Supporting front-line health workers to end malnutrition

By Rebecca Phwitiko, UNICEF Malawi

An Out-Patient Therapeutic Clinic in session at Machinga District Hospital, Southern Malawi
© UNICEF Malawi/2019/Moving Minds Multimedia

On a bright Thursday morning some fifty or so women gather at Machinga District Hospital in Southern Malawi for a weekly ritual. They bring their children whose ages range from about a year to four years old. In front of the room two hospital staff are attending to the children- checking charts, doing tests and sending them off for appropriate assistance, medication or supplies.

Enelys Kaliwo, a senior Health Surveillance Assistant (HSA), is going around the room randomly checking on the women who are waiting their turn. Her job is to supervise the work of other community health workers who run the Out-Patient Therapeutic (OTP) Clinic to make sure the nutrition assessments are done properly, and children receive appropriate care.

Enelys has been a senior HSA in Machinga for three years and has already picked up on some of the major factors contributing to malnutrition in the area.

“The women here give birth early, and more frequently. They drop out of school at a young age and by 20 years old you find they already have at least two children. Back home in the village, people think that if a breastfeeding woman gets pregnant she should stop breastfeeding, not knowing that this puts the child in danger.  In addition, most families do not harvest enough to eat all year so by November they struggle to find food,” explains Enelys.

Patuma brings baby Angela to the weekly OTP clinic
© UNICEF Malawi/2019/Moving Minds Multimedia

A second chance for Patuma’s baby

Enelys attends to 34-year-old Patuma Linot who has brought her 13-month-old daughter Angela. Patuma is a mother of seven children. Her half-smile betrays the struggle to make ends meet. She was just 17 when she had her first child. With her husband long gone, the family depends on Patuma to provide food and it is not always easy. This year, she lost all her maize crop in the floods that swept through Southern Malawi in March.

Patuma explains that baby Angela was born two months premature and had to spend a lot of time in the hospital, including three days in the Nutrition Rehabilitation Unit. “She was so tiny and weak but now she is doing much better and is able to eat some foods. She enjoys porridge which I mix with vegetables and sometimes eggs to make it more nutritious,” says Patuma.

Patuma relies on the counsel of health workers like Enelys who come to her village to teach her and other mothers how to prepare more nutrition food from locally available and affordable resources. They also teach them to spot any signs of malnutrition.

Enelys is fresh out of a Community Management of Acute Malnutrition training, supported by UNICEF. She feels such trainings are important particularly when dealing with malnutrition cases complicated by HIV/AIDS. UNICEF also provides malnutrition treatment supplies to ensure that children who come to the hospital get the appropriate care.

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