Multi-sectoral approach key in upping nutrition

SOME members of the Mongu district nutrition coordinating committee carry ing their banner during the public service day commemorations in Mongu last year.

AN INNOVATIVE programme by the National Food and Nutrition Commission of Zambia (NFNCZ) is set to improve nutrition and curb stunting among households in three districts of Western Province.

The programme encourages local communities to depend on locally available food to ensure sustainability.
To this end, Western Province provincial nutrition support coordinator Mundia Mwangala’s focus is beyond the family food basket in his catchment.
While ensuring that families, especially women of child- bearing age in Kalabo, Mongu and Shangombo districts, eat nutritious food, he also has to ensure that families in the three districts where the NFNCZ is implementing the intervention depend on locally available food such as fruits and insects such as grasshoppers and inswa.
The NFNCZ is implementing phase one of the ‘Scaling up Nutrition, first 1,000 most critical days’ programme in three districts.
It is being implemented in 14 districts countrywide. Other districts on board are Chinsali in Muchinga Province; Chipata and Lundazi in Eastern Province; and Kaputa, Kasama and Mbala in Northern Province. Others are Mansa and Samfya in Luapula; Mumbwa in Central Province; and, Mwinilunga and Zambezi in North-Western Province.
The pilot project started in 2015 and ran up to last year.
Mr Mwangala says a lot of donors have expressed interest to scale up the project by bringing 16 more districts countrywide on board and that the decision on which new districts will join the programme will be based on the outcome of the mapping and gap analysis.
“The neediest [districts] will be the first to be brought on board. The mapping and gap analysis results will determine which districts do not need donor funding in terms of nutritional Intervention,” he said.
Agriculture is the major thrust of NFNCZ’s intervention which encourages communities to depend on locally available food.
“Our main aim is to ensure that there is adequate food for our populations. We encourage our communities to depend on locally available food, including insects,” he said.
The NFNCZ encourages farmers to plant orange maize rich in vitamin A, sweet potatoes and leguminous crops such as beans.
Mr Mwangala says the NFNCZ also encourages people to preserve food – fish, vegetables and fruits – which they can fall back on when these foods are out of season.
“We attach nutrition-sensitive messages to the social cash transfer by urging the beneficiaries to prioritise good nutrition.
With the Cashew Infrastructure Development Programme (CIDP) in full swing in the province, the NFNC is riding on it to counsel subsistence farmers not to focus on cash but on the health benefits of the crop.
“Before you sell, you need to eat. Cash is not rich in protein,” Mr Mwangala said.
The African Development Bank (AfDB) is funding the CIDP, which is expected to transform lives of thousands of small-scale farmers in the province.
The US$55.4 million project is expected to transform livelihoods given that the climatic conditions in the province favour the cultivation of the crop.
The CIDP, which is being implemented over a five-year period in Kalabo, Limulunga, Lukulu, Mitete, Mongu, Senanga, Shangombo, Sioma and Sikongo, has targeted 60,000 households, of which 50 percent are women-headed.
Cashews, one of the lowest-fibre nuts, are packed with vitamins, minerals and antioxidants which are important for maintaining good bodily function.
Mr Mwangala regrets that nutrition is one aspect that has not been taken seriously in Zambia.
The NFNC is also working with other partners in rehabilitating broken down water points.
“Every school should have a water point so that children have access to water. We also encourage communities to practice good hygiene,” he said.
Schools have also been engaged to revamp maternal and adolescent education as well as health and nutrition activities.
“Each school should have an orchard, and have vibrant school gardens with diverse crops,” Mr Mwangala said.
He is happy with the coordination structures which have been set up in all the wards using a multi-sectoral approach.
Mr Mwangala said the NFNC has been training and orienting officers who are implementing the programme in the three districts.
The programme, funded by the Department for International Development (DFID), which leads the United Kingdom’s work to end extreme poverty, Care, Irish Aid, the Swedish International Development Agency (SIDA) and the Zambian government, has handed out bicycles to all ‘foot soldiers’ to ensure the smooth implementation.
While DFID, Care, Irish Aid and SIDA provide financial support, Government has availed human resources to ensure the programme’s success.
“Every month, we meet with district administrative officers and programme coordinators to review performance and plan for the next month. It is worth commending our Government, we have support from our provincial administration,” Mr Mwangala said.
“In every district, we have support of district administration officers and district commissioners to ensure that our programme succeeds,” he added.
NFNCZ food scientist Gladys Kabaghe said the success story in the first phase of the multi-sectoral implementation of the programme has been the establishment of coordination structures which are functional in all the 14 districts.
These are district nutrition coordinating committees, ward nutrition coordinating committees and zonal nutrition coordinating committees.
“[The] multi-sectoral approach has been embraced – it is not easy coming from a silo way of doing things [such as] each sector going to implement their activities as a sector without taking interest in other sector activities and how these complement what that sector is doing,” Mrs Kabaghe said.
She added that the concerted effort in making sure that the same household receives all the different services is a success in itself as sectors in the silo approach are not concerned about convergence of services.
Mrs Kabaghe said in the 14 districts the programme is well known, including in wards where it is not yet being implemented. Neighbouring districts have been requesting that they too become part of the scaling-up nutrition-funded districts.
The country faces a huge challenge of stunting.
Mrs Kabaghe said the malnutrition levels in the country is at 40 percent, with Northern Province being at 48 percent; Muchinga [43.6 percent]; Eastern Province [43.3 percent]; Luapula [43 percent]; Central [42.5 percent]; Southern [37.2 percent]; North-Western [36.9 percent]; Copperbelt and Western 36.2 percent each and Lusaka 35.7 percent, according to the 2013-14 Zambia Demographic Health Survey.
“Note all of the provinces are above the cut-off points, according to World Health Organisation, and therefore stunting is of greatest concern as it points to inadequate nutrition over a long period of time. Scaling up nutrition, technically, speaking has already started. It started in the 14 phase one districts which also were pilot districts – learning to coordinate, implement in a multi-sectoral manner,” Mrs Kabaghe said.
She said the next phase (phase two) will include rolling out to the wards where implementation was not taking place within the 14 phase one districts and an additional 16 new districts.
“The total will be 30 districts. The 16 districts have been selected based on a number of criteria, including high stunting levels in the districts; districts already implenting some nutrition interventions; proximity to the districts already implementing the ‘1st 1,000 Most Critical Days Programme’ for easy learning,” she said.

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