Abstract
Over the last decade Zimbabwe has made noteworthy progress in reducing both underweight and wasting in children under the age of five years, however one in four children in Zimbabwe is stunted. The rate in the decline of the number of children stunted still falls short of meeting the World Health Assembly target, and it goes without saying that effective, innovative community-based strategies are required by the government and development partners to accelerate the rate of stunting reduction. This paper presents experiences from using the Care Group approach for promoting improved maternal, infant and young child nutrition (MIYCN) and care based on lessons from the Amalima program, a seven-year United States Agency for International Development (USAID) Office of Food for Peace intervention. The Amalima program has been promoting Care Groups as a community and family centred approach to improve maternal and child nutrition in Zimbabwe. Care Groups are an innovative community-based strategy that has been rolled out as part of the Amalima program activities in four food and nutrition insecure districts in Zimbabwe. The final programme evaluation suggested the program succeeded in increasing the exclusive breastfeeding rate and reducing levels of nutritional stunting among children under two years. In the present discussion paper, we present the key lessons learned and strategies we believe may have contributed to making Care Group implementation effective; we highlight the modifications that we made in Care Group implementation to ensure a context appropriate approach; and we discuss how Care Groups can be integrated into the Ministry of Health and Child Care structure. The critical factors for successful Care Group implementation have been grouped into five broad categories: conduct formative research; ensure context specific approaches & adaptive management; leverage on social capital and cohesion; invest in human capital; prioritise quality assurance & reviews.
Highlights
Vast literature and evidence exist to highlight that adequate nutrition during the period from birth to two years of age is critical for a child’s optimal growth, health and development and that childhood stunting is one of the most significant impediments to human development
We describe the key ingredients for effective Care Group implementation, the modifications that we made in Care Group implementation, and how Care Groups can be integrated into the Ministry of Health and Child Care structure
There is a substantial body of literature documenting experiences on implementing Care Groups; this discussion article adds to experiences on operationalising the approach in a rural setting in Zimbabwe
Summary
Vast literature and evidence exist to highlight that adequate nutrition during the period from birth to two years of age is critical for a child’s optimal growth, health and development and that childhood stunting is one of the most significant impediments to human development. Perry et al (2015) state that expanding coverage of key interventions and achieving documented reductions in maternal, neonatal, and child mortality will require approaches that are low-cost, effective, and feasible at scale over the longer term They recognise Care Groups as one example of the growing importance of participatory women’s groups in improving maternal and child health and nutrition and share their experience with implementing Care Groups in Zimbabwe. Care Group members to offer one on one tailored support, reach other family members with key messages and strengthen adoption of practices Some sessions are ‘opened’ up to men, Care Group trainings focused on promoting mother in laws, grandmothers and other family members key behaviours to achieve optimal infant and young child feeding during the 1000-day window of opportunity period. Sessions should last 1 to 2 hours as neighbour women and their LM’s have a lot of other chores that they do at home, and it is prudent to be mindful of this
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