End Malnutrition for 600 Children in Ghana

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According to the World Health Organization (WHO), proper infant nutrition is fundamental to a child’s developmental health. Feeding children correctly in the first two years of their lives is particularly important because of nutrition’s role in lowering morbidity and mortality, reducing the lifetime risk of chronic disease, and promoting healthy mental and physical development.

Although every infant and child has the right to good nutrition under the United Nations’ Convention on the Rights of the Child, in many countries less than a fourth of infants have access to the required dietary diversity and feeding frequency. Inappropriate feeding practices contribute up to a third of all cases of child malnutrition.

Self-Help International’s Promoting Good Nutrition Program (PGN) team facilitates the Growing Healthy Food, Growing Healthy Children (GHFGHC) program, which is teaching mothers in rural Ghana the importance of good nutrition through nutrition education and food demonstrations. Self-Help’s team teaches the mothers about how some foods are more nutritious than others and helps them figure out healthy food options and recipes.

As part of Self-Help’s sustainability approach to ensure community ownership, partnering mothers participate fully in all of the activities. For example, mothers in GHFGHC are involved in the preparation of a food supplement called tom brown (a porridge that consists of Quality Protein Maize (QPM) and peanuts roasted and milled together). Pregnant and lactating women receive 700g of the tom brown every week. The tom brown is supposed to last mothers and infants an entire week, but many of the mothers end up using the tom brown for their families. This means the tom brown only ends up lasting a day or two.

One of the mothers partnering with GHFGHC, Ayishetu, experienced this challenge in her household.

Ayishetu confessed that her tom brown portion was not only feeding her infant in the program - it was also feeding his siblings. As a result, the 700g of tom brown lasted for a day in her house. She said her kids love the tom brown, and she decided to explore ways that she could have enough of the tom brown in her house. 

Luckily, Ayishetu already had some QPM, so she only needed to purchase some peanuts from the market. Because of the training Ayishetu received on preparing tom brown and the help of Self-Help’s PGN team, Ayishetu had the knowledge and skills she needed to prepare the tom brown in her house to feed her family.

As a result of the COVID-19 pandemic in early 2020, Ayishetu started giving out the tom brown to other people in her community of Kukuboso because the mandated lockdown in Ghana meant that people didn’t have enough at home to eat. Price increases at the market due to the quarantine took a toll on Ayishetu’s family budget, and she realized she could increase her income by selling the tom brown. 

“I now sell some of the tom brown to other people in Kukuboso whose families have developed a taste for it, and I’m able to generate an alternative income,” Ayishetu said.

In 2019, Self-Help International provided breakfast for over 800 students from ten schools in rural Ghana, resulting in increased school enrollment and attendance. 

As more children go to school, other challenges emerge including: a lack of access to water, latrines, and trash containers. Nkwakrom, one of the rural communities with a Self-Help School Feeding Program, has boreholes (pumps to get water from the ground) supplying safe drinking water; however, the boreholes are located several meters from the primary school. 

Young children like Mary (pictured) couldn’t make the trek to fetch water, especially during school hours. Many children, including Mary, stayed dehydrated and had nowhere to wash their hands after visiting the toilet. Diarrhea, cholera and worm infestations are some of the issues that can result from lack of access to clean water.  

In response to this challenge, Self-Help Ghana’s nutrition team supplied all ten schools participating in the School Feeding Program with barrels to hold large amounts of clean water and outfitted the barrels with spigots, towels, and soap. 

The Self-Help nutrition team realised that the majority of the kids at school (not only those in the School Feeding Program) didn’t know how to properly wash their hands, especially under running water. Self-Help facilitated hand-washing trainings for all of the students at the school to teach them how to effectively wash their hands. This initiative was timely considering that the hand-washing training will not only improve the children’s health at school, it also will go a long way to keep them healthy during the COVID-19 pandemic.

This intervention has brought relief to children like Mary. They now have access to drinking water any time during school hours and don’t have to risk missing classes. They are also able to wash their hands each time they use the bathroom and before and after eating.

Mary wants to become a nurse and take care of the sick in her community, and having access to drinking water and proper sanitation at school is the first step to keeping Mary’s dream alive.

Nutrition plays a key role in the development of individuals, families, communities, and the nation of Ghana as a whole. The United Nations’ second Sustainable Development Goal calls for the total elimination of hunger and all forms of malnutrition across all ages. Poverty has rendered a great number of people food insecure, which has caused inadequate dietary intake, diseases, and malnutrition.

Self-Help International is working to tackle this development goal by addressing infant malnutrition through the Growing Healthy Food, Growing Healthy Children (GHFGHC) program. 

Alima feels that Self-Help’s GHFGHC program has benefited her entire family. Alima is not a resident of the village of Kukubuso where Self-Help has a GHFGHC group, but she attends the mosque in the community every Friday. In 2019, she was one of the women who enrolled in the GHFGHC program in Kukubuso. Although she has to walk over 5 km (over 3 mi) to Kukubuso on Tuesdays to attend the meetings, the distance does not prevent her from attending. 

According to Alima, she is motivated to come to the meeting because of the counseling and the food supplements she receives weekly. She said that she and her husband could not afford to give her child eggs, so she sees the program as a means to ensure that her children have access to good nutrition. 

“The supplement I receive from Self-Help is able to provide breakfast for my family every two days,” Alima said. “My involvement with Self-Help has helped me learn how to provide a nutritional weaning diet for my child using locally available foods, and I’m able to prepare them for my family. This has really eased the burden of providing food for the family in the morning and has also helped improve our standard of living.”

Good nutrition is an important part of living a healthy life, and food choices impact people’s health and how they feel today, tomorrow, and long into the future.

“With the help of Self-Help, my family is able to get adequate nutrients in our diet,” Alima said.

Alima shared that every aspect of her life has seen a positive change as a result from the nutrition education she is getting from Self-Help’s nutrition staff. Alima is one of the mothers who is able to provide helpful answers to questions asked during nutrition counseling sessions - an indication that she has learned something from her time with the program.

Alima has moved from thinking that every food is merely food to adopting a more conscious thought process for selecting what she feeds herself and her family. Alima gratefully thanked Self-Help for helping her family and her enjoy good, nutritious meals. 

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This report was written by Self-Help International Board Member and nutritional advisor, The Rev. Dr. Mary Jane Oakland, following a trip to Ghana in November 2019. Dr. Mary Jane Oakland is an emeritus professor of Food Science and Human Nutrition at Iowa State University. She has served on the Self-Help International Board of Directors since 2006.

Self-Help International’s Growing Healthy Food, Growing Healthy Children program is improving the health and nutritional status of pregnant and lactating women and their babies. The program provides nutrition and health education along with teaching the mothers and their families to grow ingredients for a nutritional weaning food and to participate in income generation strategies.  

Today was my last day with moms and babies in the villages of Beposo and Kukubuso, Ghana.  I saw two little toddlers who are growing and thriving despite being separated from their mothers during the all-important breastfeeding period.  Without this program of intensive nutrition support, they well may not have made it to toddlerhood.  

I have the privilege of working with two fine Ghanaian nutritionists in this program, as well as agriculture specialists and program leaders for empowering women and girls.  This whole team is changing the trajectory of the lives of women and children in a village where most scrape together an existence as share-cropping cocoa farmers.   

For women who join the program during pregnancy, all of them have been able to successfully exclusively breastfeed their babies with excellent growth patterns during the first six months.  Weaning from breast milk is a challenge because of the low nutritional value of the family diets, but we are seeing women willing to feed their babies according to the new information they learned who are having positive results. Last year, the moms and babies lost weight during the cocoa harvest, so this year all the women haven taken a pledge not to let that happen again.  The women brainstormed ways in which they can work in the fields and still feed their babies and themselves.   

There is still much work to be done - until enough food is grown and income generated so these villages are no longer perpetually hungry.  The response of the moms and their children has shown us that the stunting rates that impacted the development of the children have been dramatically improved.  

Today, I looked into bright eyes of two active toddlers.  Last year, I feared we were not going to be able to turn them toward healthy growth and development.  Thank you to all of our dedicated staff and to you, our supporters, who are helping Self-Help International make a difference in the lives of moms and babies.

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Jamilatu moved from her home near the Ivory Coast to Kumasi at just ten years old. She was staying with an aunt who had promised to pay her school fees and support her while she was in Kumasi, but her aunt did not follow through on her promise. To support herself, Jamilatu sold water on the streets, often in very dangerous road conditions. She met her husband through this work and moved to Beposo, a small village outside of Kumasi. 

Life in Beposo has been challenging. Her husband rents land to farm and making a profit off this rented land is often difficult. Jamilatu tries to supplement their income with growing and harvesting peppers, okra, and small eggplants found in West Africa known as “garden eggs.” 

When Jamilatu was five months pregnant, she was no longer able to work on her farm. She started attending Growing Healthy Food, Growing Healthy Children (GHFGHC) nutrition education sessions. She told Self-Help International nutritionists that she was not planning to receive antenatal care during her pregnancy because she already had two children and was familiar with being pregnant. Self-Help staff spent extra time counseling Jamilatu on the importance of doctors’ visits and medical care during her pregnancy, and she quickly realized how vital those visits would be. After visiting the doctor, Jamilatu learned that she was expecting twins! She was so grateful to have visited the health center. 

Jamilatu had a new onset of questions after finding out that she’d be having twins soon.

Getting Support to Have Two Healthy Babies

“Although I have two children already and I know some of the challenges that come with raising kids, I was afraid of having twins because of breastfeeding and the general care twins need,” Jamilatu shared with Self-Help nutritionists. 

Again, the Self-Help team spent extra time with Jamilatu to help ease some of her fears and equip her with the knowledge she needed to raise two healthy babies at the same time. They counseled Jamilatu through to the healthy delivery of her new babies and provided direction on breastfeeding and healthy eating for her as a new mother. 

“It took the magic of Self-Help’s staff to show me how to breastfeed children who will not open their mouth to eat,” Jamilatu said. “With my previous pregnancies, I depended on my mother to travel to Beposo to take care of me.”

Self-Help Trainings Benefit the Whole Family

In fact, Self-Help trainings have benefited Jamilatu’s whole family.

“My husband came with me to the first financial management training organized by Self-Help to help me take care of the children, and he became an unexpected beneficiary of the training,” Jamilatu said. 

Self-Help staff were discussing good financial management practices during the training. Her husband had not been sharing the family’s income with Jamilatu and had not been saving enough for the family’s supplies and necessities. After the training, he told Jamilatu that he had been listening attentively and understood that he should not be keeping money for himself. 

“He has now opened a savings account with a bank in a nearby community and has stopped spending on unnecessary items,” Jamilatu said.

Jamilatu is still involved in the program and is helping other mothers overcome any challenges they may encounter with breastfeeding. 

“I listened attentively to Self-Help staff when they were educating us on caring for our babies,” Jamilatu said. “Self-Help has indeed made me an even better mother.”