Context:

The Beri-Nut Nutrition Status Data Management tool from February 2021 was conceived and had started being developed. Over time, the need for field testing became an obligation. With the focus of Beri-Nut being to reach the most crisis affected zones, the best testing zones would be rural areas. These testing zones had to reflect the target zones in that the poverty, illiteracy and malnutrition rates needed to be relatively higher compared to Urban areas. This was the basis on which the choice of the locations was made. Given the fact that Dr Njeba Bruna already renders service in the Ngaoundere Urban District, Urbano-rural areas like Bamyanga Hamadjangui, Bamyanga Marza, and Gadamabanga were solicited.

Executive Summary

The survey was conducted from the 16th of August 2021 till the 1st of October 2021, time within which a total of 1045 children aged between 6 and 59 months were screened for malnutrition.

Of this total number, 48 children were malnourished, precisely 7 SAM cases and 41 MAM cases. These figures are on the basis of MUAC screening as the team could not adequately move through the community with a weighing scale and a height board to obtain Z-scores.

Once the MUAC readings were taken, the children suspected of malnutrition were referred to the nearest Health facility for confirmation and treatment to be commenced.

With the Beta tests not being aimed at clinical consultations, some mothers who are in a habit of avoiding health facilities, received our counsel and referral but did not finally visit the health facility.

A total of 13 children have been received at the different health facilities with 3 visiting CSI Bamyanga Hamadjangui, 4 visiting CSP Catholique Yves Plumey de Marza and 6 visiting CSP Catholique de Gadamabanga.

Achievements

  • This activity though very little had a significant influence as it increased mother’s awareness of malnutrition.

  • This activity encouraged early diagnosis of malnutrition as the team referred all MAM and SAM cases gotten by the MUAC readings.

  • It enabled children who had been hidden at home on account of malnutrition to be reached.

Shortcomings

  • With the lark of finances, a large team could not be recruited, reducing the number of children which could have been visited.

  • The weather made it difficult to attain the targeted number of children as movement under rain was very restricted.

  • As this was a Beta test, the Beri-Nut tool needed to be revised after the first 3 days of data collection, suspending activities for 7 days.

  • The team did not have adequate transportation means, which could enable them circulate in the community with a height board and weighing scale needed to test the Z-score scale on Beri-Nut.

Key Events

During the survey period, a 9-month-old male was found in his mother’s arms, fighting for his life, as he was severely malnourished (MUAC: 102mm) with oedema and desquamation. This child was instantly referred to the Regional Hospital for care, but passed away at the hospital the next day.

At the end of this experience, the Community Health Workers in my team were all very cognizant of the importance of active screening and raising awareness of the risks of malnutrition in the community. This also gave us a greater push to continue the data collection and concomitant search for malnourished children within these test communities.

With the language barriers I experienced, penetration of the community would have been impossible if the community health workers whom they already know and can communicate with, were not present. This adds to the reason why this tool was made; to empower community health workers to obtain anthropometric readings which can be quickly interpreted for immediate actions to be taken.

The Community Health Worker here has been trained on how to take the measurements but had difficulties with interpretation of the measurements he was taking. He was very elated with the idea of the Beri-Nut tool interpreting the results at once for him, avoiding errors of interpretation.

The community health workers had received trainings from UNICEF sponsored workshops where they learnt about basic 5 star feeding. In the image above, we see the Community Health Worker transmitting this knowledge to a mother with a Moderately malnourished child in the local language.

Conclusion

On a general note, the issues with the Beri-Nut tool which were discovered during the first week of testing were resolved, enabling the tool to adequately generate data and reports.

The application will undergo another round of testing so the Z-score interpretations are tested, as well as any other bug which was not discovered during phase 1 tests. All this will be done to ensure that the quality of the product once it hits the market would be at its best.