Late last year, Uganda unveiled an integrated early childhood development policy meant to guide the country towards achieving holistic growth for children.
The policy includes an array of strategies and services that “provide basic health care, adequate nutrition, and nurturing and stimulation” in a caring, secure and safe environment.
As a result, Uganda is currently among a few countries that have their eyes trained on the welfare of pre-school and school-going children with the belief that a healthy nation starts at conception.
Among the issues that the country’s health ministry, in collaboration with partners, is hoping to significantly reduce is the level of malnutrition in the country, something the ministry is tackling through various programmes.
One year on, a team comprising fellows of the International Centre for Journalists set out to assess a model programme at Kabale District in the western region of the country.
We navigated the hilly region of Kabale to make our way to Muko sub-county, a quiet region in the expansive hilly district. It was here that we caught up with Amos Tugumisirize, a village nutrition teacher, as he was making his routine visits to groups of women taking classes on how to make more nutritious food.
A member of the Bwindi Bacara Turinda Amagara (We Save Our Own Lives) group was hosting Tugumisirize and his monthly class in her tiny compound. The session was attended by dozens of adults, some with children in tow.
Tugumisirize’s mission has remained the same for the past six years: to help the sub-county out of the dubious reputation as one of the most “malnourished areas”. The 30-year-old educates 22 groups in the sub-county on how to use locally available foods to create balanced diets.
His aim, and that of Community Connect, the project he represents, is to completely eradicate malnutrition in the area. Through the monthly classes the women are taught about the importance of proper nutrition for children, especially during the first 1,000 days of life.
“Ensuring a balanced diet for children does not require buying expensive foods; what is needed is for them to use the available foods in the farms as they supply all the necessary nutrients,” he said.
The Community Connect programme was established in 2011 as cases of malnutrition in Western region (Uganda’s bread basket) rose. “People used to sell all their produce and either be left with too little to eat or resort to buying alternatives like baked breads, most of which are not as nutritious as the sweet potatoes they cultivate for sale.”
The 2011 Uganda Health Demographic Survey showed that 45 per cent and 19 per cent of children in the Western region of the country were stunted and underweight, respectively. Currently, only 3.7 per cent of children are wasted and 9.8 per cent are stunted in Kigezi region, which constitutes Muko sub-county, according to the latest Health Demographic Survey.
Since then, Tugumisirize says, incidence of malnutrition among children have gone down to about three cases from over 30 in 100 children per sub-county.
Tugumisirize is one of the village health teachers trained by Uganda’s ministry of health and Unicef to ensure continuity of provision of health at the community level.
“During the classes, we touch on every bit of child health. We come with height boards to test for stunting and weighing scales for weight measurements,” he said. During a class, Tugumisirize sets up a display of various nutritious foods to help the attendees further relate with the lesson.
The session we attended had a table displaying dried omena, avocado, pumpkin seeds, a variety of fruits, beans, eggplants, sorghum and eggs, products that were all sourced from members’ farms.
The plant-based foods easily grow in the area whose mean annual rainfall is from 1,000mm to 1480mm and falls twice every year during the months of March to May and September to November, according to Uganda’s meteorological department.
Omena, also known as the silver cyprinid, Lake Victoria sardine or mukene, is a small silvery freshwater fish that only grows to a maximum length of about nine centimetres. It is readily available from Lake Victoria and can be bought in quantities costing less than a dollar.
Using a traditional stone grinder and with Tugumisirize’s guidance, the members crashed the ingredients including omena, dried stinging nettle, sweet potatoes, pumpkin seeds, sorghum and beans to make porridge. Blended avocado, fruit juice and an egg were later added to the pot just before it was removed from the fire.
“We encourage mothers to give the porridge to their children every three hours, and this has greatly helped to reduce the number of malnourished children per group,” he said.
Sorghum, which is the main base of the porridge, is a good source of nutrients including dietary fibre, carbohydrates, starch and also rich in magnesium, iron, copper, calcium, phosphorous and potassium, according to the Food and Agriculture Organisation (FA0).
Avocado has high fat content and vitamins while stinging nettle is rich in vitamins.
Beans, Omena and eggs are a good source of protein, while pumpkin seeds are rich in zinc and fruits contain vitamin.
The eggplant has a number of nutrients including dietary fibre and vitamin K. Maureen Karugyado, a 23-year-old single mother of a two-year-old boy, is one of the hundreds of beneficiaries of the Community Connect nutrition class.
Having become pregnant at a young age and unable to afford the less-than-a-dollar fee for a visit to a health facility, she missed out on all four of the recommended ante-natal clinics (ANC), leaving her to grapple with raising a baby with limited knowledge.
“I was referred to the group by a friend and got great support from some members during my pregnancy. After giving birth, they also encouraged me to exclusively breast feed for the first six months, and later I learnt how to make nutritious meals for the baby through the Community Connect classes,” she said.