In Chad, Première Urgence Internationale is training mothers to detect malnutrition in children

In 2020, communities in Chad are still vulnerable to malnutrition. The challenging climate, limited access to water, poor crop production, and insufficient medical infrastructure have created a crisis situation to which the COVID-19 pandemic now also contributes. For two years, Première Urgence Internationale has been working in close cooperation with mothers and guardians to make diagnosis easier and to treat seriously ill children more quickly.

© Première Urgence Internationale – February 2020.

In Chad, the issue of nutrition in children under the age of 5 and women of childbearing age (15 to 49 years old) is still worrying despite the efforts made over the last few years by technical and financial collaborators and by the Ministry of Health in terms of improving treatment for malnutrition. The Ouaddaï region, located in the east of the country, is in a recurrent emergency situation with a total acute malnutrition rate of over 15%.

Since May 2018, Première Urgence Internationale has been carrying out a prevention and treatment project for severe acute malnutrition in children under the age of 5 and pregnant or breastfeeding women in the Ouaddaï region. The aim is to help reduce the morbidity and mortality rates in children under 5 and pregnant and breastfeeding women. One of the ways to do this is to improve the quality of treatment in nutrition units and to improve the coverage of the nutrition programme through community detection and referral to healthcare centres. The so-called “Mamans PB” (“MUAC Mums”) approach seems to be one of the most effective in early detection of malnutrition in children under 5.

Measuring arm circumference to detect malnutrition in children

This is an approach involving the detection and diagnosis of malnutrition carried out by mothers or guardians who have been trained in advance to use MUAC (Mid-Upper Arm Circumference) measuring tapes. They measure the MUAC, i.e. the circumference of the biceps between the shoulder and the elbow. This is essentially a diagnostic tool used in healthcare centres which has been used extensively within communities.

This community referral process has been implemented through several stages:

• information and mobilisation of the community,
• identification of women’s groups,
• raising awareness and training Mamans PB on using a measuring tape to detect malnutrition,
• raising awareness of effective practices in terms of feeding infants and young children,
• monitoring, assessment and reporting the activity.

Throughout this approach the Mamans PB are guided by community health workers and Première Urgence Internationale healthcare supervisors.

Between May 2018 and December 2019, more than 15,000 “Mamans PB” were selected and trained in 24 healthcare centres in the Adré (11 centres), Abougoudam (4 centres) and Abéché (9 centres) districts. During this period, the mothers and guardians were able to detect more than 66,600 children, aged between 6 months and 5 years old. Amongst these children, 6,979 (10.5%) were diagnosed with severe acute malnutrition and were referred to a nutrition care unit.

© Première Urgence Internationale – February 2020.

Involving mothers in their children’s health

The Première Urgence Internationale teams have recorded excellent work carried out by the Mamans PB  in detecting children who need to be accepted into the nutrition programme (detection rate over 70%). This success is due to the promotion and participation of mothers in the care of their children’s health. They take ownership of this process which they perform on a voluntary basis.

Involving mothers in the detection of malnutrition allows them to better understand the signs of malnutrition, to participate in monitoring their children’s nutritional intake and to increase the rate of detection of children at a community level. At the start of the programme, the objective was one mother for one child. Today, one Maman PB detects around 3 children per month.

All of these activities are carried out by Première Urgence Internationale thanks to the support of UNICEF and the European Union through the DG ECHO (Directorate-General for European Civil Protection and Humanitarian Aid Operations).