How family screening checks malnutrition in children in Borno, others

The growing rate of malnutrition in the northern states has underscored the need for initiatives that help to shore up prevention and treatment of the condition in children. One of the measures being adopted is the family screening approach. Another one is women groups across wards communities organised by community volunteers and mobilizers where mothers […]

The growing rate of malnutrition in the northern states has underscored the need for initiatives that help to shore up prevention and treatment of the condition in children.

One of the measures being adopted is the family screening approach. Another one is women groups across wards communities organised by community volunteers and mobilizers where mothers are taught exclusive breast feeding and other ways  to ensure optimal nutrition in their children.

Mothers and nutrition stakeholders in Borno said the approaches are helping to mitigate and ensure timely intervention for malnourished children.

According to the United Nations Children’s Fund (UNICEF), children in BAY (Borno, Adamawa, Yobe) states are battling escalating levels of malnutrition.

The UNICEF Chief of Field Office, Maiduguri Dr. Tushar Rane said approximately 2.8 million children under five and pregnant and lactating women (PLWs) were in need of preventive nutrition services.

He said 206,779 pregnant and lactating women were expected to suffer acute malnutrition if there was no intervention.

“As you are all aware, malnutrition is a present threat affecting children who are already dealing with multiple vulnerabilities,” he said in Maiduguri, Borno State during a child malnutrition media dialogue and capacity building for journalists, organised by UNICEF Nigeria Office, in collaboration with the Child Rights Information Bureau (CRIB) of the Federal Ministry of Information and Culture.

He said across the BAY states, UNICEF and the Borno State Primary Health Care Board are adopting a proactive screening approach to identify children with Severe Acute Malnutrition (SAM).

He said, “Across Northeast Nigeria, the family approach to malnutrition screening has led to the empowerment of more than 100,000 caregivers to screen and identify children with acute malnutrition.

“Mothers play a crucial role and contribute to promoting the health of their children to ensure proper growth and development.”

He explained that the aim of the family screening approach is to shorten the identification, referral and treatment gap and also train caregivers to provide household screening for their children, using the Mid-Upper Arm Circumference (MUAC) tape.

Rane further said UNICEF is excited that this approach is already yielding results. In Banki, a community in Borno State, more than 1 in 4 children (30%) receiving acute malnutrition treatment are identified through the family screening approach.

He added that the family approach is a game changer leading to prompt and early identification of children with acute malnutrition than in previous years

Our experiences- mothers, nutrition mobilizers

Aisha Mohammed, 30 is one of the mothers who received the MUAC tapes distributed to women in her community.

She belongs to the Alheri women group, one of the two women support groups under a lead mother in the Maari Ward, Maiduguri where mothers meet to learn about nutrition for children.

However, none of her children has so far tested positive to malnutrition because of her learnings from the meetings.

Aisha, who held her eight months old son whom she had exclusively breast fed for six months said she learnt about exclusive breast feeding from the group and is also learning further ways to feed him along with breast milk. She said her child has been very healthy

Another mother, Kalthun Bukar, 30, joined the group when she was pregnant. She applied what she learnt from the nutrition volunteers.

She said her five months old son is healthy and looks bigger than he really is because she has been doing exclusive breast feeding.

Hussaina Aba Ibrahim, a nutrition volunteer, who oversees the Alheri and Godiya groups in the ward said the women were trained on how to use the MUAC tapes.

She said it was not initially easy to convince women about exclusive breastfeeding and other preventative measures against malnutrition.

She added that since the nutrition programmes from UNICEF in collaboration with other partners commenced, the women have been learning about preventing malnutrition and applying it.

She said, “Especially for hygiene; before they thought that they could not wash their hands without detergent but now they learnt that they can use ash.

“Poor hygiene was one of the reasons why their children were having malnutrition but now the percentage of children suffering in the area has reduced. Also, for exclusive breast feeding, they used to believe that Maiduguri is hot and babies need to drink water but they were enlightened that breast milk contains water for their babies under six months.”

Priscilla Bayo Nicholas nutrition specialist for UNICEF, focused on malnutrition prevention in Borno state said with the family screening approach, “Now 40% of admission cases that we treat in facilities are referred by the mothers of the children”.

She said it was cost effective, adding that UNICEF in collaboration with the state government works for prevention and treatment.

She said “Prevention of malnutrition comes first then when it fails, there must be treatment.”

She said mothers at the support groups are counselled and sensitised on nutritious foods.

While saying the groups operate without any form of payment or incentives, she explained that the family screening approach involves giving mothers the tape to measure children themselves.

She said, “It is colour coded because most of them cannot read and write; red, yellow and green.

“So the mothers are trained that if you see red is dangerous, take the child immediately to the health facility.

“When it is green it means the mother is feeding the child well.  What we do is give mothers the MUAC tape and only train them on how to use it.

“This is one way of sustaining screening at the household level and also at the community. In the future, we don’t need to pay people to go and screen. Mother’s will screen their children, bring them to the facility and get services.”

She added that there were over 4, 000 women support groups across the country and over a 1,000 in Maiduguri.

“The support group is one of our initiatives to be able to reach mothers because some of these mothers don’t come to facilities,” she added.

Grace Chindam,  nutrition Supervisor in charge of  Mairi Ward said nutrition officers were able to wither resistance to the initiatives in the community with support of the Bulama in the area.

On the family screening approach she said, “It has really been helpful for women to do it themselves. We have community mobilisers, but they can’t be every where at the same time. “

Simon Solomon, nutrition facilitator covering Jere LGA said the initiative has helped shore up screening for malnutrition, thus reducing the burden of going house to house to screen children.

The UNICEF Chief of Field Office, Maiduguri Dr. Tushar Rane said nutrition programmes in the North- East states  were integrated within government health facilities where there are 765 outpatient treatment programme (OTP) sites in the BAY states providing treatment for children with SAM without medical complications, and 50 Stabilisation Centres (SCs) treating SAM with medical complications.

He said with support from UNICEF and donors such as the United Kingdom Government (UKAid) and the German Ministry for Economic Cooperation and Development (BMZ), among other donors, government across the BAY states were currently supporting 4,383 child nutrition mobilisers (CNMs) supporting malnutrition screening at the community levels.

He said, “The CNMs are an important link in the nutrition system. They reinforce nutrition best practices in the communities and, from house to house, they build the capacity of mothers to screen their children.”