Fighting Malnutrition Through Diversified Diets

Zaina, a new mother in eastern Uganda, could tell that there was something wrong with her 8-month-old twins. Nakato and Wasswa were thinner than other children their age in the community, and they behaved differently, too. Neighbors encouraged her to seek help.

“Before I brought them to this hospital, neither of my children acted like a normal baby,” Zaina explained. “They were just sitting and had no energy.”

At Jinja Regional Referral Hospital, she found out what was wrong: Her babies were severely malnourished. They needed to stay in the hospital for intensive treatment until they were strong enough to go home.

On the Road to a Brighter Future

Zaina’s situation echoes that of many mothers and caregivers in Uganda who don’t recognize the early warning signs of malnutrition. With 2.2 million children under 5 stunted, and another 300,000 too thin for their height, Uganda suffers major health, economic and educational burdens from malnutrition.

Malnutrition during early childhood inhibits growth and development and is an underlying cause of about 45 percent of child deaths. Stunted growth in early childhood has been associated with less educational attainment, decreased wages, and reduced likelihood of escaping poverty in adulthood.

A focus on preventing and reducing the effects of malnutrition during childhood helps children like Nakato and Wasswa grow into strong, productive citizens and promotes stable, self-reliant societies.

USAID is working with the Government of Uganda to build national and local government-level systems that are critical for scaling up nutrition interventions. With USAID support, health facilities and communities across Uganda are implementing programs that include routine monitoring, appropriate nutrition rehabilitation, counseling and education for caregivers of children to prevent and treat malnutrition.

USAID is training health and community workers to better identify and manage malnutrition, helping Uganda to more effectively address the high prevalence of malnutrition. In 2017 alone, USAID reached over 1.7 million children in Uganda with nutrition interventions and helped more than 1,000 health professionals receive nutrition-related training.

Foods That Protect, Build and Energize

Today, 10-month-old Nakato and Wasswa are doing much better, but they still have a long way to go.

Zaina and her twins have transitioned to an outpatient program, which includes regular checkups and nutrition education — such as cooking and gardening demonstrations — conducted at the hospital.

Zaina and other caregivers learn how different types of food benefit their children’s health and development. They learn about three categories: foods that protect their child (foods rich in vitamins and minerals), foods that build their child’s body (foods high in protein) and foods that give their child energy (foods that contain carbohydrates).

Hospital staff teach the caregivers about the importance of engaging their children while feeding, meal frequency, hygiene and food consistency (starting at six months, children should eat pureed and semi-solid foods, like oatmeal, and then work their way up to solid foods).

Growing Educational Tools

With support from USAID, Jinja Regional Referral Hospital has revived and expanded its garden, which includes sweet potatoes, mangoes and other produce common to the region. Through hospital gardening classes, Zaina learned how to grow these crops, and she took seedlings home to plant her own garden.

Monitoring Progress

Ateach bi-weekly hospital visit, health workers measure Nakato and Wasswa’s height and weight and take their mid-upper arm circumference to determine their nutritional status.

The health workers then sit with Zaina and discuss her twins’ progress and ask about efforts to improve their feeding. They give Zaina two weeks’ worth of ready-to-use therapeutic food packets. Calorie-dense and protein-rich, this peanut-based therapeutic food is meant to be used as a complement to food prepared at home.

Soon, Nakato and Wasswa will reach their normal weight and graduate from the program. When that time comes, Zaina is confident she can support her twin’s growth and development at home using the knowledge and skills she has learned.

“I am so appreciative of this program,” she said. “I have learned how to feed my children nutritiously and observe proper sanitation and hygiene, and I feel my children are very supported here.”

The Ugandan Government and the country’s health workers are committed to moving the dial on the country’s high prevalence of malnutrition.

As Judith, a volunteer nutritionist, explains, “This is my region, and I really get attached when I see all the malnourished children. I feel the need to do something to help, so I do my job with zeal and passion.”