July 10, 2000 - USAID Guinea: Africare keeps Children in Good Health in the "Hearth" Program
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July 10, 2000 - USAID Guinea: Africare keeps Children in Good Health in the "Hearth" Program
Africare keeps Children in Good Health in the "Hearth" Program
Caption: This woman is learning how to make nutritious meals for her young child through Africare's Hearth sessions.
Read and comment on this story from USAID Guinea on the "Hearth" program for nutritional rehabilitation of malnourished children from 6 to 36 months of age in the Dabola region of Middle Guinea. Hearth is the name for the model of the program developed by the Mothercraft Centers in Haiti and other countries in the 1960s. Since its inception, the program has expanded and has been successful in treating malnourished children in countries such as Vietnam and Bengladesh, as well as in a number of other African countries.
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Keeping Children in Good Health*
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Keeping Children in Good Health
Mothers learn good nutrition on a shoestring
This woman is learning how to make nutritious meals for her young child through Africare's Hearth sessions.
The mothers in Dabola generally come quite early with their young children to the Hearth sessions so they can get back to their chores at home and out in the field. They knew in the beginning that the Africare sessions were about the health of their young children, a subject that is of great importance to them, so they agreed to come. They say they are learning a lot so far about keeping their children in good health.
As part of the USAID/Guinea Health SO’s Maternal Child Health Initiative (MCHI), Africare initiated the "Hearth" program for nutritional rehabilitation of malnourished children from 6 to 36 months of age in the Dabola region of Middle Guinea. Hearth is the name for the model of the program developed by the Mothercraft Centers in Haiti and other countries in the 1960s. Since its inception, the program has expanded and has been successful in treating malnourished children in countries such as Vietnam and Bengladesh, as well as in a number of other African countries.
For today’s session, the mothers and their small children convene under a small grass hangar, where water is already boiling over a large pot. Each child has a bowl and a spoon to be able to eat the nutritious porridge recipe that the Maman Lumière is going to teach the mothers to make. The mothers mill around and greet each other, and watch as the Maman Lumière gathers together the ingredients that the mothers have contributed to make the porridge.
Caption: In this Hearth session, Maman Lumière is instructing other women how to make a nutritious meal for their young children.
The program uses nutrition educators in cooperation with a local "Maman Lumière" or "enlightened mother"  from the community to serve as an example to implicate mothers and caretakers in the rehabilitation of malnourished children. During the sessions, the Maman Lumière uses inexpensive foods that are found locally to show that nutritionally balanced meals alone--without the use of medicine--can usually rehabilitate the child.
The Maman Lumière explains the ingredients she’ll use to make the porridge. She had planned to use corn meal, sugar and peanut butter, but since there is no peanut butter available, she says the use of palm oil will do just fine. She begins making her porridge as the mothers look on.
The program has two major goals. The first is to see that the malnourished children attending the sessions achieve a normal weight gain, and the second is to assure long-term changes in mothers’ habits in feeding their young children.
Today’s session is about the importance of good hygiene, and the Maman Lumière explains how the mothers must wash and dry all cooking and eating utensils, and that they must really soap up and wash their children’s hands before they give them a meal. When the porridge is ready, the mothers follow the Maman Lumière’s advice, and soap up each child’s hands and wash them over big water basins. Now the children are ready to eat.
Caption: Each Hearth session teaches women a new nutritious recipe.
The Dabola program implements three one-month Hearth cycles over a period of ten months. The three weeks of preparation prior to the Hearth session is time-intensive. It involves monthly weighing to identify malnourished children and potential Hearth intervention sites, a 24-Thour diet recall survey and home visits to identify a Maman Lumière, negotiation with the Maman Lumière and her family, particularly her husband, to ensure her full participation. From the beginning, the woman's husband is engaged in the process since his approval is key to allowing the Maman Lumiere to leave behind her work for twelve days to lead the workshops.
The mother is then trained by Africare staff to enable her to successfully communicate Hearth health messages to other mothers. Before, during and after the intervention, local field agents work in collaboration with Africare staff, a nutritionist, and local health post staff to ensure appropriate follow-up of all children in the Hearth program.
The Maman Lumière gathers the bowls together and starts dishing out the orange-tinted porridge for each child. The children are seated, and slowly begin putting their spoons into their porridge, play with it a bit, then they start putting it into their mouths. The mothers appear quite happy to see their children eating well, and the mood is festive.
Caption: Women whose children are already in good health are often chosen to be the "Maman Lumière," who serves as a guide to other women during the Hearth sessions.
The Hearth program has the advantage of being low-cost both for the participating mothers as well as for the implementing NGO—the majority of the costs for the sessions are paid for by the community themselves (the women contribute by bringing the food to be prepared), which attests to the enthusiasm the mothers have for participating in the Hearth sessions. In addition, the nutritious meals the mothers learn to make cost on the average no more than 25 cents, an affordable price for poor mothers in the rural Dabola area.
A workshop for local and international NGOs was sponsored by USAID and UNICEF was held in Dabola October 11-15, 1999, in which Africare shared ideas and lessons learned form their Hearth program in Dabola. The workshop sparked great interest in implementing the program, and since then, one other NGO, ADRA, has applied the model to target mothers of malnourished children in poor neighborhoods of urban Conakry.
Other NGOs as well as the Guinean Ministry of Health are looking into applying the model in such varied environments as hospitals and refugee camps. Africare is planning another international workshop on the Hearth model in Guinea sometime in January, 2001.
The Maman Lumière gives one more short talk about the importance of food diversification. Then she asks the women if they’ve understood the recipe, and if they can do it by themselves at home. The women nod yes, they’ve understood. One woman is asked to summarize what she has learned. She says, "I know that to keep my child healthy, I should follow the rules we’ve learned. Whether I’m busy or not, I should always wash my child’s hands with soap and water before he eats. I should always prepare nutritious food, use clean plates and silverware, and give him potable water to drink. That’s what we’ve learned, and that’s what we should do." The Maman Lumière praises the woman for giving a good summary.
Hearth sessions in the Dabola region have had great success. Home follow-up visits after the Hearth sessions have shown that 80% of the children achieve normal weight gain by the end of the session. Mothers, fathers, and health workers become enthusiastic as the sessions advance, and are often ecstatic at the progress their children have made. Moderately malnourished children who are typically sick and listless during the first two weeks of participation are transformed into healthy young children, full of life.
 The Enlightened mother is termed a "positive deviant,"a mother who has successfully maintained her child's nutritional status using locally available resources.
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This story has been posted in the following forums: : Headlines; COS - Guinea; Special Interests - Development
I relly like what I have seen I just wish we had a printer that work so I can print out of some of this stuff I have learn about Guinea for my report that I am doing. I have to stand in front of the class and talk to the class about my country Guinea and I will be graded on it, how my project is, and how I wrote it,if its neat or sloppy and how I act toward the class,and how I spoke,qitely,soft,or just right.
I relly like what I have seen I just wish we had a printer that work so I can print out of some of this stuff I have learn about Guinea for my report that I am doing. I have to stand in front of the class and talk to the class about my country Guinea, and I will be graded on it, how my project is, and how I wrote it,if its neat or sloppy and how I act toward the class,and how I spoke,qitely,soft,or just right.