Integrated Mother and Child Health Support (IMCHS) program in Ethiopia

EthiopiaA new focus for sharing Life & Love!

Cabrini Ministries Ethiopia (CME) continues its journey to serve the most vulnerable people in our community who are women and children. In such a patriarchal and rural society, it is difficult to find a voice for women and children. CME is not seeking to just give a voice to these children but it seeks to give a lifeline to Mothers and Children who have become victims of malnutrition and inaccessible health services.

CME has officially launched an Integrated Mother and Child Health Support (IMCHS) program. This program is aimed at supporting children suffering from malnutrition using a two-prong approach – Preventative and Curative.

The preventative program focuses on pregnant mothers who are high risk due to poor access to health services as well poor fetal growth during pregnancy. Secondly, the curative aspect focuses on identifying children suffering from malnutrition in our community. The CME outreach team has to daily navigate the difficult terrain during the rainy season, as well as in the dry season, to identify the children most neglected and hidden in their community and families.              

Photo(R): Sena Mabaso (left), Director of the program with staff of one ‘team’ – Tadalech Sala, Aynalem & Aynalem

Our IMCHS program works with community health extension workers and our community coordinators to identify these children. The measurement of upper arm circumference (MUAC) is used for community screening. It is upon positive screening that children are then brought to St. Mary Catholic Primary Hospital in Dubbo, the only Hospital in the Woreda (district). At the hospital, a diagnosis of severe acute malnutrition (SAM) is confirmed and the children are then initiated to the first phase of treatment. Phase 1 works as stabilization – children are stabilized, re-hydrated and then introduced to ‘F75’ milk for therapeutic feeding. After they complete the first phase, they are then introduced to transitional stage which is Phase 2 initiation. This phase begins with appetite testing before admission to our rehabilitation center. A child has to pass the appetite test to be admitted to Phase 2. The appetite test utilizes ‘Plumpy-nut’ and water to determine if the child is ready for Phase 2. Once the child passes the appetite test, he/she is then enrolled in the second phase. Phase 2 includes the initiation to meals, ‘F100’ therapeutic milk, and ‘Plumpy-nut’. This process is accompanied with introduction to a high balanced diet. During this time, most of the children begin to recover and start thriving towards their milestones.

The program also tries to address reasons for malnutrition, which is mostly the mother’s lack of food during pregnancy. This situation gets worse for the child around 6 months of age, when they are supposed to be initiated to solid food. Most of the families we serve cannot even afford just one meal a day. This means that the children continue on only breast milk for 8 to 9 months. This causes a delay in their developmental milestones due to malnutrition. More than 50% of the children served in the program are already born severely underweight. More than 95% of children served, show signs of stunting (or are already stunted), poor speech development, skin problems, and slow response to any stimulation. The program has ensured that the Center of Life walls are painted in such a way to provide a stimulating environment. Every day, we see children shifting from being indifferent to the environment to beginning to take an interest in their surrounds and start smiling. These moments are hopeful moments, and give so much hope to care givers. It is even more fulfilling to see children beginning to catch up with their developmental milestones. The care giving team takes time to celebrate all these moments.

Parents and guardians of these children are then initiated into the livelihood program which is aimed at addressing the socio-economic factors leading to malnutrition. The mothers and guardians also receive weekly training on diet & nutrition, water, sanitation and hygiene, malnutrition, possible business startup, and child development. It is important to note that most of our mother’s ages range from 16 year-old mothers to those in their early & late thirties. A couple of the mothers do not know their age or even to count properly due to illiteracy which is very prevalent in this area, and which limits the opportunities for women who have to also remain care givers to children. The program also gives nutritional packages to support families in the initial stages of recovery. These packages ensure that the families begin to have at least three meals a day. In this way, the risk of the whole family sharing the therapeutic food for the child recovering from malnutrition is minimized.

The program also focuses on prevention of child mortality at birth caused by giving birth at home without proper support. 100% of the women enrolled in our Ante-natal Care (ANC) support program have never delivered in a health facility before our intervention. 40% of the women served have already lost children either at birth or soon after birth when they delivered at home.

Women enrolled in our program are helped to develop a savings plan aimed at enabling them to begin income generating activities (IGA) to help support their families. In the meantime, the outreach team continues to follow up the children who are now discharged from the program, to ensure that they continue to recover and grow. This follow up helps to identify concerning issues and enables the team to ensure that these issues are dealt with swiftly. 100% of the school-age children discharged from the program are now enrolled for education both in our kindergartens and other public schools near their homes. 90% of the 2019 group now can safely provide meals for their families and are still continuing to expand their IGA opportunities. The most successful mothers have now begun to be mentor mothers for the other women who are still in the initial stages as they share testimonies of how the program changed their lives.   

 

(Thanks to Thinky Mabaso for this article, and the great work being done.)
Thanks to the Holy Spirit newsletter for this article 

 

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