Wednesday, December 19, 2012

Take-home treatment for malnutrition gets Cambodian children back to health

23-month-old baby has received therapeutic food for five months and gained 2.5 kilos.
© UNICEF Cambodia/2012/Maggie Lamb

The early morning quiet in Chongrok commune in Kampong Speu province is broken only by the sound of a bouncy and active little girl clapping and giggling as she chases a dog across the front porch of the Chongrok Health Centre. Her grandmother Skaio Sivannary looks on and smiles at the progress her granddaughter has made in recovering from severe acute malnutrition.

“She is my only granddaughter, and it makes me very happy to see her so happy, healthy and active,” Sivannary said.

When Chanika was 18 months old, her grandmother observed that the little girl was small for her age, tired, inactive, and frequently ill. While her mother wanted to take Chanika to a traditional healer, her grandmother, a midwife at the Chongrok Health Centre, recognised the symptoms of malnutrition and took Chanika to the health centre to be assessed.

At that time Chanika weighed only 7.5 kilos. Over the past five months, Chanika has received ‘ready-to-use therapeutic food’ every morning and her weight of 10 kilos is now within the normal range for her age.

Therapeutic food is a specially designed food used in the treatment of severely malnourished children. It can be eaten straight from the packet as a biscuit or it can be prepared as porridge, depending on the child’s preference. Each biscuit contains specific amounts of protein, carbohydrates, fat, and micronutrients to allow fast recovery from severe malnutrition.

“Chanika loves the [therapeutic food], and eats it right out of the package. She asks for it every morning”, observed her grandmother.

Childhood malnutrition a public health concern

Malnutrition in Cambodian children is one of the most significant contributors to the country’s child mortality rate and can have a permanent impact on children’s physical and cognitive development. More than one-quarter of Cambodian children under 5-years-old are malnourished and 4 of every 10 are short for their age. These rates remain very high in comparison to other ASEAN countries.

Children suffering from malnutrition may be short and thin for their age, listless, and susceptible to frequent illness and infections.

Every child brought to selected health centres in Kompong Speu province is checked for signs of malnutrition. Health workers also identify malnourished children during health centre community outreach activities such as vaccination drives.

Therapeutic food allows children to continue treatment at home

It had been observed that many children who were treated for severe malnutrition in Cambodia were not completing the full course of treatment after returning to their homes. If children do not complete the treatment programme, they can easily slip back into malnutrition.

With support from the Spanish Government through the MDG Joint Programme for Children, Food Security and Nutrition, UNICEF (in collaboration with WFP and WHO) initiated a programme in 2010 with five health centres in Kampong Speu province to help them provide ongoing care for children diagnosed with malnutrition. The children are sent home from the health centre with “therapeutic food” so that they can continue their treatment. Caregivers are counseled in the use of the food and arrangements are made to bring the children back to the health centres for follow up visits every two weeks for the following two months.

This programme is an integral part of UNICEF’s efforts to achieve Cambodia’s Millennium Development Goals 1 and 4: to eradicate extreme poverty and hunger, and reduce child mortality.

In 2012 the programme was expanded to 19 health centres in Kampong Speu and Svay Rieng province. Presently nearly all of the children are completing their treatment and are making full recoveries from malnutrition.

Working directly with health centres, UNICEF is enabling local health care workers to more readily identify and treat childhood malnutrition in the communities they serve. Health centre staff can work in their communities to educate parents and caregivers on childhood nutrition and monitor each child’s progress as they continue to receive nutritional support.

By Maggie Lamb

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