PS Kenya’s child survival efforts are focused on finding the most appropriate channels to reach caretakers and provide them with high quality, cost-effective and integrated health services that address the main causes of childhood disease and death. Our program addresses the common illnesses that children under 5 in Kenya encounter: diarrhea, pneumonia, malaria and malnutrition.
THE NUTRITION PROGRAM
In Kenya, malnutrition is the single greatest contributor to child mortality, accounting for more than a half of deaths among children under five. In collaboration with the county governments, PS Kenya with support from UNICEF implemented a community-centered campaign to strengthen community resilience to handle shocks and stress in Kilifi, Kitui and Kwale Counties. The key practices were packaged in an umbrella campaign dubbed ‘Shika Tano’ (High 5) that supported and congratulated mothers who practiced 5 key behaviors. Shika Tano’s 5 key behaviors include:
- Exclusive breastfeeding
- Treatment of diarrhea with ORS and Zinc
- Food diversity – giving foods from more than 4 food groups
- Iron/Folate supplementation amongst pregnant women
- Vitamin A supplementation amongst children 6-59 months
In Kitui County, PS Kenya is also supporting enhanced nutrition counselling among households receiving the cash transfer for improved nutrition outcomes. The program, known as NICHE (Nutrition Improvement Through cash and Health Education), is anchored on the Shika Tano campaign, with an additional emphasis on budgeting and meal planning and management.
STORIES OF CHANGE: THE OVERLOOKED CATALYSTS OF CHANGE
In PS Kenya’s implementation of the NICHE (Nutrition Improvement through Cash and Health Education) program in Machakos and Kitui, we visit households mapped to receive Orphans and Vulnerable Children Cash Transfer and in addition, the UNICEF cash top-up. In these select households, we carry out intensive nutrition counselling and health education targeting pregnant mothers and children less than two years of age with the aim of improving their nutrition and health status. The beneficiaries are counselled on Maternal,Infant, Young Child Nutrition (MIYCN) practices, their importance to health and how to adopt them by Community Health Volunteers (CHVs) trained to implement this program.
Our field activities bring us to the home of Wayua Munyoki in the remote arid lands of Kivaa ward, Masinga sub-county in Machakos. 40 year old Wayua is a mother of 8 children ranging between 25 years to 6 months and is a beneficiary of the UNICEF cash top up for her youngest child, baby Kanyipu. Because she has some mental challenges, Wayua is assisted to manage her family by a close relative. We find Wayua outside her house breastfeeding baby Kanyipu. Around her, the younger children are playing about while the older ones are catching up with various house chores after returning from school. Upon our arrival, the children assemble and listen in to our discussion. The CHV, Joseph Munyoki informs us that this is usually the norm every other time he visits the household and finds the children home.
As we continue our session, we notice that Leah, the fifth born child in standard three, is very engaged in the conversation. Every time we pose a question to her mother, she answers the question. Leah is aware about Shika Tano and how to tend to their kitchen garden which is providing a lot of important nourishment for the family. We were surprised to find out she knows and recalls some of the messages communicated and is aware of their importance to health, arguably better than the mother! We simply had to give her a high five! Together with her other siblings, the children help in carrying out simple activities that however impact highly on nutrition. They put up a hand washing facility (which at times their mother removes due to her mental condition) and ensure that it has water all the time.
As we left the household, we learnt something significant from Leah. Young children when present need not be left out during these learning sessions in the household visits. Like Leah, they can understand the messages being taught, take interest and in their small capacity, help their mothers/caregivers implement these behaviors like helping with simple tasks such as refilling the hand washing tin near the latrine, looking after their younger siblings or even merely reminding them; while adopting these practices themselves that are very beneficial to them and their entire families! Their engagement also means they grow into healthy, knowledgeable and productive youth and adults who become agents of change in sustaining an equally healthy, knowledgeable and productive society. Indeed, the NICHE program has many other change catalysts beyond caregivers!