Building Bonds and Resilience: outcomes of our Emergency Response
Community health projects at SEED place sustainability and long-term impact at the forefront of programme development, so that the communities which we aim to serve can benefit from lasting change long after the end of projects. Whilst the main goal of SEED’s Emergency Food Distribution Programme is to alleviate the suffering of malnourished children in southeast Madagascar, interviews with programme beneficiaries and healthcare workers have indicated there are many positive long-term outcomes of the programme, which go beyond food security.
In southern Madagascar, 1.14 million people are currently experiencing high acute food insecurity, with over 400,000 at risk of famine.1 Extreme food shortages and rising food prices as a result of drought and failed harvests are being exacerbated by the economic impact of the COVID-19 pandemic.2 It is estimated that crop production this year is 50-70% below the five year average.3
SEED is responding to this crisis by collaborating with 15 local community health centres, the Medicine Inspector, and the Operational Coordination Centre against Famine to alleviate food insecurity in southern Madagascar. The programme is currently supporting malnourished children and families from 86 villages across Southern Madagascar.
SEED's Emergency Food Distribution Programme begins with children being screened in their communities for signs of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM). Children identified as suffering from MAM and SAM are then directed to their local community health centre for confirmation of diagnosis. SEED distributes ready-to-use therapeutic food (RUTF) to children with MAM every 15 days, for a total of 60 days, whilst children with SAM receive RUTF provided directly from the healthcare centres to allow closer monitoring of their condition. Families of all children with malnutrition receive unprepared food parcels containing rice, beans, and fortified oil every 30 days whilst children undergo treatment. Families also have the opportunity to attend information sessions covering nutrition and water, sanitation and hygiene (WASH) when collecting their RUTF and unprepared food.
Education is an important element of SEED’s Emergency Food Distribution Programme as it focuses on encouraging positive behaviour change that can bring about long-term benefits to children’s nutritional status. SEED’s targeted information sessions are led by our Food Distribution team, who cover three key topics: proper nutrition for children, the identification and treatment of common childhood illnesses, and health-promoting hygiene behaviours. Specifically, sessions include: exclusive breastfeeding, the management of healthy drinking water, the preparation of RUTF, the importance of nutrition in relation to child development, and handwashing practices. Beneficiaries are also encouraged to purchase local nutritious food products, such as sweet potatoes, which not only has a direct impact on the children and families supported by the programme, but can also have a positive impact on the market by supporting local farmers.
SEED spoke with a number of mothers who have been supported by the programme to gain their perspective on the information sessions our team have been providing. All of the mothers interviewed highlighted their increased knowledge of nutrition for young children aged six to twelve months, as well as the importance of exclusive breastfeeding. Some of them also discussed the importance of handwashing before food preparation and how to mix their children’s emergency nutritional supplements. Most mothers reported they began to feed their children aged over six months additional food as well as continuing to breastfeed, as a result of SEED’s targeted education sessions. Tsaravavy, a mother of one of the 45 children diagnosed with malnutrition who SEED is supporting in Mandromondromotra commune, explained, “The education I received during food distribution enabled me to know that my child should eat protein-based food to gain strength and energy.” Not only have there been impressive rates of recovery amongst children during the first round of the project (98% MAM recovery rate and 99% SAM recovery rate), but reports from the field indicate more people are accessing the community health centres for other health ailments as a result of the programme’s partnership with local community health centres.
SEED’s nutrition education has helped me a lot. Those sessions helped me to know that infants over six months should be fed additional food three times a day, and I should keep breastfeeding until my baby is two years old. Once I started to apply this education, I soon saw that my child’s health [had] gotten better.
Beatrice, mother of 10-month-old Frido who is receiving MAM support
To gain a deeper understanding of how health-seeking behaviour has changed, SEED interviewed multiple community members and community health centre staff members supported by the programme. The results were overwhelmingly positive: all participants said their trust in the community health centres has increased following the programme, and all community health centre staff members said they are seeing more patients use their facilities. Many community members and community health centre staff attributed this change to the awareness-raising sessions on community health centre services during food distribution. Beatrice, whose 10-month-old Frido receives support for MAM, said “my trust towards the community health centre has increased since SEED started food distributions, this is due to the awareness-raising they deliver each time we receive food distribution about the healthcare services they provide at the community health centre.” Multiple community members cited an increased understanding of specific services such as malaria treatment, family planning and childbirth services.
Being part of SEED’s Emergency Food Distribution Programme encouraged me to trust the community health centre with their healthcare services, the project built a bond between me and the community health centre.
Tsaravavy, whose 14-month-old Mary Rosni receives MAM support from SEED
Beyond providing vital food aid during this period of heightened uncertainty for southeast Madagascar, SEED hopes that its contributions to health-seeking behaviour change will also have lasting effects on the health status of communities. Razafindratema Felene is a community health centre staff member working in Soanierana who has seen a positive change in health-seeking behaviour in the population:
There is absolutely an increase of patient numbers at the community health centre since the food distribution programme, this is because it’s the first time malnourished children have been supported by an organisation at the community health centre level.
Razafindratema Felene, a community health worker
Our Emergency Food Distribution Programme was originally designed to be a short-term humanitarian project responding to the increasing food insecurity in southeast Madagascar. However, after interviews with beneficiaries, it is clear that it has brought about positive impacts which extend far beyond the original scope of the programme. Together with communities and local health centres, we are creating long-term health-seeking behaviour change by working to strengthen trust in community health centres and enhancing nutrition and WASH knowledge. This has the power to continue to improve the health of communities long after short-term programme cycles have ended, accelerating their recovery, and enhancing their resilience into the future.
References
1 Food and Agriculture Organization of the United Nations (FAO), “GIEWS Update the Republic of Madagascar,” FAO, August 4, 2021, http://www.fao.org/3/cb6192en/cb6192en.pdf. Accessed 15 October 2021.
2 ReliefWeb. (2021, 11 May). Southern Madagascar | Response overview (May 2021). Available at: https://reliefweb.int/report/madagascar/southern-madagascar-response overview-may-2021. Accessed 15 October 2021.
3 FEWS NET. (2021, June). Madagascar Food Security Alert. Available at: https://reliefweb.int/sites/reliefweb.int/files/resources/Madagascar%20Food%20Security% 20Alert%20- %20June%2010%2C%202021.pdf Accessed 15 October 2021.