In Mozambique the dreadful facts are that 44% of all children under 5 suffer from chronic malnutrition. The Government has launched a national plan to reduce chronic malnutrition – called the PAMRDC. The objectives of the plan include strengthening nutrition education, improving the health of adolescent girls, reducing micronutrient deficiencies, increasing levels of exclusive breastfeeding, improving family diets and the better use of locally available food.
Tete Province is the first to develop its own 5-year action plan to achieve these objectives. With the help of numerous stakeholders, including children – a government team in Tete devised a rights-based child-focused nutrition education programme, Children’s Participation in Learning and Action for Nutrition (PCAAN – in Portuguese). Children for Health provides technical support. PCAAN recognises:
- The important part children already play in caring for the health and nutrition of their siblings
- The enthusiasm and time children have; the capability of children to learn and share nutrition messages and practices; and
- The ability of children to adapt what they learn about nutrition and health to their own reality and make it ‘live’.
The DANIDA and USAID funded PCAAN approach to Nutrition Education is working in 15 schools: 12 in Tsangano district, a district in Tete Province with high levels of chronic malnutrition despite high levels of food availability and 3 in Tete City (these began after a workshop in May 2015). The 8 topic areas are all linked to the objectives of the PAMRDC, the National Primary School Curriculum plus health messages created for families by the Provincial Ministry of Health in Tete.
During regular Saturday Morning sessions, 25 child members of the School Club learn and adapt nutrition messages and practices with adult facilitators – usually a teacher and a member of the community. Active, fun methods are used like drawing, singing, dancing and role-plays. The following week children then share the messages and activities with children at their grade level at school, using time allocated for local curriculum. Following this all children from Grades 4-7 work together to plans and share messages and conduct activities with other children and younger siblings at home and in the community. This is nutrition education by children, with children, for children.
The PCAAN approach to Nutrition Education programme began in January 2014 with a training of 60 teachers, community youth workers, school principals and community leaders. 120 children also joined this workshop for three afternoons of practical work. Since then we have had follow-up training to finish co-creating a teacher’s guide, a reflection meeting, a training on monitoring and evaluation and a workshop to expand the programme to three more schools in Tete City. At the end of this year (2015) we will be conducting a training of trainers workshop and an evaluation.
Here is a picture of a role-play where two boys take on the role of mothers. This was during the practice sessions with the children at the workshop. One ‘mother’, who is cradling the small parrot, tells the other she is not breastfeeding her baby who is small and undernourished. The other ‘mother’, who is cradling the big parrot, tells her why it is important the baby has colostrum, that exclusive breastfeeding is important and not to give extra fluids or water until the baby is older. ‘She’ tells her that this helps the baby grow and prevents disease.
Monitoring of the PCAAN approach in all the schools is ongoing, using a number of different reflective tools and methods. We are exploring the use of SMS as many school are remote and it is hard for district teams to get the fuel and transport to get to the schools.
The programme is currently reaching around 6,000 children and their families in 12 villages in Tsangano District, Tete province. The idea is to co-create a programme with the teachers and children that will then be replicated in all school throughout Tete province. The programme is also catching the interest of those involved in designing and running nutrition programmes in other provinces.
Further information on this programme can be found by contacting us and by clicking the following links: