Get it right, compose it right, start it right and feed it right is all it takes to raise a healthy, bouncy baby who will grow healthier, smarter, and stronger to benefit a family and society in general.
The Ghana Health Service professionals and other stakeholders in health have put in place a lot of efforts in providing health and nutrition education and counseling to pregnant and breastfeeding mothers and caregivers on appropriate infant and young child feeding and nutrition during antenatal, postnatal, and home visits. However, the challenges of caregivers being able to translate these learnings and counselings into practice have always persisted.
The Generating Revenues and Opportunities for Women to Improve Nutrition in Ghana (GROWING) Project is an integrated Climate Smart, Agriculture-Nutrition-Marketing action research project implemented by the International Potato Centre (CIP) in partnership with Care International in Ghana, the Ghana Health Service (GHS), and the Ministry of Food and Agriculture (MoFA). The GROWING project adapted a behavior change nutrition module which facilitates nutrition trainings by organizing female and male members of farm households into clubs known as Growing Futures Clubs (GFCs), which seek to help households learn healthy nutritional behaviors using the “learning by practice approach”.
This, the GFC Nutrition Modules do by engaging households with visual tools and skills training on adequate maternal nutrition for exclusive breastfeeding, appropriate infant and young child feeding and nutrition practices, promoting inclusive household decision-making and good water and sanitation practices for good maternal and child health.
What is the Healthy Baby Toolkit?
TGhana Health Service has always used tools such as job aids and counseling cards, including dummies in training and counseling of caregivers in their nutrition education sessions. However, without the support of innovative approaches it is challenging to translate abstract and imaginary information into actual practice. The GROWING project’s Healthy Baby Tool Kits (HBTK) is one of such innovative tools that has been properly demonstrated by CIP in East Africa.
The HBTK refers to a demarcated sizeable bowl with a slotted spoon and a counseling card designed to aid pregnant and breastfeeding mothers – and other caregivers, with limited literacy – to improve infant and young child feeding practices. The locally contextualized nutrition Counseling Card is used alongside the bowl and spoon to increase mothers’ nutritional knowledge and diversify the family’s diet.
While the slotted spoon is aimed at aiding mothers to determine the consistency of their baby’s food when introducing complementary feedings at six months, the bowl helps them with frequency of feeding and the quantity to give per feeding session.
My mathematics has not failed me:
This GFC Nutrition Module has seen interesting revelations, by project beneficiaries, on the diversity of opinions regarding the use of the HBTK during training sessions. So far, in our engagement with beneficiaries on this project, we have no less than 36 communities covering a beneficiary population of about two thousand-three hundred.
The above caption “my mathematics has not failed me” is inspired by our interactions with the beneficiaries from these communities. For instance, in the Lower Buteon community in the Saboba District of the Northern Region of Ghana, a beneficiary remarked during a session recap in the local dialect” Maa ki kpa limukl ki jocha Maa ga kpin mabo tijikaar” which literally means “I have no more difficulty in determining the quantity of food my baby should feed on”.
In the Alhassankurah community in the West Gonja Municipality of the Savannah Region of Ghana, another beneficiary indicated with excitement that “the quantity of food is equivalent to the age of my child!”
The above excerpts are suggestive of how the HBTK has simplified the mathematics of beneficiaries, particularly those with low literacy levels, in relation to the quantity of food that children should have for healthy growth and development based on their age. Indeed, the simplistic mathematics of the HBTK has not failed the beneficiary communities.
The mark is my main.
Home visits are an integral part of the GFC Nutrition Module. “The mark is my main” caption was carved during one of such visits to a GFC beneficiary. GFC nutrition trainings have revealed that beneficiaries are used to the traditional mode of feeding babies. This was the challenge of introducing the HBTK of this nature. Interactions with some project beneficiaries have indicated that there are a lot of benefits from the use of the toolkit bowl. The following are some experiences shared by beneficiaries.
In the Sumniboma community in the East Mamprusi Municipality of the North-East Region, one beneficiary exclaimed “once there is a mark, my main objective is achieved!”
A similar remark was captured at Alhassankurah in the West Gonja Municipality of the Savannah region where a GFC member indicated to the effect that the lines in the bowl are my pointers.
Schooled to spoon
“With just a small spoon, I am able to know if my 6 months old Rawudatu’s kooko is thick enough to make her full”, remarked Sahada Ibrahim! From Bowko Community in the East Mamprusi Municipality. For Ibrahim Abubakari, his understanding of the use of the bowl will enable him to help his wife Sala Ibrahim to eat well for strength to be able to feed their 3 months old baby Rahama Ibrahim!
He states as follows: “the way Sala has been complaining of tiredness anytime Rahama feeds, I concluded that the breastfeeding was draining her”. Indeed, Faustina Tia, simply put it thus “I have been schooled to spoon today”. The above comments are views expressed by mothers and fathers who are GFC members and have participated in the nutrition module trainings on how to use the HBTK.
To the Community Health Officers (CHOs), the HBTK has made their nutrition counseling and education more practical as they are able to get communities to learn by doing. Mothers are now able to practically demonstrate consistency, amount, and diversity in their homes using the slotted spoon and the counseling card. CHOs stated to the effect that they have always had the challenge of getting men to support their wives with child feeding but they are now beginning to see more men actively participating in the trainings. The aforementioned excerpts give the project team the immediate impression of the positive effect that the training on the HBTK is beginning to influence members behavioral change regarding infant and young child feeding practices.
Conclusion and the way forward.
In summary, learning by doing with the HBTKs has the potential to influence the adoption of new views on nutrition and influence the change of behavior in communities. The GROWING project is promoting nutritious crops (Orange-fleshed Sweetpotato, Papaya, Amaranth, Moringa and legumes) in a nutrition-sensitive approach and hence, changing the nutrition related behaviors of farm households could support both men and women farmers adopt the production and consumption of these crops.
The above feedback indicates that, caregivers and for that matter both fathers and mothers have seen and acknowledged the benefits of the HBTK. The major challenge with implementing this innovation so far has been the low participation of men and the unavailability of means of transport for health staff to visit GFC members at home to assist them implement their new learnt ideas for possible adoption.
However, the ability of CHOs to conduct home visits to support GFC members in fully practicing their newly acquired knowledge and skills from the innovation would facilitate behaviour change in a more vigorous and sustainable way. The assumption that nutrition is the role of women according to the local gender-based division of roles therefore suggests that gender transformative nutrition interventions are crucial. More is yet to be done towards the institutionalization of the nutrition training approach for wider scaling and making the HBTKs locally available.
Article written by Dorothy Aawulenaa. Contributions made by Birhanu Biazin Temesgen, Joanna Dove and Dr. Clement K. Kubuga
Acknowledgement
This activity was made possible through support provided by the Global Affairs Canada (GAC). CIP partnered with CARE International in Ghana, Ministry of Food and Agriculture (MOFA), the Ghana Health Services (GHS), and the University of Development Studies (UDS) for the implementation of the GROWING Project. The opinions expressed in this activity are those of the authors and do not necessarily reflect the views of GAC, CARE International, MOFA, GHS, and UDS.
Post a Comment