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PCAAN & PCAANS! What’s next?

PCAAN PCAANS!  A school-based nutrition and health programme. What’s next?

Children for Health worked for over A DECADE on a Nutrition and Health programme in Mozambique in three main iterations. The schools loved it. The donors loved it. The evaluators loved it. The government loved it (and formally invited us to scale it in February 2020).

Some of you may already know about this programme – well, it’s less ‘a programme’ and more an approach to nutrition and health education. Its main features are to connect children’s learning with their life and to mobilise them to become activists and leaders in health in their own families and communities. 



It works.

For those who don’t know the programme or who might want a refresher… the following article sets out the history of the programme and where we are with it TODAY. 

The wonderful Bibiche Sangwa has been the key person in the development and the success of the programme and here she is with our PCAANS 2022 Toolkit (available in English and Portuguese) which you can download for free at the end of this post.

Please get in touch for more information or if you’d like to set up a webinar so we can answer questions and provide details. 

The PCAAN approach was implemented between 2014 and 2016 in 12 schools in Tsangano District, Tete Province. This was on the back of planning and discussions that began in late 2011. It was funded by DANIDA and the Government of Mozambique, PCAAN was an education strategy and part of a government-led plan, The Multisectoral Action Plan for the Reduction of Chronic Malnutrition (PAMRDC) and coordinated by a group called SETSAN. SETSAN had a national secretariat and a provincial secretariat in Tete Province where we worked. 

PCAAN mobilized children 10-14 years old (Grades 5-7) to understand, learn and share government approved nutrition and hygiene messages and activities with the aim of decreasing malnutrition through behaviour change communication.

The participatory approach allows children to identify opportunities and challenges and ensured that the programme was relevant to their lives and families. Children are effective nutrition and hygiene activists.

Children and their teachers met on Saturdays using an extracurricular education structure and a government approved scheme called, Interest Circles, and followed a 2-year scheme of work based around eight messages, co-created by the Provincial Government of Tete and the schools.

Teachers guides, storybooks and a poster were co-created and tested. These were linked to the local curriculum and to the emerging results of the programme.

After two years, the University of Zambèze, SETSAN and DANIDA evaluated the approach and concluded that it delivered success in the nutrition and hygiene education of children and their families.

In 2017, FAO adopted the approach adding it to their lower school programme, Vamos Comer Alimentos Nutritivos. This combined programme was implemented in three districts in Tete: Tsangano, Macanga and Angónia in a total of 36 schools.

The PCAAN approach has been showcased in many national and international meetings and the storybooks and poster accessed by mobile phone and used widely by teachers and children all over Mozambique and in other countries in the world.

As the roll out developed, some expressed doubts about the sustainability of the Saturday club system with teachers asking for overtime payments. Linked to this, the teachers asked for simpler ways to mobilise more children at school within the capacity of teachers with minimal extra training.

In February 2020 and with local technical consultants, Children for Health helped to run a workshop worked with a group of children aged 10-14 and their teachers at the school, EPC Changara. The workshop was opened by the District Director of Education, in the presence of Education Technicians from the District and Provincial Directorate.

The workshop demonstrated children’s capacity to quickly identify health issues of concern, learn about them, find creative ways to communicate health messages for behaviour change, and develop simple activity plans that addressed nutritional and health issues relevant to their school and community. In this photo, Bibiche is showing the children’s work to the District Director of Education.

Bibiche (right) is showing the children’s work to the District Director of Education

In Changara District, children and their families are affected by malaria, malnutrition, diarrhoea, and other health problems. Government technicians and administrators at every level were keen to understand how children could contribute to health and wellbeing. In the above photo we are doing a fun ranking activity where children help to identify health issues that they feel are a priority for them and their families.

The children learned key messages and learned about three health topics using drawing and simple group activities. These were all fun and participatory, the children made a record in their notebooks.

Facilitators showed the children how a plan would look to promote Balanced Diet; in groups they made a plan for Hand Washing; and by themselves the children made a plan to prevent Malaria

In the last session, the children organised into five neighbourhood colour groups. One boy and one girl were selected to lead each group. They decided where and when they would meet in their neighbourhood groups for their weekly sessions, and they presented their plans.

It was after this workshop that PCAAN Became PCAANS that means Children Participation for Learning and Action in Nutrition and Health!

The school director explained to the children all the many opportunities they will have to teach other children and together share health and nutrition messages in school, in classrooms and extracurricular time, in their homes, and the community at large. He described this approach as bringing the school and community closer together and a way to involve health workers in the school, too.

See below for a link to see a slideshow on our workshop (English or Portuguese).

In the days after the workshop, we had the chance to present our progress to the Ministry of Education in Maputo. Many colleagues there were already aware of the program as it had been part of the national level initiative to combat chronic under-nutrition in the early days. A team of government officials were at the presentation and concluded the meeting with a formal invitation to scale the programme throughout the country. 

A few weeks later the Covid pandemic arrived, and everything went on hold.

Sadly, we have not yet managed to secure interest in this proven, successful programme. We have made several attempts, but for an organisation of our size, our capacity to develop major proposals is limited… we have tried with two donors and not yet succeeded.  

Instead we have invested our time in going back to the school, putting together the workshop materials into a teachers’ toolkit and checking with both children and teachers that there is willingness and an appetite for the approach – which indeed there is. Here is a photo of the children at this reunion.


It is frustrating to have got so far and with over a decade invest in this programme all for it to still not to have ‘landed’ despite the results and the appetite for it. We hear of many programmes which share similar goals which are starting afresh, and we’d like to share our experience of this programme.

We will always be willing to hear from and collaborate with organisations who wish to hear more details on how we implemented this programme and mobilised the children as outstanding activists for health. We must be incredibly proud of getting as far as we did with PCAANS, and we very much hope that the publication of the PCAANS Toolkit is the beginning of the next chapter.

Look at all these PCAAN and PCAANS Programme Resources!

You can find ALL our resources on our website.

Look at…


The storybooks were co-created with teachers and children in Mozambique and are available for free in English and Portuguese.

They are aimed at children aged 9-14 and for children of this age to read to younger children. In the back of the storybooks are lots of questions and fun activities for teachers and older children to use.

Everyone Counts (Sharing Food Fairly)

Everyone Counts tells the story of the need for sharing food fairly. ZaZa and ZuZu the parrots are angry that the men always eat first and do not remember to leave enough food for the children and for Mama. What can the parrots do to make sure that the children have enough to eat? The story tells of how they find a clever way to show the family how to use plates and share the food out before eating.

The Rainbow Garden  (Balanced Diet)

The Rainbow Garden is a colourful, well illustrated book that tells the story of a group of children as they learn the importance of a varied and balanced diet. The teacher at school helps the children to plant a garden full of colourful vegetables they learn that to be strong and healthy they need to eat food of many colours. The rainbow food helps baby Sylvia get well and strong again and gives the children a surprising way to find a lovely birthday present for Mama Ruth.

How to Be Good at Football (micronutrients)

How To be Good at Football tells the story of a boy called Mika. Mika loves football and wants to win the match at school, but he is feeling too weak and sick. He finds out that small things like nails are very important because they hold big things together and learns that the micronutrients in colourful food help to keep his body strong so that he can play football well

The Puzzle (Hygiene)

The Puzzle tells the story of two children, Mika and Christina going on a journey to find a series of puzzle cards hidden around their village. They work out the answers to the puzzles find out how to stay healthy and avoid the germs that make people sick. They learn how to make a tippy tap to wash their hands and other ways to beat the germs.

We are clearly very passionate about this programme and would encourage your to share this post far and wide within your network. If you know of any government, NGOs or schools that would find this programme valuable, please introduce us! We’re always keen to hear how people are using our matierials too. Please contact us regarding any of the above.