The Right to Height — Addressing Stunting in Sudan
The World Food Programme (WFP) runs nutrition centres across Sudan where children receive protein-rich supplementary foods that are filled with essential nutrients to address stunting and malnutrition during the first 1,000 days of life.
Greeted by familiar faces at the nutrition centre, Saadia Abdalla Al-Zain, mother of seven brings her youngest son Omran, 9 months, to the local centre twice a month. Mothers gather and make small talk, while their babies are weighed and health records are checked. There is a strong sense of familiarity between mothers as they arrive with baby in hand, quickly escape from the striking sun and register their attendance. They know the process, suggesting perhaps they have visited the centre many times before.
It’s hard to imagine finding a tiny shelter for nutrition while driving through remote areas in Sudan. In fact, they do exist across all states. They help address common issues like stunting; which is when children fail to reach their optimal growth (cognitive and physical).You notice children in the village tend to be smaller than you’d expect, which makes it difficult to guess the age of babies under 5 years — they all look a slightly similar age at first glance.
Stunting leads to longer-term growth deficiencies and is often due to limited nutritional intake. Stunting leads to longer term growth and learning deficiencies that are irreversible — leaving only a window of opportunity during the first 2 years of life to ensure children reach their full potential.
Research shows, the most effective interventions for stunting take place during the first 1,000 days of life — from the womb up to 2 years of age. Luckily Saadia has regular access to the centre, where trained staff provide nutritional supplementary food — a blend of cereal packed with essential vitamins — provide education and other preventative measures.
If I didn’t have access to the nutrition centre, I wouldn’t know that Omran is short for his age or why it matters.
“I only have other babies in the community to compare Omran to, which can be confusing because they are usually the same weight and height. If I didn’t have access to the nutrition centre, I wouldn’t know that Omran is short for his age or why it matters,” explains Saadia.
In the reception area, children are measured for their height and weight, and their ‘Middle Upper Arm Circumference’ (MUAC) is taken. This is an effective way to identify any health changes between visits. Staff often notice that babies born to underweight or stunted mothers are more likely to experience the same issues.
Unfortunately, undernutrition becomes something that is passed down from one generation to the next.
Repeating the Cycle of Learning
“The key here is prevention, so through our education centres we encourage mothers to bring their babies in for regular check-ups and treatment,” said a staff member.
Saadia is also a member of the women’s club, an additional service provided by the nutrition centre, where she receives regular sensitization on different activities ranging from hygiene practices, breastfeeding and nutrition.
“The key here is prevention, so through our education centres we encourage mothers to bring their babies in for regular check-ups and treatment.”
“We are grateful to this nutrition centre and especially to the countries that continue to support it. Our children’s health is continuously improving since we joined the centre. We also learnt how to make a small home garden to grow fresh produce at home like okra, lettuce, cucumber and mullokhia (corchorus),” said Saadia.
Changing the mindset of the community is an approach WFP has taken through its Social Behaviour Change Strategy, which is proving to be an effective and holistic approach to targeting nutrition related issues like stunting.
“It’s only natural that to help address the root causes of a problem in the community, we must work to change the way nutrition is thought about,” said a staff member.
Participants who receive this type of training graduate at the end of the month and a new batch of trainees join the centre. Graduates of the women’s club move on to teach others in their community, continuing the cycle of learning. They share their ideas with neighbours, sometimes it’s a cooking tip or a new way to prepare food.
Interestingly, the nutrition centre also works with traditional healers to educate them on safe nutrition practices. “This has been a really successful way to make sure that the community is receiving similar advice from traditional practices, and in many cases parents are trusting the centre more,” said a nutrition staff member. Specifically, this approach has been a good way to help bridge any misconceptions about the role of the centre in the community.
Why Addressing Stunting Matters
This not only impacts the family caring for the child, but has broader social and economic impacts — as stunted children fail to learn at the same speed. Reaching optimal height matters because we know the correlation between a healthy population and the longer-term productivity of a country. Investing in human capital is critical to a country’s development.
With generous international support from the European Union, stunting and malnutrition are being targeted simultaneously in eastern states of Sudan, including Red Sea, Kassala and Gedaref states that have considerably high rates. There are currently 2.2 million children across Sudan, under the age of five, who are acutely malnourished and more than 2 million children aged 24–59 months, who suffer from stunting.
In Sudan, while WFP attempts to provide preventative measures through nutrition centres — this can only be impactful and sustainable if there is consistent funding. The reality on the ground is that sometimes funding for nutrition related activities comes and goes — but healthcare is something we cannot afford to be inconsistent about.