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Why isn’t there funding for this proven nutrition programme?

Children for Health has worked for over A DECADE on the PCAANS programme in Mozambique, in three main iterations. The schools loved it. DANIDA 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 its 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.

FAR FETCHED?

NOPE!

It works.

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

Please get in touch for more information or if you’d like to set-up a webinar so we can answer questions and provided 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 mobilised 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 lives of the children and their families. Children are effective nutrition and hygiene activists.

Children and their teachers met on Saturdays using an extra curriculum education structure 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. Please read one to see the updated interest circle project below.

Teachers’ guides, storybooks and a poster were co-created and tested (in English and Portuguese). These were linked to the local curriculum and to the emerging results of the programme.

And in English
And in Portuguese
And in English
And in Portuguese

All of these are available for free from our resources section.

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 worked with a large group of children aged 10-14 and their teachers at the school, EPC Changara and 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 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 can also contribute to health and well-being.

The workshop was opened by the District Director of Education, in the presence of Education Technicians from the District and Provincial Directorate.

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 a 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.

The School Director and the District Education Director were pleased and impressed by what the children had achieved in such a short time!

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 and at 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.

To see a slideshow on our workshop (English or Portuguese) – please get in touch.

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 progress as it had been part of the national level initiative to combat chronic undernutrition 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. 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!

It is frustrating to have got so far and investing over a decade with this programme for it still not to have landed despite the results and the appetite for it. 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 have to 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.