Where we work

Updates from the field

Training community volunteers in South Africa

January 2010

Benny Sikhakhane, consultant for the IYCN Project, shares his experiences working on a community-based nutritional measurement project in South Africa.

On October 20th, I conducted an orientation for 46 community volunteers, including young mothers, grandmothers, and a grandfather, who had been chosen to lead weekly nutritional measurements of children and pregnant women in Nigel, South Africa. The volunteers conducted measurements for six consecutive weeks from October to December in eight different sites that varied from open spaces, to schools, to churches, and even to a community member’s house, and allowed mothers access to important information on the growth and nutrition of their children, close to where they lived.

Members of a ward committee meet in Nigel, South Africa to discuss integrating nutrition interventions into development programs.

I trained the volunteers on how to use scales to weigh children, to measure mid-upper arm circumference (MUAC), and to record measurements for each child. I also trained them on how to interpret the data and on actions to take for children requiring urgent care. Additionally, we discussed simple messages on proper infant and young child feeding that the volunteers could share with mothers during weekly visits. The trainings had a very personal touch, as some of the volunteers brought their own children to help with practice using the scales and MUAC bands.

The ward committee, which included many of the volunteers, chose to conduct the session weekly because of their enthusiasm for the program and their desire to really connect with the care of children. I visited the sites each Friday to provide support to the volunteers and to ensure that they were measuring, recording, and interpreting the data correctly, and to provide counseling for mothers on changes in weight. I was very excited to see the great turnout and positive reaction from the community. The response was overwhelming, and most of the sites were overflowing with mothers, especially during the first three sessions. Each week, we had a total of about 250 mothers and children participate at different sites, and the volunteers showed a real ownership of the activity. In fact, at one of the sites, the volunteers dipped into their own pockets to buy batteries for a borrowed loudspeaker used to make announcements to encourage mothers to attend. At other sites, volunteers went door to door to make certain mothers and children came out for their weekly visits.

This community-based nutritional measurement project was the first activity of an innovative new partnership formed between the IYCN Project and J&J Development Projects Trust in South Africa to integrate nutrition into existing community development programs. We are employing a community development approach to mobilize communities to adapt existing structures (such as Ward Committees and municipal clinic staff) that have shown success and impact to include nutrition support in their programs. The focus is on improving the nutritional status, dietary intake, and feeding practices of infants and young children less than 2 years of age, orphans and vulnerable children up to 5 years, and pregnant and lactating women.

J&J Trust has led ongoing community development projects in South Africa, such as social cohesion through sports development and housing development aimed at improving township establishments in Nigel, a subdistrict of more than 140,000 people located outside of Johannesburg. IYCN chose to collaborate with J&J Trust in Ward 86 because it is the poorest ward in Nigel, and it is willing to address problems of malnutrition within pre-existing development projects. IYCN and J&J’s work began with a series of meetings and trainings with stakeholders and decision-makers, including the Department of Health, local government officials, and Ward Committee members, to ensure our work is in line with government priorities, and to orient them on the linkages between nutrition and development and why it is critical to integrate nutrition into the current planning process.

In addition to helping mothers track the growth of their children and understand the impact proper nutrition has on improved nutritional status and growth, we also collected a large amount of data on child growth. In collaboration with local government staff, the project team will finalize data analysis and conduct a feedback meeting with the Ward 86 Committee and key stakeholders. The meeting will include a discussion on how to integrate the findings into the ongoing community-based planning process. Additionally, we will assist the committee with conduct planning sessions to integrate nutrition into their 2010 development plan and budget.

I have seen the level of interest in nutrition in the community increase, and now members are empowered to influence the development plans of the municipality and the district to prioritize support for nutrition.

World Breastfeeding Week highlights from Haiti

August 2009

Rose Mireille Exumé, IYCN country coordinator in Haiti, shares her experience during World Breastfeeding Week in Grand Goâve and La Gonâve Island.

On Thursday, August 6, I was in Grand Goâve, a small city in southwestern Haiti, to participate in the first of several World Breastfeeding Week events. More than 400 people from the community gathered in front of a church along the main road of Grand Goâve for a celebration, organized by our partner, MDM. The organizers shared important information on breastfeeding through singing and dancing and other cultural activities. IYCN assisted by providing posters and other communications materials with key breastfeeding messages.

The crowd gathers to celebrate World Breastfeeding Week in Grand Goâve.

One of the highlights of the celebration was a ten-minute play spotlighting the importance of good breastfeeding practices. In the skit, a mother gave birth in the presence of the father, a grandmother, an educated Matrone, or traditional health worker, and a community health worker (CHW). The Matrone and the CHW shared important messages about good breastfeeding practices with the new mother such as early initiation, correct positioning, and practicing skin-to-skin contact.  

Later in the month, I traveled by motorboat to participate in extended World Breastfeeding Week activities on La Gonâve Island, an underserved area about 30 minutes northwest of Port-au-Prince. The Ministry of Health held a community event in the town of Anse-a-Galets on Sunday, August 16. Participants included members of the Ministry of Health, regional coordinators, community leaders, and hundreds of people from the community. Mothers representing nine different mothers’ support groups spoke to the crowd about their positive experiences with breastfeeding. Earlier in the week, I had joined partners from the Ministry of Health and World Vision to venture across the island to select one advocate from each of the island’s nine mothers’ support groups to speak at the event.  

Rose Mireille Exumé with a baby at the World Breastfeeding Week celebration on La Gonâve Island.

After their speeches, we selected one mother to be the ambassador of breastfeeding for all of La Gonâve Island. We chose Michelene Ineus, a 25-year-old mother who has two children including a 5-month-old baby who she is currently exclusively breastfeeding. When asked what she would do as the ambassador of breastfeeding, Michelene said she would speak with a wide range of organizations and mothers on the island to make sure they know breastfeeding is advantageous for the mother, baby, father, country, and society.

I am especially proud of Michelene because she was the representative from one of the support groups I visited, and she integrated the messages we shared with her earlier in the week. She eloquently conveyed the messages in her own words and remembered all of the important information.

These events were very important because they sensitized the community to exclusive breastfeeding practices and highlighted the role of the whole community: the mothers, the fathers, and the leaders. The community must be involved to sustain the work that the government and other partners are doing to improve nutrition.

Learn more about IYCN activities in Haiti.  

A hopeful exchange on the future of infant feeding in Kenya

August 2009

Denise Lionetti, IYCN project director, shares her experience at the National Infant and Young Child Feeding Stakeholders’ meeting below.  

During World Breastfeeding Week, I traveled to Kenya, along with my colleague Albertha Nyaku, IYCN’s nutrition advisor based in South Africa, to participate in an infant feeding stakeholders’ meeting, at the Panafric Hotel in Nairobi. We joined more than 100 colleagues from the Ministry of Public Health and Sanitation (MOH), USAID, UNCIEF, and other organizations from most provinces in the country for lively discussions and presentations during the half-day meeting.

Margaret Brawley, a program officer for PATH Kenya, at the National Infant and Young Child Feeding Stakeholders' Meeting on August 6, 2009. .

In her opening address, Linda Komen from the MOH’s Nutrition Division, expressed the Ministry’s concern about low breastfeeding rates in the country—only 2.6% of mothers exclusively breastfeed at six months. She said that breastfeeding has further deteriorated with the onset of HIV and the post-election emergency. Echoing the theme of this year’s World Breastfeeding Week, she stressed that good breastfeeding practices should not be forgotten, especially during emergencies. Learn more about infant and young child feeding in Kenya by viewing Linda Komen’s presentation.

One presentation that really stood out to the group and captured the essence of this week was by PATH’s Margaret Waithaka. She discussed the Kenya Infant Feeding Assessment, recently conducted by IYCN and PATH. The goal of the assessment was to document mothers’ and infants’ experiences during the time they stopped breastfeeding. Everyone found this presentation very informative because it gave attention to the variety of cultural practices in Kenya that are barriers to good infant feeding practices. People make a lot of assumptions about breastfeeding and having factual information gives the nutritionists a greater ability to address these issues.

During the meeting, the MOH moderated several discussions to give participants an opportunity to voice their ideas and concerns about good infant nutrition to the Ministry. The discussions were very participatory, but also very charged. Kenya lags behind other countries when it comes to breastfeeding rates and bottle feeding appears to be increasing. People are discouraged about the low rates, but there is a lot of hope and encouragement to take new approaches back to the community, such as mother-to-mother support groups, grandmothers groups, and male involvement. And while these ideas themselves are not completely novel, there was a lot of enthusiasm for implementing community-based approaches to improve infant feeding behaviors.  

Learn more about IYCN activities in Kenya.  

Pretesting in Pitseng

April 2009

Makatleho Masoabi, IYCN Country Coordinator, shares her experience with pretesting Lesotho's new infant and young child feeding training curriculum.

Thithidi, a Nutrition Officer at the Ministry of Health and Social Welfare, and Makatleho at the workshop.

In April, I worked with the Ministry of Health and Social Welfare to pretest Lesotho’s new infant and young child feeding training curriculum for health workers. More than 20 trainers from health facilities in all ten districts of the country joined us for a training workshop in the mountains of Pitseng—about a two-hour drive from the capitol city of Maseru.

We asked the trainers—mostly nurses, one doctor, and a few national stakeholders—to take turns facilitating counseling role-plays, demonstrating good breastfeeding techniques, and leading other activities. During each session of the week-long course, participants gave feedback to help us make future training workshops appropriate for health workers in their districts.

Participants at the pretest training workshop in Lesotho, April 2009.

Now, the IYCN team is updating the curriculum based on participants’ feedback. It’s our final step in assisting the government in developing the course. I am excited to help the Ministry of Health and Social Welfare launch the curriculum for training health workers across the country soon. 

One of the participants, Victor Inegbedion, a physician, told me that the training is urgently needed in the district hospital where he just started working. After seeing so many children with chronic malnutrition in his first few weeks, the training came at the right time for him to learn more about how he can offer better support for infant feeding. 

"Teaching is a passion for me,” Victor told me. “I am eager to use the curriculum and share everything that I have learned with other doctors and nurses at my hospital.”  

Learn more about IYCN activities in Lesotho.  

Photos: Aurelio Ayala III, Richard Lord, Rose Mireille Exume, Evelyn Hockstein, Christine Demmelmaier, Christine Demmelmaier