En-net update, March-May 2012
By Tamsin Walters, en-net moderator
Thirty-six questions were posted on en-net in the three months March to May inclusive, eliciting 176 replies. In addition 25 job vacancies were posted.
Recent discussions have included: Mid Upper Arm Circumference (MUAC) changes in pregnancy and ongoing research into what are the most appropriate thresholds to use for pregnant and lactating mothers in programmes to treat acute malnutrition and how they correlate with adverse outcomes, dilemmas of whether to use weight-forheight or MUAC to diagnose acute malnutrition and the potential biases of the two measures in different population groups, the challenges inherent in attempting causal analyses of acute malnutrition, and considerations of how to continue to promote breastfeeding in community-based management of acute malnutrition (CMAM) programmes.
An interesting discussion arose from a situation in Somalia where reports came in of mothers “starving” their children in order to benefit from nutritional treatment and a protection ration being provided alongside programmes to treat acute malnutrition. This is not an unfamiliar scenario and has been reported in several countries, with greater or less emphasis, in many programmes implemented in crisis situations. The Nutrition Cluster in Somalia is trying to gather further evidence to establish how significant and widespread the problem is. Meanwhile, performance monitoring data from one programme in Somalia has shown an increase in relapses in the last three months from 8% to 17%, which could be linked to the same issue. Suggestions and solutions were sought on how to address this situation.
Discussants advised enhancing community mobilisation and counselling for both mothers and fathers, as well as engaging other influential community leaders. Contributors cited successful examples of both individual counselling as well as group discussions in programmes in Uganda, South Sudan, Ethiopia, Niger, Haiti and Bangladesh.
Despite these examples of successful approaches to address the immediate issues, it was agreed that ‘starving’ of children was most likely symptomatic of a much greater underlying problem of food insecurity. “These are usually decisions made under conditions of real stress which aid workers, agencies, donors and planners have never personally faced and often to not consider”1.
A situation where people are taking such desperate measures to access basic commodities suggests a large unmet need in terms of general rations and basic household food needs. It is a survival strategy for the family.
Excerpts from a letter from Nelson Mandela on World Food Day, September 2004, was quoted to bring home the real issues people are facing and the decisions they are making in such situations: "Hunger is an aberration of the civilized world... Families are torn asunder by the question of who will eat. As global citizens, we must free children from the nightmare of poverty and abuse and deprivation. We must protect parents from the horrifying dilemma of choosing who will live.2"
The discussion concluded with a consensus that mothers should never be shamed or punished in nutrition programmes, but efforts should be made to understand and help them. Mothers do not harm their children unthinkingly; they are facing desperate life and death decisions for their families. Our work is to try to understand and respect the reality of their day to day lives and adjust our programmes accordingly to meet their needs.
To view the full discussion, go to http://www.en-net.org.uk/question/717.aspx
To join any discussion on en-net, share your experience or post a question, visit www.en-net.org.uk
Contributions from Fortune Maduma, Martha N, Peris Mwaura, Yara Sfeir, Chantal Autotte Bouchard, Mark Myatt, Leo Anesu Matunga, Alex Mokori, Michael Golden, Nikki Blackwell and others.
More like this
FEX: En-net update and MAMI thematic area launch
By Tamsin Walters, en-net moderator Over the period October 2013- Jan 2014, 43 questions have been posted on en-net, along with 166 responses and 48 vacancy...
FEX: En-net update
By Tamsin Walters, en-net moderator Twenty-seven questions were posted on en-net in the three months up to Christmas, eliciting 102 replies. In addition, 17 job vacancies have...
FEX: En-net update
By Tamsin Walters, en-net moderator Over the past four months1, 32 questions have been posted on en-net, generating 69 responses. Two upcoming trainings have been advertised...
FEX: en-net update, August to October 2012
By Tamsin Walters, en-net moderator Forty-seven questions were posted on en-net in the three months August to October 2012 inclusive, eliciting 152 replies. In addition, 18...
en-net: Ideas to prevent Mothers from starving their children in order to benefit from the nutritional treatment
Dear All, It seems that we have an additional problem in Somalia where several organisations have reported that mothers are starving their children in order to benefit from...
FEX: en-net summary: Summer 2022
View this article as a pdf en-net is a free and open resource that helps field practitioners gain access to prompt technical advice in addressing operational challenges for...
FEX: En-net update July to October 2016 inclusive
Over the past four months 88 questions have been posted on en-net*, generating 228 responses. Forty-two vacancy announcements have been posted, which have accumulated almost...
FEX: En-net update
By Tamsin Walters, en-net moderator Forty-four questions were posted on en-net between April and June 2011, eliciting 90 replies. In addition, 19 job vacancies have been...
FEX: en-net summary: Spring 2022
View this article as a pdf en-net is a free and open resource to help field practitioners to gain access to prompt technical advice for operational challenges for which...
FEX: En-net summary
View this article as a pdf En-net1 is a free, open resource for frontline nutrition practitioners to gain access to prompt technical advice for operational challenges where...
FEX: En-net update
By Tamsin Walters, en-net moderator Seventeen questions were posted on en-net between May and July, eliciting 48 replies. Seven were posted in the Assessment area, four in...
FEX: ENN update
View this article as a pdf Field Exchange Special issue on wasting in South Asia Asia is home to half of the world's wasted children (25.9 million) and severely wasted...
FEX: en-net highlights : LNS and implementing CMAM
Between August and October 2009, 19 questions were posted on en-net, eliciting 38 replies. A variety of issues have come up including the challenge of developing age-adjusted...
en-net: Safe alternatives to breast milk in rural sub-Saharan Africa that are not formula milk?
In South Sudan, many women report not being able to breastfeed. Whilst in some cases this is about traditional beliefs and practices around infant feeding, maternal nutrition...
FEX: Prevalence of moderate malnutrition in infants
Summary of en-net discussion By Tamsin Walters, en-net coordinator Contributors: Nina Berry, Mike Golden, Mark Myatt, Marie McGrath A recent discussion on en-net concerning...
FEX: en-net update
By Tamsin Walters, en-net moderator Over the past three months, 37 questions have been posted on en-net, generating 59 responses. The forum areas for Prevention and management...
FEX: Update on en-net discussions
By Tamsin Walters, en-net Moderator This is a summary of some of the 'hot' discussion topics on the online forum, en-net, www.en-net.org.uk since the last issue of Field...
en-net: SAM & Vit.A
I would like to know the update of use of Vit.A in SAM,when it be given in first day or later on,with many thanks. This issue is discussed in the 2013 WHO update on SAM...
FEX: En-net update
By Tamsin Walters, en-net moderator Over the past four months (1st October 2015 to 17th January 2016), 56 questions have been posted on en-net generating 206 responses....
en-net: SQUEAC/SMART
Is there an upcoming training on SQUEAC/SMART....anyone any information please share.. Hello, Are there any additional trainings planned for coverage surveys? Workshop on...
Reference this page
Tamsin Walters (). En-net update, March-May 2012. Field Exchange 43: Government experiences of CMAM scale up, July 2012. p62. www.ennonline.net/fex/43/ennet
(ENN_4298)