Violet, a young mother living in Karonga district in central Malawi, delivered her first baby at a community hospital in September. Throughout her pregnancy, she attended six antenatal care (ANC) visits. Her delivery was smooth and without complication, due to her good health and nutrition. Her husband attended her delivery as her guardian.
Immediately following the birth of her son, Violet and her husband received counseling from a nurse in the maternity ward on how to breastfeed, as well as counseling for continued breastfeeding and proper nutrition after discharge. The hospital has taken on a number of other on-site initiatives to support maternal nutrition: women and couples are counseled on the importance of the mother’s diet and hydration before, during, and after pregnancy and through breastfeeding.
One of the health care workers noted, “We would see guardians and visitors bringing Fanta when coming for a health visit care, but as a hospital we discouraged pregnant mothers from eating crisps and soda. Now, people are so used to our rules that when they go home most of them follow these rules, particularly the breastfeeding mothers.” This simple change in hospital practices promoted healthy habits in the home.
Violet is a success story. She received comprehensive care throughout her pregnancy, was counseled on a healthy diet, and supported to eat diverse foods. She will return home with the confidence to continue breastfeeding her son and awareness of nutritious habits that may make it easier for her to continue breastfeeding. Additionally, the Ministry of Health (MOH) in Malawi is taking steps to advance policies in support of maternal and child nutrition. They have acknowledged the need to build an enabling environment for breastfeeding. “In Malawi, women leave exclusive breastfeeding due to several factors within their environment. It is therefore important that nursing women should have a support system within the community to ensure they breastfeed babies.”
Many women and children are not as lucky.
Women in low- and middle-income countries are often the bedrock of families yet tend to lack access to and control over resources to ensure a diverse and nutritious diet before, during and after pregnancy. Poor maternal nutrition has an effect that can sadly last through generations.
For example, newborn weight is closely tied to maternal nutritional status, and low birth weight babies have higher levels of stunting in childhood. Stunting, in turn, affects childhood development, putting families in an endless cycle of poverty. Additionally, nutrition interventions are often siloed from other maternal health services and implemented without underlying gender considerations.
Luckily, integrated gender sensitive nutrition programming is gaining traction. Improving the status of women with gender sensitive programs and policies to address gender inequities can have a powerful effect on health and development outcomes, including on maternal and child nutrition.
Management Sciences for Health (MSH), through USAID’s ONSE Health Activity, is supporting Malawi to strengthen core health system functions for maternal, newborn, and child health (MNCH)/family planning (FP)/reproductive health (RH) and nutrition services. Our experience shows the health of women, children, and adolescents is among the best indicators of a robust and resilient health system that effectively responds to the health needs of growing populations. ONSE is ensuring nutrition services are integrated across the continuum of care, throughout the reproductive life cycle and with a gender sensitive lens that avoids unintentionally reinforcing or exacerbating disparities. Pregnant women are counseled on appropriate diet and caloric intake as part of ANC. Recently delivered women are supported to start and continue breastfeeding, mothers and caregivers are counseled on how to introduce new food, and on how to prevent and treat diarrhea. Importantly, men are encouraged to participate in family care and communities to lead strategies to address inequities.
These programs and policies are relatively simple and cost-effective interventions that go a long way towards empowering women, and helping to ensure healthier lives for them, their children and their families.