By BGR Staff
The following article is based on the final report for the first year of a three-year project being implemented by Helen Keller International (HKI), a long-time BGR partner. The project, which is being funded in its entirety by BGR, aims to improve nutrition for pregnant women, infants, and children in the Korhogo District of Cote d’Ivoire. Cote d’Ivoire is among the poorest countries in the world, ranking 172nd out of 188 countries on the UNDP Human Development Index. Estimated child mortality under five years is 195 per 1,000 live births and life expectancy is just 54 years. Malnutrition, including vitamin and micro-nutrient deficiencies, is a major contributing factor to the high rate of infant mortality. Chronic malnutrition affects about 33% of children under five. Together, HKI and BGR are doing something to address this problem.
With the support of Buddhist Global Relief, Helen Keller International has launched this project to tackle malnutrition in the Korhogo Health District, located in the Poro Region in the northern part of the country, where child malnutrition is most pronounced. The overall goal of the program is to reduce the incidence of malnutrition among women of childbearing age, expectant and breast-feeding mothers, and children during their first 1,000 days of life. This enables newborns to reach a healthy start in life, decreasing the incidence of stunting and improving children’s cognitive development.
The program utilizes the Essential Nutrition Actions (ENA) framework, a package of proven, achievable interventions focused on expectant mothers and their newborn children during the first 1,000 days. Drawing on this framework, HKI is promoting optimal nutrition practices using all available platforms to reach mothers at the right time with the right message. The program promotes women’s nutrition, breastfeeding, complementary feeding, feeding the sick child, vitamin A and iodine supplementation, and the integrated control of anemia.
The project aims to train an average of five health workers at each of 77 clinics in the Korhogo Health District over a three-year period, for an estimated total of 385 health workers. HKI expects to provide approximately 77,000 expectant and nursing mothers and their children with nutrition education and services. It intends to increase the use of recommended ENA interventions—such as iron, zinc, oral rehydration salts, deworming tablets, and malaria prophylaxis—in every clinic involved in the project.
In September 2016, HKI contracted Mrs. Salimata Coulibaly to serve as master trainer in nutrition practices in the Korhogo Health District. Salimata benefited from special “train-the-trainer” sessions organized by HKI to build her capacity to reinforce health workers’ understanding of the ENA framework during a regional workshop organized for nutrition experts from French-speaking Africa.
Subsequently, Salimata trained 181 health workers in charge of nutrition at 76 health centers in Korhogo on the Essential Nutrition and Hygiene Actions during four training sessions organized at the Regional Hospital Center of Korhogo. The following topics were covered during the course: (1) nutrition of expectant and breastfeeding mothers; (2) exclusive breastfeeding for the first six months of a newborn’s life; (3) appropriate complementary feeding and continuation of breastfeeding for the first two years of a child’s life; (4) feeding the sick and malnourished child; (5) vitamin A, iron, iodine and zinc deficiency; and (6) essential actions in hygiene.
Over 34,000 expectant and breastfeeding mothers and their children benefited from nutrition coaching and cooking demonstrations. In addition, three-day coaching sessions were organized on a site-by-site basis in 32 health centers in Korhogo District in order to improve the community-based nutrition services provided. Two days were devoted to training the health workers, and one day of the training provided the health workers with an opportunity to practice their nutrition counseling skills with community members.
The project has so far been very successful. As a result of project activities, health workers are better equipped and aware of nutritional advice to provide to expectant and breastfeeding mothers, and are better prepared to provide community trainings on improved nutrition practices.
Here are a few testimonies HKI collected from health workers in the Korhogo Health District:
“The training has enabled us to start providing nutrition education, screenings for malnutrition, and treatment of moderate malnutrition cases. In the past, we were not providing those services. Following the training, we tasked a nurse from our center to implement Essential Nutrition Actions. We set up a weighing calendar for children. The women who attend our newly established cooking demonstrations are very satisfied and continue bringing their children to be weighed and measured at our center.” Dr. Traore, Lead Doctor, PMI Clinic, Korhogo
“The training was very helpful. Since we received the training, our center has started providing regular cooking demonstrations and nutrition counseling sessions to expectant and breastfeeding mothers. However, we hope to be able to better treat moderately malnourished children with the support of our partner HKI through the supply of improved porridges.” Mr. Adingra, Monitoring and Evaluation Director, Social Center 2, Korhogo.
“From the day I received the awareness training, I understood that the number of meals and the quality of food I eat plays a very important role in the health of the mother and her child. We don’t necessarily need a lot of money to eat well. Also, now I pay attention to what I eat.” Mrs. Cisse, expectant mother.
“After the awareness session in the center, I understood that because of my misunderstanding of the nutritional composition of food, I lost my first child who I did not breastfeed because I thought my own milk wasn’t good. I didn’t have enough money to buy milk powder in the pharmacy, and so I gave my child cow’s milk and porridge I bought in the market. Now I understand that for the sake of this child, I must eat well myself in order to produce milk, and I learned how to make porridge that is good for my baby.” Ouattara Karidja, breastfeeding mother.