure that young children attain maximum benefits the nutrition caregivers will provide.
Specific objectives
This training was aimed at;
• Providing knowledge and appropriate support on nutrition actions for all participants aimed at preventing malnutrition and promoting proper nutrition practices/behaviors.
• Identifying and fostering linkages between the health facility, community and other services for improved livelihood, food security and economic advancement.
• Conducting food demonstration to participants to cause change in behavior regarding appropriate complementary feeding practices especially for the vulnerable groups.
• Appreciate the importance of nutrition in promoting good health and development.
• To assess the contributing factors to malnutrition in the communities in relation to WASH.

The facilitator used the following appropriate adult training methods to deliver information to the participants. The methods include group discussions, demonstrations and return demonstrations, hands on practical, group work and storytelling.
Importance of good nutrition and hygiene/sanitation practices
Appropriate feeding practices promote growth, prevent stunting and increase a child’s chance for a healthy physical, mental and social development needs during hearth sessions.
Definition of key terms
The term nutrition was defined as the process of taking in and digesting food for body functions like growth, reproduction, respiration, immunity, work and health. There are key terms found to be used in nutrition and they were defined as below:-
Food -Anything edible that provides the body with nutrients.
Nutrients –Substances in the food that the body uses to function properly, and are divided into macro and micro nutrients. Micro nutrients are those needed in small quantities by the body e.g. vitamins and minerals while macro nutrients are those needed by the body in large quantities e.g. carbohydrates, fats and proteins.
Malnutrition –A condition that results from the imbalance between the body needs and intake of nutrients which can lead to syndromes of deficiency, toxicity or obesity.
Under nutrition –A condition of the body resulting from inadequate intake of nutrients or diseases. This condition can cause impairment of the physical functioning of a person’s body, performance and processes including growth, pregnancy, lactation, physical work etc.
The training was particularly focusing on under nutrition among children under five years and pregnant and breastfeeding mothers due to high burden of under nutrition in these groups of people.
Some of the signs of under nutrition are silky brown hair which easily plucks off, presence of skin folds (baggy pants), sad/ irritable, no interest in playing, muscle wasting, swelling of both feet, pot belly etc.
The causes of malnutrition include; lack of food, diseases, insecurity, gender based violence, drought, floods and poor child spacing.
The consequences of malnutrition include; lowered immunity, reduced productivity and death. This was mainly through brainstorming and group discussions. The strategies to address under malnutrition were discussed and these included family planning, WASH, food security etc.

Food demonstration
There was a session on food demonstration and food preparation. The facilitator presented the basic food groups and their sources that are locally available, culturally acceptable and affordable. Different kinds of food were brought and grouped by participants according to their nutrients content. This was important as it gives alternative choices for the community in knowing different categories of food. The participants were asked to classify the various foods into three major groups of GROW, GO and GLOW foods as follows;
1. Carbohydrates (go foods)which are energy giving foods e.g. maize, millet, sorghum, rice, sweet potatoes, cassava, yams, bananas (matooke).
2. Proteins (grow foods) which are body building foods. Proteins are divided into two that is plant proteins and animal proteins.
Plant proteins within this community include beans, peas, groundnuts, simsim, robina nuts, Bambara nuts and soya beans while Animal proteins include; meat, milk, chicken, eggs, silver fish (mukene), fish, white ants etc.
3. Vitamins and minerals (Glow foods) which are body protective foods. Their sources within the community are fruits like mangoes, oranges, guavas, apples, jackfruit, tangerines, tamarinds; and vegetables like dodo, pumpkin leaves, nakati, sukuma wiki etc.
The participants were taken through the basic steps involved during menu preparation using locally available and culturally acceptable foods.The following locally available foods were used during food preparation: – maize flour, rice, g. nuts, mukene, pea leaves, potatoes, matooke, dry fish, meat, pumpkin leaves, oranges, avocado, egg plants, mangoes, nakati, tomatoes, pumpkin, cassava, soya bean flour, millet flour, passion fruits, salt, and cooking oil.
Food preparation Procedure
The participants arranged the food according to their various groups that is the “GO”,”GLOW” and “GROW”. The participants were taken through the steps on how to prepare the multi mix food (Ekitobeero) .
The food is measured using palmfuls since there are no weighing scales in homes. The ratio is as follows;
• One palmful of carbohydrate
• Two palmfuls of protein; one plant protein and one animal protein
• A ring of leafy green vegetables
• One pinch of salt
• One tea spoonful of cooking oil
• An appropriate amount of water
• Fruits are served as the food is being prepared.
NOTE. The above measurements are for one child but the ratio has to be maintained depending on the number of children to be served.
The food was cooked by steaming and then mashed before serving.
Lesson Learnt
 Good and improved community attitude, knowledge and practices on nutrition, hygiene and sanitation reduces on the burden of malnutrition occurring in the community.
 Majority of the community members do not know which food group is needed for growth, protection and energy hence feeding children with only one type of food. There is no balanced diet.
 About 40-50 participants attended the training session.
 The facilitator was able to cover the organized package for the training as it was scheduled.
 All the participants were very active and all had hands on practical sessions.
 They acquired knowledge and skills in nutrition since they were able to prepare Ekitobero properly.
 High numbers of teenage pregnancies who end up with malnourished children.
 Poor male involvement, very few men attended the training yet they are the decision makers in homes.
 There is lack of support from the husbands/fathers in carrying out child care practices. They think child care is for women.

 There is need to sensitize the men (husbands) on child care practices so that they can support their wives in practicing the new behaviors learnt during the training.
 To facilitate these families to be able to put up a garden of fruits and vegetables and rearing domestic animals at home. This will help in improving both food security and income in the homes.
 Such trainings should continue so as to empower communities with knowledge on proper nutrition.