SAVE LIVES OF 600 MALNOURISHED CHILDREN IN UGANDA

REVISING AND TRAINING OF HEALTH WORKERS ON NEW IMAM GUIDELINES.

1.  Introduction

Management of malnutrition cases in the Uganda keeps evolving depending on the presenting cases and the research studies conducted. In Uganda, the Integrated Management of Acute Malnutrition (IMAM) guidelines were made and have over the years been revised to solve the existing complications in malnutrition cases. Child and Family Foundation Uganda (CFU), being a champion in research and nutrition management with collaboration with the Ministry of Health in Uganda and other partners led the revision of the guidelines and training health workers in Uganda about the new changes made in the guidelines.

Over the past months, revisions were conducted and the changes made were aimed at improving the screening for malnutrition and related complications at household levels, improving referral chains from villages to the health facilities as well as management in both In-patient and out-patient clinics to reduce the burden of disease, malnutrition related deaths as well as reduce the cost of treatment of malnutrition if detected and managed early enough.

Health workers from the Eastern part of Uganda were the first batch of health workers to be trained in the new improvements in management for five (5) days. The training was aimed to train health workers who will become trainers of other health workers in their respective districts and health centers they are attached to. These health workers were trained in theory and also got a chance to have practical sessions in Jinja Regional Referral Hospital in Eastern Uganda.

  Family led MUAC concept was taught to the health workers and it was emphasized as a key concept for screening and early identification at household level. The trained health workers had a chance to train Community Health workers who in turn trained mothers and family caregivers how to conduct these assessments. The same route will be taken in reverse when referring the identified cases for management at health centers with reassessment at all levels. In the first batch, over 100 health workers were trained and more will be trained soon.   

Achievements:

•  Complete Revision of the Ministry of Health 2025 IMAM guidelines.
•  100 health workers trained in the new revisions in the guidelines. 
•  Community Health workers were trained and had a chance to cascade information.
•  Family led MUAC concept was trained and it ensured early detection and Identification of nutrition cases.
•  A refresher training for health workers in the eastern region in collaboration with the Ministry of health.
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• image_food_demonstration.docx (DOCX)

1.  Introduction

Cases of malnutrition in Uganda are occurring and keep fluctuating both in the urban and rural areas. Unstable food supplies is a major contributing factor for malnutrition as people from different households fail to have even a descent nutritious meal for themselves especially in the dry seasons. Most of the prevailing malnutrition occurrences are due to reduced food supplies from the rural farming communities and also high food prices in the markets around the country. The long spells of drought destroy crops in the area leading to food insecurity in the country and consequently a rise in the malnutrition cases recorded at the end. Child and Family Foundation Uganda (CFU) conducted community screenings especially in the slums of Kawempe division in Kampala city and got a number of malnutrition cases registered among which were children from the urban poor populations.  Referrals were also received from the community health workers as well as other health facilities and they were admitted to Child and Family medical Center Nutrition clinic for management.

Achievements:

•  28 children managed and discharged as cured.
•  Series of nutrition education to the mothers and caregivers
•  Nutrition education about food storage for sustained food supplies even in dry seasons.

SUCCESS STORY

Paul a 15-month-old boy was referred to CFU medical center from one of the health centers in Kawempe division where he had been taken to get treatment. The mother had reported mild cough and fever with low appetite for food. On assessment, the nurses found out that the colour coded Mid Upper Arm Circumference (MUAC) tape used showed red colour which indicates Severe Acute Malnutrition (SAM). This nurse is one of the health workers trained in nutrition assessment and identification of malnutrition cases by CFU staff as facilitated by the funds from the GlobalGiving family. He was then referred to CFU medical center for nutrition management.

On arrival at CFU medical Center, Paul was examined and diagnosed with Severe Acute Malnutrition, with MUAC readings 11.0 cm (RED) and cough. The mother reported that being the breadwinner at home, she could not afford meals for herself and her two children since the prices have gone high as a result of the dry spells in the rural farming communities. She opened up that this has always been the case in her home during the dry season. Paul received the treatment for cough and also started his nutrition journey from SAM to a normal nutrition status.  Paul started improving day by day from weight of 6.0 Kg and MUAC 11.0 cm to the weight of 8.1 Kgs and MUAC 12.8 cm (Green) at discharge from Clinic. The mother was connected to the livelihood program of Child and Family Foundation Uganda (CFU) for skilling and be able to earn a living in order to afford descent meals for her household. We greatly thank the GlobalGiving family for the continued support towards the lives and households with children having malnutrition.