Prescribing knowledge as a cure for malnutrition

According to Unicef, Kenya records as high as 12 per cent of children born have low birth weight.

In Summary

•After a mother learnt what she and her children needed to eat, she needed help to get the food.

•And when she did, her creativity saved more than her children.

Josephine Kericho’s sons, now healthier, playing with her phone in the ATPU facility where there were born in Isiolo County, Kenya.
Josephine Kericho’s sons, now healthier, playing with her phone in the ATPU facility where there were born in Isiolo County, Kenya.
Image: LAMECK ODODO

So many things were working against the pregnancy of Josephine Kericho, a mother of five in Ngusoro village in Isiolo County in Eastern Kenya.

She did not regularly visit a health facility for any check-ups. At the same time, the World Health Organisation (WHO) stresses that a pregnant woman needs a nutritious and safe diet to establish sufficient reserves for her survival and her unborn child's. Still, there was hardly any money for her to purchase the food. 

“I did not even know I was carrying twins,” she said.

Clasping her hands as she plays with her eight-month-old twins, Josephine says that her memories of her pregnancy are those of hunger and exhaustion.

So severe was her case that when a community health volunteer passed by her house in the usual house-to-house calls, he recommended that she goes to the nearest health facility, the ATPU Health Centre. At the health facility, the clinician told her that she was anaemic. 

Apart from the anaemia, women like Josephine face other life-threatening challenges, such as delivering babies with low birth weights.

Josephine Kericho breastfeeding one of her sons during an interview in her home in Ngusoro village in Isiolo County in Eastern Kenya in July 2021.
Josephine Kericho breastfeeding one of her sons during an interview in her home in Ngusoro village in Isiolo County in Eastern Kenya in July 2021.
Image: LAMECK ODODO

According to Unicef, Kenya records as high as 12 per cent of children born have low birth weight. When she delivered her babies, they were underweight, and so was she. 

“I was so tired I passed out after the delivery and woke up seven hours later,” she said.

Josephine said that while delivering her child, she learnt the importance of seeking health services from the facility.

The community health volunteers from this ATPU facility taught her what she needed to eat and why. She also learnt about the mid-upper arm circumference (MUAC) tape, a colour-coded paper strip that looks like the tailor’s measuring, which can guide the mother to know the degree of malnutrition.

When the circumference ends at the green, the mother knows it is a safe well-nourished child. Yellow shows the baby has moderate acute malnutrition.

Action Against Hunger piloted MUAC tapes in Isiolo between 2017 and 2018 and showed that mothers and families could screen for acute malnutrition independently instead of waiting for health workers.

In areas with other barriers to seeking care, caregivers can refer themselves to the facilities, reducing the alarming numbers of malnutrition in Kenya.

What put her in this dire situation— poverty and not knowing what foods to eat— was not solved, and the situation deteriorated when she took her children back home.

As a small-scale farmer, it did not help her that the rains failed in 2021. The government’s record reported ghastly statistics that more than 10 per cent of the children in Isiolo County were malnourished.

To fend for herself and her children, the new mother left her home to till the lands, leaving her already malnourished children deprived of the first line of defence, her breast milk given to them exclusively for the first six months of their lives. 

“The babies’ health deteriorated even further,” she said. 

When she used the MUAC on her children, the babies' circumferences were red, a sign of life-threatening, severe acute malnutrition that needed immediate medical attention.

So, she took the babies back to the health facility, where the health workers prescribed and administered lifesaving Ready to Use Therapeutic Foods (RUTFs).

With support from global financial firm UBS, Action Against Hunger has supplied Isiolo with cans of the much-needed RUTFs that have saved babies' lives, such as Josephine’s.

Dan Cliff Mbura, Action Against Hunger’s nutrition programme manager at Isiolo County, said nutrition averts pregnancy-related deaths. Mothers should eat meals rich in fruits, vegetables, dairy, fish and meat. Dancliff said. 

“It is important that mothers have nutritious diets during pregnancy for the baby, especially breastfeeding when they need more energy and nutrients,” Dan said. 

Mr Mbura acknowledges that even when mothers know what to eat, they may not afford it. Through the cash transfer, Josephine got Sh3,000 (about US$30) each month for three months. The money was more than food for the mother of five. As a result, she reduced her time in the scorching sun looking for food and dedicated more time to breastfeeding her children.

When the burden of food was out of the way, Josephine had room to explore her enterprises and creativity to attend to her first love, farming. Part of the money she got from the cash transfer augmented her earnings from tilling the land and buying seeds for her farm.

She now keeps goats and awaits to harvest her first batch of onions and kale. The mother of twins runs the village kiosk, which stocks household items such as sugar, salt and cooking oil.

A hard worker, Josephine joined the Ngaika Mothers Village Savings and Loan Association (VSLA) group. Together with other women, she saves her money and expects interest at the end of the year, a lump sum that she says she will use to invest in her farming business.

This story is part of the “Focus on the North” project produced in collaboration with Defrontera Media Group in the Star’s solutions journalism initiative.

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