C-IYCF, a golden way to eliminate child malnutrition
In Ghana, many children suffer from health issues resulting from malnutrition and according to available statistics, two in five children are stunted.
Advertisement
Parents who lack information on how to feed their children properly, especially in the rural areas, tend to blame their fate on witchcraft or believe that their babies are possessed by demons when they become malnourished.
To find solutions, they end up consulting native doctors and herbalists who, equally clueless about the problem affecting the child, provide all manner of concoctions which rather worsen the child’s condition. Some children eventually develop complications and die.
In an effort to reduce the rising cases of stunting and to promote breastfeeding in the Volta Region, the nutrition section of UNICEF, in collaboration with the regional health directorate, has developed a programme dubbed Community –Infant and Young Child Feeding (C-IYCF) to cover stages of nutrition from birth and upwards and also assist pregnant women and lactating mothers to eat right.
When the programme started in 2013 with 513 trained health officers, over 100,000 children, representing 28 per cent in the region were said to be stunted.
The region’s approach in tackling the problem has been described as outstanding as it had been able to achieve zero per cent of severe acute malnutrition as of 2014.
According to the statistics, stunting levels had gone down from 22 per cent in 2011 to 19 per cent in 2014 and wasting (when a child looked more of a skeleton) had gone down from nine per cent to 2.5 per cent.
Behavioural change
A complete behavioural change of Aneta, a farming community in the North Dayi district, resulted from the obedience of a young mother who followed recommended baby feeding practices by community health nurses using the C-IYCF approach.
When the community health officers (CHO) started C-IYCF in the community three years ago, the women had not accepted the education wholly and had continued to practise what they knew.
Lactating mothers were not practising exclusive six months breastfeeding of a newborn and pregnant women were also not eating right and, therefore, suffered some health challenges, including anaemia.
The mother of five, Ms Josephine Opokuwaa, had decided on her own to stick to the guidelines given to her by the nurses on how to raise healthy children. Starting with her fourth baby, Opokuwaa had only wanted to make a comparison between the infant and her other siblings, especially concerning their weights and how healthy they appeared.
She, therefore, practised exclusive breastfeeding for six months and continued with other family foods until the child attained two years, paying close attention to other guidelines.
Opokuwaa attested to the fact that her fourth child always looked healthy and was not underweight or malnourished as her other three children when they were infants.
She has welcomed her fifth child and is ready to go through the same process to have another healthy child.
More women advocates
Other women who initially tried to discourage her but later came to realise the benefits of feeding babies properly have rather become advocates of the C-IYCF programme and were helping nurses to educate other women in the surrounding communities.
This goes to confirm that behavioural change towards bad practices can serve as a catalyst for correcting the wrong.
Today, following the success story of C-IYCF, two other communities among 65 communities in the North Dayi district where the programme had been introduced, Fu and Konda, have become the pioneers to implement a component of C-IYCF called Baby Friendly Community in the Volta Region and the country at large.
The Volta Regional Nutrition Officer, Mr Nutifafa Glover, who is leading the implementation process, explained that five strategies were developed to achieve the goal.
Strategies for C-IYCF
They included mother-to-mother support groups, action-oriented group, Healthy At Two (HAT), Model mother and Smart school approaches.
The HAT approach has to do with the monitoring of pregnant women assigned to health officers from when the child is conceived and with correct indicators to ensure that till the child gets to two years, he or she is healthy and well nourished.
The mother-to-mother approach is formed in the communities for mothers with the knowledge to support others that have nutrition challenges.
With the Smart school approach, adolescent boys and girls are educated on good feeding practices to be able to give a helping hand in child care at home. The smart kids are helping the directorate to communicate various subject matters such as open defaecation, exclusive breastfeeding, and four-star diet, among others, through drama.
Women who are able to go through the guidelines and have healthy children at two are declared ‘Model Mothers’ to assist the health nurses in promoting the programme.
Evidence on the ground
A tour of selected communities such as Yor-danu Aneta (North Dayi), Hlefi (Ho West district), Hodzo (Ho Municipal) , and Amuzudeve (Adaklu district) by officials of UNICEF and the regional health directorate, witnessed how malnourished babies had been transformed into healthy children.
A typical case was a woman who had a premature baby and because she had no money decided to take care of the child in the house but effective breastfeeding saved the boy’s life.
Another was a very malnourished child who weighed 1.8 kilogramme(kg) in her fourth week but after her mother had followed exclusive breastfeeding practices gained 2.4kg in the fifth week. Her situation improved with time and when she was four months she weighed 5.2kg.
The success, however, had not come without challenges from tradition and adverse advice from relations.
One of the model mothers, Madam Antoinette Kakali, at Hlefi said: ‘‘I faced opposition from in-laws, mothers and grandmothers over the exclusive breastfeeding because they believed that water was a necessity and, therefore, the child needed it to grow.’’
Baby Friendly Community
Meanwhile, at Aneta, the chiefs and the people have embraced the programme and with the implementation of the Baby Friendly concept, the people have agreed to have a convention with sanctions that ensured that all pregnant women followed the C-IYCF programme to have healthy children in the community.
In the Adaklu district, 169 mother-to-mother support groups have been formed since June 2014 for the same purpose.
30 per cent population not covered
Although the region had made significant progress in reducing malnutrition, and had targeted reducing chronic under- nutrition of children under two years by 25 per cent of the regional average by 2020, a chunk of 30 per cent of the total population could not benefit from the programme because they found themselves in hard-to-reach areas or better still on islands.
The Regional Director of the Ghana Health Services, Dr Joseph Nuertey, said people in those areas received health care once a year during immunisation programmes and explained that although there were enough workers, inadequate logistics was a constraint on their work.
‘’These people are part of the region and the country and, therefore, we have no excuse not giving them the best of health care. We need motorbikes, vehicles and boats to get to them,’’ he said in an appeal for support.
Commendation
The country representative of UNICEF, Madam Susan Namondo Ngongi, was impressed with the level of commitment from the people and the health directorate in ensuring that malnutrition of babies and pregnant women became a thing of the past.
‘’These strategies from the Volta Region should be adopted by other regions to address malnutrition in an integrated manner,’’ she said.