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Children for Health Consults Children on Nutrition

Between November 3rd and 13th 2013, Clare Hanbury, Director of Children for Health and a fellow consultant, Nuzzly Ruiz de Forsberg were tasked to support a participatory action planning process for a Child Participation in Nutrition Pilot Programme in the Province of Tete to begin in 2014. As part of this process we felt it was important to consult a group of children. The School Principal at Josina Machel Primary School in Tete City, Veronica Maria da Conceicao Ngwenga arranged for 25 members of the School Club aged 10-13 (grades 4-7) on Wednesday 6th November between 10:30 and 12:30. In addition to the children, adult participants in the consultation process included teachers from the school (3), parents who are on the School Council (the governing body) and a nutrition specialist and government technical education specialists.

There were three aims of the session:

  1. To understand some of the challenges and opportunities around nutrition education from the child’s perspective;
  2. To demonstrate to how easy it is to set up and run short participatory activities that provide important information and learning for children of different ages and that are empowering and fun for children to do and that they can easily share; and
  3. To generate discussion opportunities with key stakeholders (principal, School Council members, teachers and technical staff from Provincial Departments) based less on ‘theory’ about what we could do but rather on their experiences and observation of a practical session with children.

Session Design

The children were divided into 5 groups according to their ages/class from grades 4-7. Two groups were a mix of grade 4 and 5. The session was divided into three stages:

  • Stage One: Introduction and information gathering questions;
  • Stage Two: Group Work; and
  • Stage Three Debriefing with the adults

Stage One: Introduction and information gathering questions

The aims of this session was to:

  • Set the context and inform the children know what we were doing and why we were here and to introduce them to the puppets, ‘ZaZa and ZuZu’.
  • To give the children an opportunity to opt out of the activities if they wanted to.
  • To seek their permission to take photographs and film and to explain what this was for and to promise that the school would receive a photo-report.
  • Using a poster, to give an overview of the shape of the morning.
  • To demonstrate a rapid-fire data gathering method that can be used as a methodology in the implementation of nutrition activities with children. It can also be used as a method to quickly test assumptions. The other important purpose for the rapid fire is by asking questions that ‘set the scene’, this helps children start thinking about ideas they will need to conduct subsequent activities effectively e.g. a draw and write activity on healthy diets.

Stage Two: Group Work

At Stage Two, each group took part in a separate different activity. For the grade 4 group, instructions were given verbally and for Grade 5-7 groups we provided written instructions and the groups were requested to read though these instructions while we briefed the youngest ones (Grade 4). Once this was done we went around to each group giving the instructions. After working on the activity for an hour, the children were given fresh fruit juice and then we asked each group to present its work.

Group 1 (Grade 4, 10-11 years):

The children in this group were given a health message to learn and put to actions that were suggested to them: Food that makes you GO (arms in front with fists) and makes you GROW (arms up) and makes you GLOW (rubbing checks with hands) is GOOD food (arms in front with thumbs up)’

They were then asked to put this message to a song and practice a specific role-play with the scenario:

A teacher teachers a lesson on the message, ‘food that makes you GO and makes you GROW and makes you GLOW is GOOD food’. His two pupils practice the message in ‘class’ and then they go home and there meet a child who is their friend but she has not been in class with them. The two children teach their friend the message and together they make up a song to remember the message even better. When the two children next see their teacher they tell him what they did to spread the message and the learning and the children get a ribbon as a prize.

This group did a marvellous job practising and practising the message, the song and the role-play without supervision. They added a lot of personality and creativity to the role-play adding funny bits that made it very engaging. After the presentation all the children in the group joined in with the message and action – it was already sticking in their heads and the children got a huge round of applause! More than any other group, the youngest ones demonstrated brilliantly the potential for this approach. It took approximately 6 minutes to give them instructions and they were able to develop everything from there. It was notable that the children mobilize the rest of their peers and taught them the message at the end without being asked to do so.

Children in Grade 4 in the middle of practicing their role play!
Children in Grade 4 in the middle of practising their role play!

Stage Three: Debriefing with the adults

After the workshop we had a brief chance to speak with the teachers and other adults who had been involved in the morning. The overall impression was extremely positive.

They were impressed with how relevant and pertinent to what they do and want to do as a school to promote nutrition education. Much the children know and how much they felt they could do and of their agility to come up with good ideas on the spot and in one case turn it into an entertaining drama.

We discussed how important to keep things fun and simple but also not to lose the richness that can come from a more complex reflective activity such as the ‘opportunities chart’.

Concluding remarks

The work with the children met its objectives.  The key things learned include:

  1. How quick and easy it is to engage children in participatory activities in nutrition.
  2. That simple yes/no surveys can be done in 10 minutes and useful ‘results’ can measured from an exercise like this.
  3. That children from grade 4-7 show capability, thought and care in their work on this subject.
  4. That carefully designed short activities can quickly reveal important issues that need to be addressed when strengthening and developing good nutrition habits at family level.
  5. That the most successful activities were
    • The simplest (message + song + role play done by the grade 4 children); and
    • The most complex (the opportunities chart done by the grade 7s)

Noted was the need for activities like these to be used as a catalyst for further discussion and work. Because these activities go ‘deeper’ than many traditional health education approached, there is a need to address false beliefs and incorrect understanding as they come up and this can be a challenge for a teacher.  For example, the children in Grade 6, doing the story thought that the best way children can promote health was to take a younger child with malnutrition to a traditional healer. In this context our nutrition colleague was on hand to lead a discussion with the children on the pros and cons of this approach and what other approaches might be available to them. In a class room setting, this might be more challenging but teachers need to be ready to discuss these deeper issues with children and in a way that is respectful of their family habits and values.

The work of this group and other groups suggested children needed more opportunity to understand what is meant by

  • Good food
  • Unhealthy food
  • Balanced diet

Plus they needed more examples of the way in which children can help take action to resolve problem as this dimension seemed beyond most of their experience, hence the great value and potential for this programme!

Enjoying the unexpected!

Two days after this workshop we met up with the School Principal who told us that on Thursday the key message on food learned and shared in the role play was being chanted all over the school!