Leading the way: community workers bridging the nutrition gap in Cameroon
After decades of reduction, global hunger is now on the rise (increases were observed in both 2016 and 2017): over 150 million children are stunted and 50 million people are affected by wasting State of Food and Nutrition in the World 2018 reports. Cameroon like many other sub-Saharan countries does not escape this rising threat.
The report calls for participatory approaches for local solutions to address malnutrition, particularly focusing on the engagement of local people, and encouraging open community consultation when designing and implementing interventions help build community ownership and ensure long-term sustainability. The PRESEC project embodies this approach: the project builds partnerships with local NGOs (CADEPI and APROSPEN), and governments to improve resilience and the nutrition of local vulnerable populations, including Internally Displaced Persons (IDPs) and refugees.
Challenges of wasting and stunting
Many of the underlying factors of wasting (acute malnutrition) overlap with those of stunting (which is cause by chronic malnutrition). These factors include food security, access to quality complementary food, poor care practices, access to health services, improved sanitation and hygiene. Even in areas where health services are available, marginalised groups experience barriers such as travelling long distances to reach such facilities, and general information on how to access these services.
The PRESEC project works with Community Relays, local residents, who cooperate with our local partners to tackle nutrition issues on the ground. They sensitise communities on relevant nutrition problems, and by providing solutions to overcome them. The Relays offer a unique opportunity to deliver services aimed at the prevention and treatment of the effects of malnutrition that is accessible and based in the local community.
PRESEC supports and mentors Community Relays to provide nutrition counselling in remote communities. The Community Relay workers are not meant to replace the health facility based services, but act as a critical booster. In turn this approach also encourages civil society participation and improves overall coverage by nutrition services. The Relays have several roles to support nutritional services
Identifying at risk children
The Community Relays identify at-risk children using the mid-upper arm circumference (MUAC) a critical indicator for nutritional status and the need for additional support. They also refer malnourished children for treatment, however PRESEC recognises that referrals are only effective if the services are truly accessible to users. Hence, the project is currently upgrading local treatment centres by providing a space for nutrition counselling with the parents
Implementing the MUAC test
Educating communities on nutrition and agriculture
The Relays also engage their communities and demonstrate how to prepare foods and meals that can nourish the child using locally available foods. They also provide information on breastfeeding, complementary feeding, hygiene and other relevant topics with target groups.In a complementary fashion, the PRESEC project simultaneously stimulates farmers to grow nutritious foods to improve local access to diverse foods.
"The seasonality of food is an issue, and food is not stored. Improving food access is more sustainable than just providing plumpynut. June to September period is an issue, there is not much food and it is the rainy season, which also increases malaria. Community Relays are important for promoting good practices, but there is an issue around retention”. - Municipal Health Officer, Dr. Tsibou Daniel
Looking forward and addressing systemic issues
For many years, the treatment of wasting was considered to be a solely a humanitarian issue. Today, the tide is shifting, and the treatment of wasting has expanded beyond emergencies with a stronger focus on preventive interventions, such as those in PRESEC.
There are undoubtedly operational and sustainability problems that need to be overcome. For example, retaining Community Relays is key to sustaining essential nutrition services for vulnerable populations in rural and remote areas. Investing in community workers now will address not only the existing malnutrition crisis but will also serve as a means to strengthen the nutrition system, accelerate country ownership and help avoid future crises.
We are reaching a tipping point in the discovery of what communities and Community Relays can do to reduce hunger and malnutrition, but we need to continue to invest in these frontline resources, or risk global rates continuing to rise.