SAVE LIVES OF 600 MALNOURISHED CHILDREN IN UGANDA

Introduction

The Saving Lives of 600 malnourished children project is still being implemented by the Child and Family Foundation Uganda (CFU) to ensure that malnutrition cases in Uganda are reduced and then eliminated. The existence of malnutrition is partly due to the high cost of living in the communities with these households. The children challenged by Malnutrition in the different parts of Uganda are helped and have their lives saved. This is through nutrition screening, assessments, and management of related illnesses. Malnutrition cases fluctuate in both Rural and Urban areas of Uganda with the main causes including high prices of foodstuffs and poverty due to unemployment, especially in urban areas. CFU is delivering Nutrition-specific interventions to all the people in the Kampala division.

In the first Quarter of 2024, the number of clients has increased with more clients benefitting from the program. Most of these people know what to eat,  the problem is that they cannot afford it. Some of these households have women as their breadwinners since some men divorce and neglect the families due to various reasons.

29 children (8 MAM and 21 SAM) were identified in the last quarter by the CFU teams. Some have already recovered while others are still receiving treatment in the nutrition clinic operated at Child and Family Medical Centre where all clients are assessed whenever they come to the clinic for services, community referrals, and at immunisation. Community Health Workers or VHTs conduct nutrition assessments during home visits in the communities and send all cases of malnutrition for nutrition management at the clinic. The clients referred had either Severe Acute Malnutrition (SAM) or Moderate Acute Malnutrition (MAM). MAM patients received Nutrition education, while Patients with SAM were managed using Ready to Use Therapeutic Food (RUTF) and all other medication at a free cost. Upon attaining normal nutrition status, the clients are discharged and a follow-up visit is made after a month, before being fully discharged.

SUCCESS STORY

Kevin a 9-month-old boy born to an HIV-positive mother, was found in one of the community outreaches conducted by CFU medical center staff in which free health services are given to the underserved community members. Kevin had only been immunized once (BCG and Polio at birth) instead of the six times recommended by the Ministry of Health at 9 months. On that day, He received his second immunisation and was referred to CFU Medical Center nutrition management since his Mid upper arm circumference (MUAC) indicated Red means SAM.

At CFU Medical Center, He was reassessed, and several tests were conducted. The mother reported that her baby was too small and always had recurring diarrhea. She also narrated that she had stopped breastfeeding Kevin at one month due to her serostatus since did not want to infect her son. About failure to conduct immunization, she said that her baby was too small and thought he would get side effects. Their Mid-upper Arm Circumference (MUAC) measurements were in Red which indicated SAM.

On Assessment, Kevin had;

1. Mid upper arm circumference (MUAC): 10.0cm (R)
2. Weight: 4.1Kg
3. Length: 53.2cm
4. Respiratory rate of 47b/min

His mother presented the baby's PCR test results for HIV and they were non-reactive.

Interventions

1. Immunization
2. Blood smear to rule out Malaria.
3. Ready to Use Therapeutic Food (RUTF)
4. Nutrition counseling message with the following topics:

• Preparation of a balanced diet with locally available cheap foods
• Water Sanitation and Hygiene (WASH) by boiling drinking water and its safe Storage.
• Enriching home meals such as porridge with common foods like milk, eggs, silverfish powder, or peanut paste.
• Proper dispensing of the RUTF

During the follow-up visits, Kevin started improving gradually gaining weight as follows (4.1Kg, 4.3, 4.5, 4.8, 5.2, 5.4, 5.7. 6.0, and 6.1kg respectively) and the MUAC also increased (10.0 cm, 10.6, 10.8, 11.1, 11.7, 12.0, and 12.2cm respectively).

With the above progress, Kevin is still being followed up and will be discharged from the Outpatient Therapeutic Centre (OTC) to be followed up by the trained Community health workers in-home visits.    

1. Achievements

• Enrolment and discharge of clients from the nutrition clinic when they are well.
• Immunization for Children who had missed their routine immunization schedules.

1. Challenges

• Diarrhea is a common disease affecting the progress of the clients. This is due to poor access to safe water in the slums.
• High food prices especially in urban communities made them unable to afford the nutritious food stuff.

1. Lessons Learnt.

• Giving free health services in communities increases health-seeking behavior and early diagnosis of diseases.
• More malnutrition cases are identified when Community Health Teams conduct nutrition assessments in communities.
• Timely referral for early interventions saves the client's life.

Conclusion

• There are many causes of malnutrition in our communities which calls for continuous interventions and need for more support to save the lives of these children. Child and Family Foundation Uganda (CFU) is still focused on making this happen since a lot of children are benefiting from this great project and their lives are being improved. We greatly thank the GlobalGiving community for the support. The communities appreciate the efforts.

1. Introduction

Child and Family Foundation Uganda (CFU) is gladly still taking the lead to ensure that children challenged by Malnutrition in different parts of Uganda are helped and have their lives saved. This is through nutrition screening and assessments, treatment, and management of related illnesses. Malnutrition cases are still rampant in both Rural and Urban areas of Uganda with the main cause being high prices of food stuffs and poverty due to unemployment, especially in urban areas. CFU is delivering Nutrition interventions to all the people in the Kampala division

In the last Quarter, after training the community health workers about nutrition assessments, CFU distributed nutrition assessment tools such as MUAC tapes which are being used for nutrition assessments. We also conducted community dialogues with the local leaders, community members, as well as health workers to discuss what best can be done to curb the cases of malnutrition occurring in the urban areas yet it would have been low since most of these people are middle class and know what to feed on. Poverty was mentioned as the cause of the malnutrition.  

40 Integrated community outreaches were conducted in the communities. This was aimed at screening for malnutrition and delivering Maternal Child Health and Nutrition services to underserved urban communities. 86 children (71 MAM and 15 SAM) were identified by the community teams. Some have already recovered while others are still receiving treatment in the nutrition clinic.  

CFU operates a Nutrition clinic at the Child and Family Medical Centre where all clients are assessed whenever they come to the clinic. Community Health Workers or VHTs also conduct nutrition assessments in the communities and send all cases of malnutrition for nutrition management at the clinic. The clients referred had either Severe Acute Malnutrition (SAM) or Moderate Acute Malnutrition (MAM). MAM patients received Nutrition education, while Patients with SAM were managed using Ready to Use Therapeutic Food (RUTF) and all other medication at a free cost. These clients are later discharged once they attain a normal nutrition status.   

SUCCESS STORY

Pauline and Gloria are 10-month-old twins born to an HIV-positive mother, who were referred to CFU medical center by a Community Health Worker. Her main concern was that the babies were too small, sickly, and had a very low appetite. Their Mid-upper Arm Circumference (MUAC) measurements were in Red which indicated SAM. The twins were brought to CFU by their mother for treatment on 6th October 2023.

On Assessment, Pauline had;

1. Mid-upper arm circumference (MUAC): 11.1cm (R)
2. Weight: 5.2Kg
3. Length: 58cm
4. Respiratory rate of 46b/min

Gloria had;

1. Mid-upper arm circumference (MUAC): 11.3cm (R)
2. Weight: 5.6Kg
3. Length: 59.5cm
4. Respiratory rate of 48b/min

These children had missed two previous schedules of their Immunisation. The PCR test for HIV for the children were nonreactive (negative)

Interventions

1. Blood smear to rule out Malaria.
2. Immunization
3. Ready to Use Therapeutic Food (RUTF)
4. Nutrition counseling message with the following topics:

• Proper use of the RUTF
• Preparation of a balanced diet with locally available cheap foods
• Water Sanitation and Hygiene (WASH) by boiling drinking water and its safe Storage.
• Enriching home meals such as porridges with common foods.

During the follow-up visits, Pauline started improving gradually gaining weight as follows (5.2Kg, 5.7, 6.0, 6.0, and 6.2kg respectively) and the MUAC also increased (11.1 cm, 11.4, 12.0, 12.2cm Green, and 12.4cm respectively).

Gloria started improving gradually gaining weight as follows (5.6 kg, 5.9, 6.0, 6.6, and 6.7kg respectively) and the MUAC also increased (11.3 cm, 11.6, 12.1, 12.4cm Green, and 12.5cm respectively).  With the above progress, the twins are going to be discharged from the Outpatient Therapeutic Centre (OTC), to be followed up by the trained Community health workers in-home visits.    

Achievements

• A lot of children were screened for malnutrition and well managed at the clinic.
• Children who had missed their routine immunization schedules received the respective vaccines.

 Challenges

• High food prices especially in urban communities made them unable to afford the nutritious food stuff.

 Lessons Learnt.

• Refresher training for health workers leads to more accurate measurements.
• Supporting Community Health Teams to conduct nutrition assessments in communities increases the number of children found and enrolled for management.
• Timely referral for early interventions saves the client's life.
•  

Conclusion

• A lot of children are benefiting from this great project and their lives are being improved through the services given to them. Great thanks to the GlobalGiving community for the support and more is still needed to extend the services further to more beneficiaries in the underserved communities.