Lesotho Government and Civil Society Collaborate to Provide Nutritional Support Services to Children

 {Photo credit: Moroesi Makhetha/GROW.}A health worker weighing a child, Mokhotlong district, Lesotho.Photo credit: Moroesi Makhetha/GROW.

More than 180,000 vulnerable children in Lesotho, a mountainous country, are in need of essential services such as health care, access to education, and psychosocial support. Nutritional deficiencies and conditions are a challenge because of widespread poverty, food insecurity, and inadequate access to services. In addition, community health workers, health facilities, and local civil society organizations sometimes lack basic equipment to assess child nutritional status.

Malnutrition, especially among children, is one of the most serious long-term problems in Lesotho. Along with pneumonia, it is the most common cause of death in children under 13 years old. In response, Lesotho is one of 14 African countries currently implementing the Nutrition Assessment, Counseling, and Support (NACS) framework. NACS incorporates the positive deviance hearth model, an approach to sustainably rehabilitate underweight children by empowering families and communities to discover and apply local solutions to child malnutrition. In Lesotho, NACS is currently being piloted in three districts and will be cascaded to the rest of the country.

The USAID-funded Building Local Capacity for the Delivery of HIV Services in Southern Africa Project (BLC), led by Management Sciences for Health (MSH), is supporting civil society organizations to provide essential services to orphans and vulnerable children in five districts in Lesotho. One of these is GROW, which supports 5,350 children and caregivers in the Mokhotlong district. Their services include psychosocial and spiritual support, protection and legal aid, health referrals, food and nutrition, and economic strengthening.

Acknowledging the value and contribution of other stakeholders, as well as the potential to maximize resources and impact through collaboration, GROW approached the Ministry of Health (MOH) and other key stakeholders such as the non-profit organization Touching Tiny Lives to address inadequate child nutrition in the district. They conducted community-based health campaigns in Mokhotlong in October 2013 and January 2014. During the campaigns, 530 children under the age of five years had nutritional status assessments, including weight, height, and mid-upper arm circumference. Seventeen of these children (3.2 percent) were severely malnourished, a finding that raised concerns about other children who may be suffering from inadequate nutrition.

The children and their families were provided with nutritional counseling and a feeding plan, as well as therapeutic food including fish, soya beans, mixed vegetables, milk, peas, and maize meal. The households are receiving food security interventions and the children will graduate from the support plan when they have significantly improved in weight, height, and meeting developmental milestones.

The campaigns identified several children who had missed immunizations and standard deworming, and were referred to nearby health centers. In addition, GROW used the opportunity to advocate with MOH officials to provide the necessary basic equipment in local health facilities to better identify and respond to the nutritional needs of children in the districts.

MSH promotes these kinds of interventions, which demonstrate an increasing awareness of the interdependency between government and civil society. There is greater strength and sustainability in collaboration—attributes essential to overcoming the challenges of HIV and poverty in Lesotho and other countries MSH works in.

Moroesi Makhetha, a project officer at GROW, contributed to this content.