2.1 Activity Description
A total of 24 outreaches were done In Kanyanya, Kawempe I and Kawempe II parishes (Kiganda, Ttula, kirokole, kiyanja, ssebagala and Lutunda zones).
In Kawempe, 398 children were screened for malnutrition of which 16 cases of malnutrition were managed in the months of April, May, and June 2022. These children were found during the various malnutrition screening activities conducted within the quarter and at the different health centers within the Kawempe North constituency. The primary cause of malnutrition is poverty, especially among the town dwellers who at times are referred to as the “Urban poor”
Most of the “Urban poor” survive on only one meal a day if they get a chance to have it. The meal consumed by the family may be deficient in the required food values especially proteins since they mainly afford carbohydrates from root tubers such as Cassava. This leads to excessive hunger in the homes and later Malnutrition kicks in. The members of these households do not know about nutrition and the foods they need to eat to eradicate malnutrition in their families.
During the various community visit sessions, we discovered that malnutrition is high among children with disabilities such as Cerebral Palsy. Some of these children have difficulty swallowing or chewing, reducing the amount of nutrients they take. They also have a problem with the digestion of the food they are given which leads to malnutrition after some period.
At Child and Family Foundation Branch in the Kamuli district, a total of 78 children were screened for malnutrition which included those attending OPD and Static Immunization clinic. Among them, 3 were found malnourished. They were enrolled in the nutrition clinic for management.
A food demonstration was conducted, and the members were taught how to prepare enriched porridges. Cereal porridges are commonly prepared which provide carbohydrates and ensure satiety of an individual but are deficient in Proteins. The addition of high-value proteins makes the Cereal porridges more nutritious for the individuals hence reducing the chances of malnutrition occurrences at affordable costs. This also brings about sustainability since the foods used to enrich the cereal porridges are affordable in the communities.
These porridges were enriched as follows:
- Millet porridge with milk
- Millet porridge with eggs.
- Millet porridge with simsim and peanut butter.
- Millet porridge with silverfish.
Personal hygiene was emphasized as a basic point to prevent other illnesses such as diarrhea which in turn affect the nutrition status of the individuals. The mothers were taught that proper sanitation in their communities and personal hygiene are very instrumental in the eradication of water-borne diseases which according to the World Health Organization are immediate causes of Malnutrition.
The mothers were also tasked to arrange the foods according to the food values they provide to the body. The foods included eggs, milk, millet, mangoes, nakati, red amaranthus, yellow bananas, silverfish, simsim and peanut butter, and sugar.
After the training, the mothers were able to group the foods according to their food values
Nakamaanya Nimura, a 7month old baby girl from Lutunda zone, in Kawempe division was referred to Child and Family Foundation Uganda (CFU) by the Community Health Team members attached to Child and Family medical center on 27th April 2022.
The mother narrated that her daughter had recurrent diarrhea and she was not looking healthy compared to the children of her age. When the community health worker assessed the baby, He told her it was because of “Poor feeding”. She was then referred to CFU for nutrition management.
Nimura was presenting with 5 episodes of watery diarrhea in the week as reported by the mother, with no fever and a slight cough. She was still breastfeeding with complementary feeds.
On Examination, Nimura had a fair general condition, well perfused, no dehydration, and a clear chest with:
- Respiratory rate of 52b/min
- Weight: 5.6kg
- Length: 64.5cm
- Mid upper arm circumference (MUAC): 11.2cm (R)
She was diagnosed with Acute watery diarrhea of Severe Acute Malnutrition (S.A.M). as shown below.
Medical Findings after Examination
- An oral Rehydration Solution was prescribed after every motion to prevent dehydration.
- Septrin tablets for the cough.
- Maternal HIV status was investigated in the laboratory and fortunately, it was non-reactive (HIV negative), which ruled out chances of the baby being HIV-exposed.
- The mother received a session of Health Education which included:
- The importance of eating a balanced diet to Nimura and the entire family.
- Proper sanitation was emphasized to prevent other occurrences of diarrhea.
- Preparation of Enriched porridges
- Preparation of a triple mix (Kitoobero)
- A food demonstration during one of the subsequent review visits.
On the scheduled review days, Nimura started to improve greatly, with a significant weight gain (5.6kg, 5.8, 6.2,6.5, 6.7, and 6.8kg respectively.) and the MUAC also increased (11.2cm, 11.3, 11.4, 11.5, 11.7 and 11.8cm respectively). The steady gain amused the mother because she was using affordable food items to treat her daughter.