When I was growing up in Malawi we tended to link marasmus and kwashiorkor to bewitching – we never linked it to malnutrition. However, I gradually learnt more about food groups at secondary school and University. I started to become more interested in the topic when I was working as Food Security and Nutrition Research Assistant alongside nutritionist in the Area Based Child Survival Development Programme at UNICEF. After a stint as a Government Economist I decided to study the subject and I completed a Masters in Medical Science Human Nutrition in 1997. However, it wasn’t until 17 years later that I would eventually take on a role where I could put this knowledge into practice.
I had been working on diversification of agricultural incomes, marketing and food security issues at the EU Delegation in Malawi for 10 years when in the framework of the 2012 London GlobalHunger Event,the EU made a global commitment to tackling undernutrition. We needed to realign our country programming and because of my background I had an opportunity to take on a lead role. However, after so long without practicing nutrition I really needed to reconnect with the issues and refresh my knowledge so I enrolled in the Transform Nutrition Short Course in 2014.
That one week was very helpful. They approached nutrition from a holistic perspective and presented it as a medical issue as well as a developmental issue. This made me more equipped to engage with stakeholders across the board, instead of looking at it from just one perspective.
The key outcome from the course was a realisation that we needed to carry out a mapping exercise in the nutrition sector in Malawi so that our planning and programming could be informed by what is already happening within the sector. We were able to get all the key development partners and the Government to rally behind this idea and as a result of the mapping, we have now developed a holistic multi-sectoral integrated Four Pillar Approach to addressing nutritional issues that scales up successful previous and existing initiatives and provide a platform for discussion between the different partners.
In July 2015 the Government through the National Nutrition Committee adopted the Four Pillars Approach, and now all partners supporting the government use this framework to coordinate and structure their programs in the countryto ensure the national objectives will be achieved.
The Four Pillar Approach
Pillar 1: Agriculture for food and nutrition security and improved maternal, infant and young child care and feeding
Pillar 2: Health – primary health care, therapeutic care, support and treatment and WATSAN:
Pillar 3: Integration of behavioural change and communication for optimal maternal and young child feeding and care (knowledge, attitudes and practices) among communities, learners, professional and frontline workers through nutrition education
Pillar 4: Governance, human capacity building, research, monitoring & evaluation and fortification.
We have also developed Afikepo, an EU programme to take forward and support the Four Pillar Approach. It translates from the local language as ‘let the children develop to their full potential’ and it has become a moto of some sorts for nutrition programming in Malawi.
Therefore, I took lessons from the 2014 course and applied them in Malawi, which now has the second largest EU nutrition programme in the World. However, I have also enrolled in the 2017 Transform Nutrition Short Course so I can build on my experiences, gain more insights and further improve our programmes and approaches in the country.