Improving Child Nutrition through Mothers' Support Groups in the DRC

 {Photo credit: MSH}Thérèse Ashingo proudly shows off her healthy son after two months of exclusive breastfeeding.Photo credit: MSH

In the Democratic Republic of Congo, child malnutrition is a leading cause of infant and child mortality. In the Kole health zone in Kasaï Oriental province, 23 children were diagnosed with severe malnutrition between February and April 2013, with two infants under six months old dying from the condition.

Community health workers have recently made strides in addressing this issue, with the support of the USAID-funded Integrated Health Project (DRC-IHP), led by Management Sciences for Health with partners the International Rescue Committee and Overseas Strategic Consulting.

In Tonkete, a small village in the Kole health zone with 279 residents, Ida, a 55-year old community health worker, visited the home of Thérèse Ashingo, a 22-year old first-time mother. Her three-month old son was severely malnourished. Ida asked Thérèse about her feeding practices and learned that the infant had just been fed cassava meal-based porridge and water. The young mother explained that her feeding decisions were primarily driven by her daily responsibilities managing the home and spending long hours in the fields. She was uninformed about infant nutrition, and also believed that she could not produce enough milk to feed her child.

Ida invited Thérèse to attend a local infant and child nutrition support group, which had been started with the support of DRC-IHP. To promote the adoption of healthy nutritional behaviors—including exclusive breastfeeding for the first six months of life—community health workers like Ida, local NGO leaders, and health care providers were trained in an interpersonal behavior change communications technique called Education through Listening (ETL) to lead and facilitate group discussions with mothers. In Kole, ETL-led infant and child nutrition support groups for mothers have been in place for nearly a year and have helped local mothers better feed and care for their young children. Ida, who has been a community health worker for 15 years, has become a firm believer in the effectiveness of ETL’s interpersonal communications techniques, stating that they “allowed us to transform mothers’ hesitation into motivation to improve how they feed their children.”

In Thérèse Ashingo’s case, after several sessions led by ETL-trained facilitators in a 15-person group, she decided to begin exclusively breastfeeding her son according to his feeding demands, 8 to 12 times each day. By June, her son Ataadji had made a complete recovery, growing from just under five pounds at three months to more than 15 pounds at five months. “My child was going to die, but since I have been practicing exclusive breastfeeding, Ataadji gained weight and is healthy,” she said. “I thank the support group.”

With the continued involvement of community health workers, DRC-IHP plans to build on the gains made by these support groups and continue supporting mothers in their efforts to raise healthy children, laying the foundation for a healthy adolescence and adulthood. The project will continue to expand its ETL-based outreach with mothers of young children throughout its 80 target health zones in four provinces of the DRC.

The IHP BCC team contributed to this story.

Jean Baptiste Mputu is a behavior change communications (BCC) specialist with DRC-IHP based in Kinshasa.