Project Lead(s): Florence Tushemerirwe
Issue
Malnutrition results from the inadequate consumption of calories and nutrients essential for child growth and development.
In Uganda, 33% of children under five years have stunted growth and 14% are underweight, while 5% have wasting associated with severe acute malnutrition.
Solution
Implemented in rural Eastern Uganda, an integrated model was introduced to prevent malnutrition among mothers and children newborn to two years, as a partnership between Makerere University and the local community.
A daily supplementary food product named “Grand Nutrition”, made from local foods, was developed and tested, coupled with nutrition education to correct any existing malnutrition and prevent any malnutrition relapses during the 1,000-days critical window of opportunity.
Six composite flour formulations were developed using local foods eaten in the Luuka district and green technology, i.e., germinating, roasting and sun-drying grain were used.
In addition, a nutrition education intervention was implemented, using behaviour change communication approaches to improve maternal and child caregiver nutrition knowledge, perceptions and practices.
The project also attempted to involve herbalists to prescribe a balanced diet to their patients, because there are mothers who still seek their services.
A quasi-experimental design was used to assess the intervention, with Bukooma sub-county as the intervention area and Bukanga sub-county as a control arm, separated by 30 kilometers and a buffer sub-county to prevent intervention spill-over.
Outcome
The project resulted in the development of a ready-to-use, supplementary food product, which has completed community trials and is ready to use on a large scale.
Among the core infant and young child feeding (IYCF) indicators, in both the intervention and control arms, there were statistically significant increases in the proportion of mothers who knew and practiced early initiation of breastfeeding; the proportion of mothers who breastfed exclusively, and the proportion of mothers who knew when to introduce semi-solid, solid and soft foods.
In the control arm, there was also a statistically significant reduction in the proportion of mothers giving babies pre-lactal feeds.
Nutrition education using behaviour change communication also had a positive effect.
The concept of using local foods to attain diet diversity and household food security has been adopted at the community level where mothers, in partnership with the Village Health Team members, have started making their own formulations.
In addition, the project team is exploring the integration of the simple innovation into the national Ministry of Health approaches to nutrition education implementation.
The team plans to apply for Phase II Transition To Scale funding, and also plans to engage UNICEF and USAID to fund and use the product in different parts of the country.