Intergrating MAMI programming in Uganda health sector

Editorial 

Malnutrition is a global health problem that affects one in three children and is a leading cause of morbidity and mortality in children under five years of age.

However, the prevention and management of malnutrition in children under 6 months of age compared with children aged 6 to 59 months has received little attention.

As a result, malnutrition in infants under 6 months of age remains widespread, underreported and poorly managed due to limited evidence available to inform policy and practice.

Why is the evidence lacking? One reason is that children under 6 months of age are often excluded from nutrition surveys and programs because there is no approved MUAC threshold for this age group, making it difficult to screen children in this age group.

There is also the incorrect assumption that infants under six months of age are exclusively breastfed and are therefore less likely to be malnourished. However, reality shows that this is not the case.

In fact, the number of children this age who are exclusively breastfed worldwide has dropped to less than 50%. The available evidence is contradictory.

A recent analysis of the Demographic Health Survey from 56 countries estimated that 18% of infants were born with a low birth weight.

Upon request, the Alliance’s MAMI Advisor, Save the Children’s Alice Burrell, was deployed to Uganda to assist Uganda Action Against Hunger in training and developing the medical team, as well as building the capacity of MAMI nationals to pioneer and work with the government to raise awareness of MAMI among national organizations, government officials, health care workers and staff.

Support provided includes:

On-site monitoring and training to Ugandan Famine Action staff on current MAMI implementation in Adjumani and Kiryandongo refugee camps. Developing an “action plan” based on monitoring observations to continue building staff capacity on MAMI and service delivery quality. Helping refine M&E tools, including developing a monitoring tool MAMI. Preparing and organizing a 5-day MAMI technical training for staff, with support from national MAMI, IMCI and IYCF focal points. Providing MAMI orientation for nutrition industry countries and stakeholders.

Alice’s time in Uganda has proven to be effective, especially in terms of closing the knowledge gap surrounding MAMI in the Uganda Action Against Hunger group. Training participants said they felt better equipped to implement MAMI in their work in the community. The future hope is that, now better positioned, Action Against Hunger in Uganda can foster dialogue around MAMI among stakeholders and share knowledge, tools and resources thus improving innovation at the district and regional levels to improve care for these vulnerable women and children across the country.