Nyarusange Village, Kamegeri sector

On Wednesday, we went on a field visit to see growth monitoring. Every month, all children under 5 must be weighed and their Mid-Upper Arm Circumference (MUAC) is measured. These are recorded on individual growth charts as well as large WHO growth charts, to see how the village is doing as a whole. In addition, pregnant and lactating mothers with children under two are also assessed by measuring MUAC. These measurements alert mothers and CHWs as to the nutritional state of themselves, as well as their child. The bands and the growth charts have a green, yellow, and red section. If the child is in green, they are healthy. Yellow alerts CHWs that the child is moderately acute malnourished and action should be taken to prevent slipping into severe malnutrition. If the child is in red, he or she is considered severely acute malnourished. This will force the CHW to transfer the child to the health centre for further treatment.

Before the measurements took place, the CHW gave a short community counselling lesson around preventing diarrhoea. The male binome helped to weigh the child and measure their MUAC, while the female recorded the numbers he called out. After each child was measured, the mother put a dot on the growth charts that were hanging up.

One after another, each dot was placed in the green. At one point we saw that a dot was placed in the red and one in yellow.

The child that was in the red was a 14 month old girl, that could not walk or even stand. She had previously been to the hospital, but was throwing up 6 times per day. Due to the child's illness, she could not absorb the nutrients needed for proper growth and development. This can lead to the disease-malnutrition cycle. This means that if a child is malnourished they are more likely to contract diseases as they have a weakened immune system. Alternatively, if the child has an illness they are often not able to absorb nutrients and thus likely to have a reduced nutritional state. Therefore its essential that both the illness and malnutrition are addressed in order for the child to become healthy. 

This village is in the Kigeme Hospital Zone, this means that it is not part of the Nutrition Weeks program. It would be interesting to see if, once this program is implemented district wide, whether these numbers would change.