Published: Friday, 13 November 2015 13:33

Aminata Koroma

Secure Livelihoods Research Consortium and FOCUS 1000, on Thursday 29 October, launched reports from a study on Malnutrition in Sierra Leone. As part of a two year research project implemented by the Secure Livelihoods Research Consortium (SLRC) with funding from IrishAid, researchers from the London-based ODI and FOCUS 1000 sought to understand reasons for the high malnutrition rates in the country.

The study focused primarily on Kambia district but also involved extensive interviews with key Government Ministries, department and agencies, UN agencies and International and National Non-governmental organizations in Freetown. Hosted by the SUN Secretariat at the Vice President’s office, 43 key stakeholders from Ministries of Health and Agriculture, Irish Aid, UN family, civil society and media attended. The event was opened by Deputy Minster 1, Honorable Foday Sawi who described the issue of malnutrition as an issue close to his heart requiring urgent action. Hon Sawi commended the research team for their work and encouraged all stakeholders to “use these findings to come up with key recommendations that we can act upon.” Other high level delegates at the event included the Director for Food and Nutrition (DFN) Madam Aminata Shamit Koroma, Irish Aid Representative, Eimear Murphy; Madam Kamara from the Vice President’s office and Dr. Mohamed Foh, National Coordinator for SUN Secretariat who chaired the event.
Keys findings from the research identified causes for high malnutrition rates to include “business as usual” approaches to capacity building that miss out the realities of everyday life for thousands of Sierra Leoneans. The research highlighted ‘blind spots’ that need to be addressed if government and implementing partners are to improve the nutrition status of the country, that is the plurality of the health system which relates to decisions made by individuals and households about nutrition and health care; the relational and social aspects of capacity and the wider system in which organizations and individuals work.Regarding the first communities spoke of taking sick infants to traditional healers, rather than government-run clinics, because they were more accessible, affordable and provided important treatments for spiritual causes of illness.

Second, decision makers need to be involved. Promoting good child nutrition must go beyond the dissemination of infant and young child feeding (IYCF) practices to engage with key influences on mothers’ behaviour, such as by involving men and elders in Mother Support Groups, and so creating Family Support Groups. Governments and aid agencies often attempt to prevent malnutrition by investing in the promotion of good infant and young child feeding practices, for example, early initiation of breastfeeding, exclusive breastfeeding and so on. But social forces within the household and community may mean that the women are unable to act on that knowledge.Third, the relationship between health staff and the community is critical. Technical knowledge alone is not sufficient to achieve behaviour change.

General view

Our research shows that contrary to the official statistics, exclusive breastfeeding is rarely exclusive – only 30% of mothers in Kambia did so. But in communities where they did, it was noticeable that relationships between health staff and the community were better and more communicative. Communities need to not only be told what to do, but what not to do and why – awareness raising about exclusive breast feeding needs to include specific reference to risks of warm water and bitter medicine. Finally, the wider system needs to be recognised. The ways in which communities access food vary from community to community, and so interventions need to be tailored accordingly. Seasonality is also important. Environmental hygiene is worse during the rainy season, when lack of long-drop latrines mean open defecation, leading to contaminated water sources. Plus pregnant or breastfeeding women are needed in the fields, keeping them away from home and limiting their ability to breastfeed.

In summing up Madam Koroma stated that this research was a stepping-stone for SUN movement initiatives in the country. “We must use these findings to set out priorities for scaling up nutrition, ensuring that we are able to improve health care provision for children that are malnourished but also to strengthen preventive systems through better collaboration at national, district and community levels.” she stated. A follow-up with all key stakeholders is expected to be called by ODI and FOCUS 1000 to develop an action plan in line with the findings to support efforts to eradicate malnutrition and improve the lives of women and children in Sierra Leone.