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While food availability and access issues can be addressed by increasing agricultural productivity and diversifying food products, nutrition education and knowledge dissemination, food utilization and improved household dietary habits are needed to improve people’s nutrition and health status now and in the long term.
according to The State of Food and Agriculture 2013 Two billion people worldwide suffer from one or more micronutrient deficiencies (vitamin and mineral deficiencies), 868 million are malnourished (insufficient energy intake), and 1.4 billion are overweight, of which 500 million are obese. 26% of children under five are stunted and 31% suffer from vitamin A deficiency.
In Malawi, official malnutrition statistics are alarmingly high, with most showing little improvement over the past 30 years. About half of children under five years old show signs of chronic malnutrition, with an estimated 48% stunted (shorter for their age), 30.6% underweight (thinner for their age), and 11.4% wasted (thinner for their age). A third of the population is energy insecure, leading to further disruptions in eating habits and reduced food intake. A quarter of women aged 40-49 are overweight (only women are measured), and micronutrient deficiency rates remain high among women and children.
FAO, with funding from the Government of Flanders through the Flanders International Cooperation Agency (FICA), is working with the Government of Malawi on a project called Improving food security and nutrition policies and programme expansion (IFSN). One component is a comprehensive nutrition education program for families with infants aged 6-24 months to prevent malnutrition.
The nutrition education programme has a dedicated component focused on developing improved complementary feeding practices and recipes using local foods. This component is divided into two levels, first developing locally appropriate information and recipes using a formative research method called Trial of Improved Practice (TIPS), which is applied to a sample of households.
The TIPS process is based on trying out infant and child feeding recommendations in a real family setting, determining what is feasible and practical for mothers, identifying motivators and constraints to behavior change, and setting medium-term goals to achieve the desired behavior. After TIPS, the recipes and behavior change information are disseminated throughout the community as part of a nutrition education program.
Impact on infant health
Naomi Tomoka, 28, from Josephi village in Kaluruma, T/A Kasungu, is one of the nine beneficiary mothers of babies in Kaluruma Extension Planning Area (EPA).
In a routine meeting with other beneficiaries, she described how miserable her life was when she had her first child before joining the program.
“My first child was often sick,” said Tomoka, a farmer and mother of three. “I often accompanied him to the hospital, which was very frustrating.”
But now that is all over. Her life took a turn last year when her third child, Victor, joined the FAO-FICA-supported Infant and Young Child Feeding Programme.
With training and support from the Agriculture Extension Development Officer, Health Surveillance Assistant and Volunteer Community Nutrition Coordinator, Tomoka is now one of nine mothers who prepare nutritious porridge for her babies and feed them at fixed times of the day depending on their age.
This nutritious porridge is made from three to four ingredients: 1) a starchy food such as mashed potatoes, cassava or cornmeal (locally known as distributed) with 2) a high-protein food (such as beans, peanut meal, fish or meat meal, or goat’s milk), mixed with 3) vegetables (such as pumpkin or green vegetables) and 4) fat (such as oil or avocado). This dish is served with fruit. The goal is to get the recommended six food groups in the baby by the end of each day.
“Now our lives have improved. Victor has never been to the hospital,” Tomoka said. “Before, children in our village were often sick, but now they are healthy and growing well,” she added.
Victor’s health passport bears witness to his mother’s heartfelt wishes. It shows that he gained weight immediately and dramatically after he started eating the nutritious porridge.
“At his age, his intelligence also seems to be more developed than my other children who have not benefited from the program,” Tomoka said with a motherly smile.
Soka Chitaya, the project manager in Kasungu district, agrees that the project has had a huge impact on the health of the babies so far, as they are no longer sick as often as before. “The health of the children has improved a lot since the implementation of the project,” Chitaya said during a visit to four nutrition project sites in the district.
About the FAO-FICA supported IFSN project
The first phase of the project was launched in 2008 and entered the second phase in April 2011, which will last for four years and end in March 2015. The second phase is being implemented in six special economic zones in the two target areas of Kasungu and Mzimba.
The overall objective of the project is to help the government achieve its development goals and improve food security and nutrition for the general population of Malawi through policy and programme advisory services, and more directly to improve the situation of vulnerable community members through direct grass-roots interventions.
The project aims to reach 15,000 food-insecure households and provide education and training support to 31,500 households and 10,500 schoolchildren in all affected areas by the end of the project.
Among other focus areas, the project addresses promoting livestock production; education on climate change, natural resources and the environment; capacity building and institutional support; increasing crop yields and diversification; promoting fruit production; soil and water conservation; drinking water and improved sanitation, as well as other cross-cutting issues such as gender, malaria and HIV.
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