Nutri-cereals and legumes help reduce malnutrition in Malawi and Tanzania

Children being weighed as part of a health check in a village in Malawi. Photo: A Paul-Bossuet, ICRISAT

A positive change has been seen in the growth and health of children in just 21 days, by feeding them a nutritious complementary mix consisting of pigeonpea, finger millet, groundnut, carrot and amaranthus leaves; and by addressing factors that inhibit nutrient absorption – hygiene and aflatoxin contamination.

Nutrition studies involving 100 children in Malawi and 70 children in Tanzania, in the age group 6-23 months, showed an improvement in the weight and mid-upper arm circumference (MUAC) measurements of the children. During the 21-day study period the following activities were undertaken:

• Nutritious complementary food package consisting of pigeonpea, finger millet, groundnut and maize along with carrot and amaranthus leaves was developed. The proportions were calculated, to provide the necessary nutrition to the children.
• Hygiene practices were listed and followed by the women on all days. They included: using clean water for cooking and drinking; washing vessels and hands before cooking and feeding; maintaining cleanliness of the surroundings, etc.
• Women were educated on the ill-effects of aflatoxin, how to avoid contamination, etc. They were taught post-harvest crop handling methods – segregating damaged and rotten grains, choosing good quality grains, grading and storing them appropriately.
• Information on the importance of nutrition, the nutritional benefits of pigeonpea, finger millet, carrot, amaranthus, etc, were shared and the women got hands-on experience in cooking nutritious complementary meals for the children in the study group on a rotation basis during the study period.
• Anthropometric measurements, ie, height, weight and the MUAC of the children in the test groups were taken on day 0, 7, 14 and 21. These were recorded in the health card maintained for each child. While the height did not change significantly, the weight and MUAC reading gives a good indication of the improved health of the children during the study period.

A baseline study carried out in 2015 had revealed the following:

• The current child feeding patterns, in terms of number of times the children were fed, as well as the diversity of foods they were given, fell short drastically of UNICEF guidelines. In Tanzania only 18% of the children in the study group met the nutritional requirements and in the Malawi group, only 2% met the UNICEF requirements. These children were primarily fed only maize, that too in inadequate quantities, in addition to breast milk in some cases. Maize consumed in boiled or roasted form or as Nsima (dish made of maize flour and water), though filling, does not provide the important micro- and macro-nutrients necessary for child growth.
• Poor hygiene levels in the study villages of Malawi and Tanzania were found to be a major reason for health issues, like widespread diarrhea among the children.
• The presence of aflatoxin biomarker AFM1 in the urine samples of study group children indicated that more than 60% of them were exposed to aflatoxin contamination.
• Following the baseline survey, a study group of 50 children each, in the 2 districts of Mzimba and Balaka in Northern and Central Malawi respectively, and 70 children from 5 villages of the Dodoma Region in Tanzania, were selected, to test the impact of nutritious food, hygienic practices and controlling aflatoxin contamination, on malnutrition and stunting among children.
• The Malawi study areas were selected based on government estimates of stunting in the region and the farming system in the region. Farmers in Mzimba district grow finger millet, but use the millet for brewing only, while farmers in Balaka district grow pigeonpea only for market sale.

Currently, the study is ongoing with the existing groups, and the project continues to provide complementary food mix on a monthly basis. The project will continue to record anthropometric measurements of the children.

While this was a short study, and non-conclusive on its impact on stunting, it showed positive results on improved growth, in terms of weight of the children. To study the impact on stunting, a long term study, involving more groups, across several districts needs to be undertaken.

The nutrition study is a component of three different projects (see box). The Irish Aid supported project “Malawi Seed Industry Development Project (MSIDP)-Phase II” has allowed for an expansion of the study area and to include more aspects in the study.

Nutritious complementary food prepared for children. Photo: A Paul-Bossuet, ICRISAT

The MSIDP-Phase II will address issues pertaining to: quantity of aflatoxin that results in stunting among children; effect of different levels of hygiene on health and stunting; and nutrient levels in crops and its impact on stunting. Studies are therefore planned on each of the above components through different intervention groups. Different groups will monitor the aflatoxin, hygiene and nutrition component, and their impact on malnutrition and stunting. Bioavailability studies will also be carried out.

Taking a holistic approach to nutrition, the project will address the malnutrition and stunting issue from the breeder stage (identify varieties with dense nutrients) and ensure agronomic practices taking care of soil health (microdosing) and crop health (crop rotation, inter cropping), leading to an agronomic bio-fortification process. Once improved nutrient dense grains are available, the project will address the complementary food requirement not just for children, but also for women in the child bearing age group, pregnant women and lactating mothers, by formulating recipes for each group, by including ICRISAT mandate crops that are rich in folic acid, calcium, iron, zinc and other essential nutrients.

The study was led by Dr S Anitha, Consultant, ICRISAT-Malawi, along with five MSc students.

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