Improving care-givers’ knowledge of good nutrition through monthly community-based care group trainings


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Through VHTs and Health Assistants, communities have learnt the importance of exclusive breastfeeding during the first six months; complementary feeding and preparation of balanced diets; feeding...

By 10:00 a.m., the morning sun already feels hot in Obir village, Parak Parish in Lakwana Sub County in Omoro District of Uganda. A group of 30 women – some pregnant, others breastfeeding with children below 24 months – take shade under a mango tree in the home of Pauline Akello. They gather once a month, as part of a healthy living club (HLC), to learn about complementary feeding and how to prepare a healthy diet for their babies. 

Twenty-eight-year-old Kevin Aciro is among the women in Pauline’s home. A wearer of many hats, she is a youth councillor, a housewife, mother of two and a peasant farmer. Furthermore, she is a Village Health Team (VHT) volunteer in Obir village.  Kevin is one of 400 VHTs who facilitate care group meetings. Today she will be raising awareness about good nutrition and health benefits of eating orange-fleshed sweet potato (OFSP) to reduce the prevalence of Vitamin A deficiency (VAD). Adequate Vitamin A status prevents common illnesses and provides good eyesight. Vitamin A deficient children are more likely to fall ill and even die than those with adequate levels of Vitamin A in their bodies. 

Women living in hard-to-reach areas and far from health facilities are especially vulnerable to the negative effects of VAD, as they are usually without formal education, and live in extreme poverty with limited access to essential services such as healthcare. Through the International Potato Center (CIP)’s Development and Delivery of Biofortified Crops at Scale (DDBIO) Program in Uganda, at least 10,500 pregnant and breastfeeding women have been trained on optimal infant-and-young-child feeding practices, dietary diversity, handwashing and safe preparation of food and water. CIP has also provided healthy baby feeding toolkits constituting a bowl with lines and symbols that cue age-appropriate meal frequency and volume, and a slotted spoon that promotes optimal thickness of infant foods. Other approaches have entailed holding regular cooking demonstrations, distributing T-shirts with nutritional messages and OFSP vines for planting. During the training sessions, the VHTs utilise portable audio speakers with pre-recorded nutrition messages.

The work under DDBIO is implemented in partnership with the World Food Programme, Lutheran World Federation, Mercy Corps, District Local Government and Uganda’s National Agricultural Research Organization with funding from the Foreign, Commonwealth & Development Office (FCDO), formerly the Department for International Development (DfID). In 2020, the project supported 610 VHT volunteers and 60 Health Assistants in 12 districts of Uganda (Bugiri, Busia, Butaleja, Tororo, Omoro, Adjumani, Pader, Kitgum, Agago, Lamwo, Kotido and Moroto). 

Through VHTs and Health Assistants, communities have learnt the importance of exclusive breastfeeding during the first six months; complementary feeding and preparation of balanced diets; feeding children during illness; meal frequency and volume; maternal nutrition for exclusive breastfeeding and, diet diversity including incorporation of Vitamin A foods such as OFSP.

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Dr. Fred Grant, CIP Country Manager leads a discussion on the importance of optimum nutrition with members of Acan Tute Healthy Living Club in Omoro in presence of their two VHTs, Ms. Aciro Kevin and Mr. Odongo Bosco (Photo: CIP/ Okonya).

For Agnes Nyana, a 23-year-old mother of two and beneficiary of the trainings, through the HLCs in her village, she can now easily grow OFSP, dark green leafy vegetables, pawpaw and mangoes and incorporate these foods in her family’s diet.  

“I didn’t know the amount of food sufficient for my one and a half year old daughter. She used to cry a lot but now I can use the feeding bowls I received from CIP to measure the food and know how often to feed my daughter. Because the bowl also has markings that show how often to feed the child, my girl no longer cries a lot because I give her the recommended number and amount of meals per day. The bowl also came with a spoon with holes which helps me to measure the thickness of the porridge. I suspect that my daughter cries less these days because I have learned how and when to feed her,” said Agnes. In comparison, she noted her daughter, unlike the elder brother seldom fell sick as she can feed him more nutritious meals. 

“I mix different ingredients like groundnut or sesame paste and milk, yellow banana and OFSP in porridge. Now, I know how to cook good food which is rich in Vitamin A, proteins and other nutrients using the staple foods we commonly grow to feed children hence they are healthier,” said Agnes. She adds that she is now more cautious when preparing and storing baby food and is careful to clean her hands with soap even before breastfeeding. 

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Agnes Nyana with her one and a half year old daughter in front of her house in Obir village, Omoro. (Photo: CIP/ Okonya)

Nyana’s sentiments are shared by two other neighbouring women, Grace Ojera of Obir Village, and Janet Adong of Awoo Trading Centre.  These two residents of Lakwana subcounty in Omoro District said at first, they did not think they would be impacted by the monthly lessons. However, Grace noted she had learnt that it is not just about eating different food items, but the foods must belong to different food groups. For Janet Adong, she is already traveling less frequently to Awoo HC II for treatment of diarrhoea, hence saving money that would have otherwise been utilized as hospital bills. This she notes, is because of improved hygiene practises learnt through the HLCs. 

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A member of Orib-cing Healthy Living Club feeds her child with thick enriched porridge (Upper left); Members of the community care groups participating in preparing a nutritious porridge for children 6-23 months at Burkwoyo village, Lakwana subcounty, Omoro (Upper right) (Photos: CIP/ Okonya).

Speaking to the importance of the HLCs under the DDBIO project, Everlyn Akello, the officer in-charge of Awoo Health Center II, lauded the ongoing work as helping address the issue of malnutrition in the community. “For a long time, we have been registering cases of acute malnutrition among pregnant mothers and children who attend our health services in the facility and have desired a lasting solution to these problems. Equipping these mothers with nutrition education and the technical knowhow to grow and utilize locally available foods is important,” she said. 

Joshua Okonya, a research associate with CIP – Uganda, the organization that is promoting the sweet potato based agri-food systems, said CIP and partners have trained health workers (in-charges, VHTs and Health Assistants) to train mothers in their communities on better ways to prepare complementary foods. “The problem is a lack of knowledge on how to prepare meals for children especially those that are above 6 months which has contributed to high prevalence of VAD, a form of ‘hidden hunger’ - a lack of vitamins and minerals in diets.” He said their intervention is to train VHT members and caregivers to enhance their knowledge on how to prepare a balanced diet to have a healthy and strong generation, Joshua said. 
“Our focus is to fight and reduce VAD in the community, which is why we are encouraging use of OFSP which is rich in Vitamin A as one of the components in the diet,” he added. 
Dr Fred Grant, a nutrition scientist with CIP-Uganda further explained that, “Hidden hunger poses serious threats to populations and economies not only in Uganda but globally, and prevalence is highest among children under-five years which contributes to stunting and sometimes death.” Dr Grant believes that OFSP is a major part of the solution to combat VAD especially for low-income households that already have sweet potato as a staple.
Lilian Wanican Angala, the acting District Agricultural Officer said Omoro District does so well in so many crops that are high yielding with soybean being the leading crop but unfortunately, people grow it for commercial purposes without thinking of eating it which puts the district at a high risk of malnutrition. “As Production Department, we need to increase food production and ensure food and nutrition security for every household and wipe out malnutrition in the district,” she said.

About CIP Uganda
CIP has worked in Uganda since 1988, supporting the nutritional gains, value chain development, pest and disease management, and the breeding, evaluation and dissemination of improved potato and sweet potato varieties. In collaboration with the National Agricultural Research Organization (NARO) and the Variety Release Committee of Uganda, CIP and other partners have launched 22 improved potato varieties and 18 sweet potato varieties. This work includes the widely disseminated orange-fleshed sweet potato (OFSP) varieties. In 2016, CIP and HarvestPlus scientists, including CIPs Uganda based Robert Mwanga, were awarded the World Food Prize for their work in breeding and promoting the adoption of these highly nutritious sweet potato varieties by millions of African families.

In partnership with research centers, universities, government departments, private companies and NGOs, CIP has helped improve the productivity, sustainability and resilience of the potato and sweet potato sectors, strengthened the capacity of local partners, and supported the Ugandan government and other partners in scaling interventions.

For more information about CIP and our work in Uganda, visit us on Plot 47 Ntinda II Road, Naguru, Kampala or contact our Country Manager, Dr. Frederick Grant on [email protected] and Tel: +256-393-266-252

About CIP Global
The International Potato Center (CIP) was founded in 1971 as a research-for-development organization with a focus on potato, sweet potato and Andean roots and tubers. It delivers innovative science-based solutions to enhance access to affordable nutritious food, foster inclusive sustainable business and employment growth, and drive the climate resilience of root and tuber agri-food systems. Headquartered in Lima, Peru, CIP has a research presence in more than 20 countries in Africa, Asia and Latin America.

CIP is a CGIAR research center, a global research partnership for a food-secure future. CGIAR science is dedicated to reducing poverty, enhancing food and nutrition security, and improving natural resources and ecosystem services. Its research is carried out by 15 CGIAR centers in close collaboration with hundreds of partners, including national and regional research institutes, civil society organizations, academia, development organizations and the private sector.

Follow CIP at www.cipotato.org  

This story is sponsored by the International Potato Center (CIP).