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Field Article
there were external factors beyond the control of
the programme managers despite their efforts to
contain them. These factors included the regularity
of mothers at the twice-weekly cooking
demonstration sessions, quality and quantity of
food which they gave to their children inbetween
the twice-weekly visits to the health
facilities and episodes of illness like malaria,
diarrhoea or respiratory tract infections. Efforts
to contain these external factors included:
• Home visits for defaulting mothers by CHWs
• Support to mothers of children during an
episode of illness
• Distribution of premixes (CSB, oil, sugar
and salt) to mothers of MAM children after
each weekly cooking demonstration in the
health facility when available.
The role of mothers in the management of
moderate acute malnutrition
The compliance of mothers to advice on the
preparation of enriched porridge, feeding practices
at home and their attendance record at the
twice-weekly food preparation demonstrations
played an important role in the favourable exit
outcome of moderate acute malnutrition. Despite
the challenges of increases in the prices of basic
foodstuffs, many mothers were able to mobilise
resources to purchase ingredients and prepare
enriched porridge for their children irrespective
of supplies of premix via the programme.
Conclusions
Government health facilities when given the
appropriate technical, material and equipment
support can deliver good results in the management
of MAM cases. On the job training and
supervision, feedback on performance and
regular higher level supervision of nutrition
activities played an important role in the quality
of results posted by the four health facilities
that were considered in this study.
To many mothers, MAM is not an illness and
compliance with treatment, particularly when it
requires weekly presence in a health facility, is a
challenge. The multi-pronged approach of
community sensitisation, information and
education, home visits and facility-based
management of MAM children through weekly
weighing and cooking demonstration adopted
by Fondation Tdh and the authorities of the
health facilities of the project, improved the
knowledge of mothers about acute malnutrition
in general, and MAM in particular.
Cooking demonstrations that included feeding
MAM children in health facilities and
education and counselling on good household
infant and young feeding practices were acceptable
services to mothers. Compliance with
treatment and the recovery rate was high and
the rate of default was low. Lack of knowledge
amongst mothers on appropriate feeding practices
is likely to have been a significant factor in
causing malnutrition in those children admitted
to the MAM programme.
The role of UCHWs is pertinent even where
there is a wide network of private and public
health facilities. Through the active screening of
children in their homes in the quarters, many
children who otherwise would not have been
brought to the health facility because they were
not perceived as being ill by their mothers,
were identified and sent to the health facility for
treatment for MAM.
Finally the management of MAM in an urban
setting demands a multi-pronged approach that
involves trained health workers, community
health workers, information education and
counselling of mothers, good supervision and an
adequate level of food security.
For more information, contact: Dr. Abimbola
Lagunju, email: abimbola.lagunju@tdh.ch
and Dr. Jean Pierre Papart,
email: jeanpierre.papart@tdh.ch
Dedication to Kari Noel Egge
Shared by two of her close friends and
colleagues, Mary Lung’aho and Jennifer
Rosenzweig
As we went to print, we heard the sad
news of the premature death of Kari
Egge, whom many of you will have had
the privilege of knowing and working with.
Kari graduated from Mahtomedi High
School in 1985 and George Washington
University in 1989. Kari earned a PhD in Public
Health from Tulane University where she
combined studies with HIV/AIDS- related projects.
In the following years, Kari dedicated
herself to international causes. Her career in
humanitarian aid work spanned over 20 years
with Peace Corps, Catholic Relief Services (CRS)
and the International Division of American Red
Cross (AmRC). As part of CRS’ Emergency
Response Team, she played a key role in numerous
emergencies, including the Goma volcano
disaster, Afghanistan, Southern Africa drought
and the tsunami in Indonesia. In addition, Kari
helped train hundreds of emergency responders.
Her last posting was to Thailand, working
with those in countries affected by the 2004
tsunami. During her career, she made lasting
friendships around the world. Kari was also a
loving mother to Dylan (6) and Isabelle (8),
taking every opportunity to introduce them to
new cultures and environments.
There has been a huge outpouring of tributes
on Facebook from a global community of
colleagues and friends who supported her
through her illness and are now celebrating her
life. Here are just a few:
“Kari will be greatly missed. Her enthusiasm and
passion for improving the humanitarian cause
will continue to inspire all of those who the pleasure
to work with her.”
“She was articulate, strong, and sensible and
clearly had the experience to back up all the
contributions she made”.
“A mom who managed to become an amazing
mother and still contribute to the humanitarian
field for a long time. This affected me profoundly
and I know I made decisions differently because of
her example. It is amazing how much impact
Kari’s life had, not just on her immediate family
who were blessed by her love and mourn her
departure, but also on those of us who were
merely in her presence and felt changed by her life
and the way she chose to live it.”
Some lovely memories are also shared at
http://thegeographyofsoul.wordpress.com/201
2/01/31/kari-noel-egge/
There will be gatherings for her and celebrations
of her life happening around the world
(Minnesota, Washington DC, Kenya and
Bangkok). This speaks to the incredible impact
that she has had on the world.
We express our sincere condolences to her
children, Dylan and Isabelle, on their loss, as
well as to their father, Graham Eastmond, her
parents, Robert and Deanna Egge, brother Kirk
and family.
Mary Lung’aho, Jennifer Rosenzweig
and all of the ENN Team
Dedication to Mr Abdikarim
Hashi Kadiye
Shared by Leo Matunga, Nutrition Cluster
Coordinator, Somalia
We extend condolences to the family
and friends of Mr Abdikarim Hashi
Kadiye and Mr Duale, who died on the
12th of January 2011 in Somalia. Mr Kadiye the
head of Tofiiq Umbrella Development organisations
(TUOS) and also, the nutrition cluster focal
point for Hiran and Galgaduud, had just
recently organised and chaired the Hiran-
Galgaduud cluster meeting on the 10th of
January 2011. Mr Kadiye was killed together
with his driver, Mr Duale, in an ambush by
unknown gunmen between Dhusamareb and
El Dhere. This is a senseless loss of life and a
huge loss to the work of the cluster in the
region. Mr Kadiye had been the nutrition focal
person for Galgaduud for almost a year now,
was a hard working member of the cluster, and
had tried under difficult conditions to continue
to organise partners meetings in the area and
ensure smooth operations of the nutrition
programme.
We extend our heartfelt condolences to Mr
Kadiye and Mr Duale’s families, friends and the
TUOS staff.
Leo Matunga and the ENN Team
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