By Nathalie Prévost
The power of mothers to screen their children for malnutrition and disease and take necessary action is proving a fierce ally in the fight against persistent malnutrition in the Niger.
ZINDER, Niger, 13 December 2013 – Zila squats down under the tree in front of her home to measure the mid–upper arm circumference of her baby daughter Mariama with a bracelet. She is checking Mariama’s nutritional status.
Zila has lost three children to malnutrition. She is determined to check 9-month-old Mariama twice a day – in the morning and in the evening.
Malnutrition in the Niger
Malnutrition is directly or indirectly responsible for 35 per cent of deaths of children under 5 in the world.
In the Niger, even during a good harvest year, malnutrition is a major issue. An annual survey conducted in 2013 concluded that the prevalence of global acute malnutrition in the country was 13 per cent.
The World Health Organization’s standard of emergency is 10 per cent.
A pilot programme supported by UNICEF and partners has started leveraging the care of mothers like Zila to fight malnutrition. The programme distributes bracelets like the one she has been using to monitor Mariama. It tells the mothers how to read the results, and what action, if any, to take.
This ‘mother screening’ approach was designed to improve the quality and coverage of care. Under the programme, parents don’t require community workers to come and screen their children or to determine whether their child requires medical attention. They can do it themselves. With screening capacity in the home, malnutrition should decline.
Diagnosing malnutrition earlier should also ensure that fewer children require urgent treatment. “If the child is brought to us early, he won’t develop complications and will be able to stay at home instead of being hospitalized in emergency,” explains Hassan Issa. Mr. Issa coordinates the mother screening project for national NGO Befen – one of UNICEF’s partners tackling treatment for acute malnutrition in this region.
To date, UNICEF has provided 20,000 bracelets.
Bracelets saving lives
Dogo, in the Zinder region, is one of the areas in which the programme has been piloted. The health centre in Dogo covers 49 villages and more than 37,000 individuals.
Mr. Issa reports that the results, so far, have been promising. “We started the distribution of [mid-upper arm circumference] bracelets to 9,500 women of childbearing age in Dogo health area,” he says. “We are very happy with the results: It works!”
Head doctor of the health centre Dr. Garba Seyni Mahamadou manages the activities of the therapeutic feeding centre for children suffering from severe and moderate acute malnutrition. The doctor is enthusiastic: “Since the beginning of the project, the number of reported cases increased. Moms are fully able to monitor the upper arm circumference of their child.”
“They are setting the bracelet correctly – and can even give details of its meaning,” he continues. “If the bracelet is in the red section, they know they should bring the child to the [therapeutic feeding centre for severe acute malnutrition offering outpatient treatment]. If it’s yellow – to the [centre for moderate acute malnutrition].”
And the programme is not limited to malnutrition. “Last, but not least,” says Dr. Mahamadou, “during a training, we explained them how to act when their child is presenting signs of disease.” Mariama and Sofiane
Mariama’s bracelet is in the yellow. Tomorrow, Zila will take her to the health centre in Dogo, a two-hour walk from their village, Jan Birgi. Mariama will receive a ration of fortified flour.
Zila’s neighbour Zoué is also screening her children. She learns that Sofiane, 3, is in a critical state. Sofiane has had bouts of acute malnutrition since the day he was born. Befen refers mother and child to Mirriah hospital, along with Zoué’s youngest child, who is still breastfed.
At the hospital, the medical staff will follow Zoué, Sofiane and the baby closely. The family is very poor, and Zoué has had closely spaced pregnancies. The staff will suggest ways that she can feed the children better. They will also suggest ways that Zoué can space out births.
In a few days, when Sofiane has gained weight and is walking again, the family will return to Jan Birgi.
During the first seven months of 2013, more than 500,000 children were treated for severe and moderate acute malnutrition in the Niger. NGOs like Befen have contributed significantly to a better approach to the persistent problem.
In the Niger, mothers are often illiterate, are married young and are not necessarily versed in how best to ensure their children’s health, particularly given scarce resources. Befen hopes that the mother screening programme will continue to be a success – empowering mothers like Zila and Zoué and ultimately contributing profoundly to their children’s well-being in the long term.