End Malnutrition for 600 Children in Ghana

Good nutrition plays a crucial role in a person’s life and serves as an important tool in preventing numerous diseases. It is imperative that children receive the nutrients they need for their growth and brain development, especially in the first 1,000 days of their lives. This critical stage in development can affect children throughout their entire lives.

Parents in the Growing Healthy Food, Growing Healthy Children (GHFGHC) program at Self-Help International are very concerned about the growth and development of their children. Some parents only feed their children staple foods like cassava or yams (mainly carbohydrates) which don’t provide adequate protein. As a result, their children experience protein energy malnutrition (PEM). Self-Help is working with mothers in two communities in Ghana - Beposo and Kukubuso - to ensure mothers have access to quality protein maize (QPM) for their families’ porridge, animal protein from eggs, and the knowledge to take care of themselves and their babies.

Afia is a 45-year-old mother of six living in the village of Beposo who has partnered with GHFGHC. According to Afia, she ate mostly carbohydrates prior to connecting with the GHFGHC program. The program and Self-Help’s staff nutritionists helped to reshape her choice of food to incorporate vegetables and forms of protein into her diet. She said she was not prioritizing eating fruits and vegetables because she did not know that they  contain nutrients that are important to the body. 

“The staff’s nutrition counseling has taught me that I need to add protein, fruits, and vegetables to my diet,” Afia shared. 

Madam Afia sees her daughter’s growth and development and attributes that to the eggs and the protein-rich porridge she fed her as a baby. She noted that the growth of her youngest child compared to her previous children has been different.

“[My daughter] is growing healthier and I haven’t incurred the same hospital bills. My older children used to fall sick when they were younger, but [my youngest daughter’s] case has been different - she is almost two years old and we have never been to the hospital,” Afia said.

“My daughter likes eggs and tom brown (a porridge that consists of QPM and peanuts roasted and milled together),” Afia said. “Some children only eat egg yolks and reject the [egg white], while others only like the [egg white]; but my daughter eats both the yolk and the [egg white].”

Afia said that through the program, she has learned how to diversify the weaning food she is giving to her youngest daughter by incorporating more nutrient-rich ingredients.

“I have moved on from preparing porridge with only corn and sugar to preparing more nutrient rich porridges with ingredients like corn, sugar, powdered fish, soya beans, groundnut paste or whole egg.” 

Through nutrition education, mothers like Afia are learning how to implement changes in their families’ diets that will have lasting effects on their children as they grow and develop.

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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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