Good nutrition for child growth begins with pregnancy and the development of the baby even before it is born. Poor nutrition in babies and children slows down or stops growth, weakens the body and affects the functions of the brain. Children of school age who do not get enough nutritious food are unable to concentrate at school and do not learn as well as well-nourished children.
This section of your Handbook includes 8 activities to help Rural Youth Club members to learn skills in nutrition for pregnant mothers, babies and children and detecting early signs of malnutrition in children. In addition to these activities, you as the Volunteer Leader may wish to ask a local health worker to come to one or more meetings and give your group members more information on the topics.
Resource materials for this section © Government of Namibia. Activities 4.1 - 4.3 are sourced from "Towards a Baby & Mother Friendly Nation: Guidelines for the Implementation of the Baby & Mother Friendly Initiative, 1992. Activity 4.5: "How to Use the Child Growth Card to Promote Growth: A Guideline for Operational-level & Community Health Workers", 2nd Edition, 2002, Ministry of Health and Social Services
Notes
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
|
Project skill: |
To understand that good nutrition for developing babies depends on good nutrition before and during pregnancy |
|
|
|
|
Life skills: |
Recognising self-worth Working with others Solving problems Communicating |
|
|
|
|
|
Food Guide Posters |
|
|
|
|
Preparation: |
Tell group members they may need pens or pencils and paper for this activity |
Make enough copies of the Handout for everyone in the group.
|
PREGNANCY: 1. Balanced Diet:
2. Rest, |
Display the Food Guide Poster where everyone can see it.
Make your Workpad poster by taking a sheet of your Workpad and writing down the list of the KEY WORDS as shown on the right. Save this Workpad poster to use again when doing this activity with other youth groups.
If you think it is a good idea, rather write these key words in your own language, so that group members may understand them better.
Introduction
1. Use the points or guidelines on the Food Guide poster to explain to your group that good nutrition for small babies depends on good nutrition for mothers, both before and during pregnancy.
Experience
2. Lead a group discussion about why a Balanced Diet or Healthy Eating Plan and good care is important for the pregnant mother and her baby. Encourage group members to talk about what they may have already learned about the topic from school, family members or other sources.
Process
3. Put up your Workpad Poster on this topic for easy reference by the group members.
After the end of this activity, some people in the group may wish to copy down the information from the poster in their own language.
4. Give out the Pregnancy Handouts for this activity. If you do not have enough, let members form small groups so that 2 to 4 people can share.
5. Read out (or let a group member read) the information to the group members. Let the everyone discuss each point, making sure that the information is understood.
6. Let the Group members review the information on Pregnancy by presenting 3 Role Plays:
1. Choose 2 members. Let 1 person be the worried woman who wants to become pregnant and let the other person be the healthworker who advises the woman on the importance of good nutrition and preparing herself for a healthy pregnancy.
2. Choose 2 members. Let 1 person be the Pregnant Mother and the other person should be the healthworker who advises the woman on the importance of nutrition and care during pregnancy. The pregnant woman wants to do the right things for her pregnancy and asks lots of questions.
3. Choose 2 members. Let 1 person be the husband or partner of the pregnant woman and the other person be the healthworker who explains to him about the support, nutrition and other needs for his pregnant wife. The man thinks that pregnancy is "woman's business" and does not understand why he should be involved in the woman's needs.
Give the presenters some time to prepare their Role Plays and let them tell everybody when they are ready to begin.
7. Let the actors each present their Role Plays.
Apply
8. After the Role Plays, let the group members discuss what they have watched and help them to understand things they may still have problems with. Guide the discussion by asking questions such as:
Did the role plays help you to understand the information? If so, how? If not, why?
Do you think it is important for pregnant women to get support from their partners and family members? If so, why?
Why is Healthy Eating important for a woman who wants to get pregnant?
Why is Healthy Eating important for the pregnant woman?
In what ways does good nutrition for the pregnant woman help the developing baby?
Do you think you can use what you learned in this activity to help others in your family and community?
Would you like a healthworker to come to a future meeting to tell you more about the topic?
Handout: Nutrition and Care During Pregnancy
1. Balanced Diet
The health of a woman before she gets pregnant influences her fertility as well as the health of the baby she may later have. She should have good eating habits to make sure that she gets a balanced diet.
A woman who hopes to get pregnant should have a healthy body weight. The newborn babies of women who are too thin or too fat face greater risks of complications than the babies of women with a normal body weight.
A balanced diet for the pregnant woman will keep her healthy, help the strength of her uterus and develop the placenta and amniotic fluid to feed and protect the developing baby. It is also important for the growth of breasts and preparation for breastfeeding and for making body fat to provide energy after birth.
A Healthy Eating Plan for the pregnant woman will give the developing baby all the right nutrients to prevent Deficiency Diseases and help it to develop strong muscles, eyesight, organs, bones and a good brain.
In later pregnancy, the mother may have difficulty eating a full meal at one time. Then it is better for her to have smaller meals and snacks more often during the day.
Every day, the pregnant woman should have:
4 glasses of milk or milk products, i.e. yoghurt, omahere, fresh milk (cow or goat), otekwa (sour milk).
3 portions of meat, fish, eggs, beans, etc, i.e. 1 egg in the morning, 1 piece of chicken for lunch, 1 piece of meat or fish for dinner, with omwyi (sauce, gravy).
4 portions of fruit and vegetables e.g. orange, spinach, pumpkin, apple.
6 portions of breads and cereals, i.e. 1 cup of soft porridge in the morning, 1 slice of bread midmorning, 1 cup of mahangu for lunch, 1 slice of bread for afternoon snack, 1 cup of mahangu for dinner, 1 slice of bread for evening snack.
Lots of liquids during the day, i.e. water, oshikundu, fresh fruit juice, oshinwa. No alcohol.
2. Rest
Even though a small amount of exercise is important, a pregnant woman should take rest during the day and see that she gets enough comfortable sleep at night.
The woman needs to avoid heavy work and lifting heavy objects. The family members need to help her with these kinds of tasks.
3. Hygiene
A pregnant woman should be clean and brush her hair and teeth every day to keep herself and her growing baby healthy.
|
|
4. Visit the clinic It is important that a pregnant woman see a health worker regularly so that her health, and the development of her baby, can be monitored. |
|
Project skill: |
To understand that good nutrition for babies depends on good nutrition for the lactating mother |
|
|
|
|
Life skills: |
Acquiring knowledge |
|
|
|
|
|
Food Guide Posters |
|
|
|
|
Preparation: |
Tell group members they may need pens or pencils and paper for this activity |
|
BREASTFEEDING:
|
Make enough copies of the Handout for everyone in the group.
Display the Food Guide Poster where everyone can see it.
Make your Workpad poster by taking a sheet of your Workpad and writing down the list of the KEY WORDS as shown on the right. Save this Workpad poster to use again when doing this activity with other youth groups.
If you think it is a good idea, rather write these key words in your own language, so that group members may understand them better.
Save this Workpad poster to use again when doing this activity with other youth groups.
Introduction
1. Use the points or guidelines on the Food Guide poster to explain to your group that good nutrition for small babies depends on good nutrition for lactating mothers.
Experience
2. Lead a group discussion about why a Balanced Diet or Healthy Eating Plan and good care is important for the mother and her new baby. Encourage group member to talk about what they may have already learned about the topic from school, family members or other sources.
Process
3. Put up your Workpad Poster on this topic for easy reference by the group members.
After the end of this activity, some people in the group may wish to copy down the information from the poster in their own language.
4. Give out the Breastfeeding Handouts for this
activity. If you do not have enough, let members form small groups so that 2 to
4 people can share.
5. Read out (or let a group member read) the information to the group members. Let the everyone discuss each point, making sure everyone understands the information.
6. Let the Group members review the information on Breastfeeding by presenting 2 Role Plays:
1. Choose 2 members. Let 1 person be the worried but proud new mother and the 2nd person should be the healthworker who advises her on the importance of breastfeeding and good nutrition.
2. Choose 2 members. Let 1 person be the grandmother of the new baby who doesn't understand all the new information and thinks that things were fine in her day, when mothers and babies had to just do without going to clinics. She also does not agree with all this new "nonsense" about "Food Groups" and even sleeping with the new baby or "demand feeding", which just makes the baby spoilt and "naughty".
The other person should be the healthworker or family member who explains to the grandmother about why the baby and mother should go to the clinic, why a balanced diet and demand feeding are important. She should also explain to the grandmother how she can be a big help to the new mother by showing her support and helping her.
Give the presenters some time to prepare their Role Plays and let them say when they are ready to begin.
7. When the actors are ready, let them each present their Role Plays.
Apply
8. After the Role Plays, let the group members discuss what they have watched and help them to understand things they may still have problems with.
Guide the discussion by asking questions such as:
Did the role plays help you to understand the information? If so, how? If not, why?
Do you think it is important for new mothers to get support from their partners and family members? If so, why?
Why is Healthy Eating important for a mother and her small baby?
In what ways does good nutrition for the mother help the baby to grow?
Do you think you can use what you learned in this activity to help others in your family and community?
Would you like a healthworker to come to a future meeting to tell you more about the topic?
Handout: Breastfeeding (the first 6 months)
1. The mother should continue to have a good, Balanced Diet after the baby is born. This gives her energy and is important for producing breast milk.
2. The baby should have only breastmilk from birth until about 6 months old. The average healthy woman will produce 850 ml of milk per day, which is enough for the baby's needs.
Do not give other drinks or food during this time as it is not necessary and may spoil the baby's appetite.
The baby's stomach is too small and weak to take solid food in the first 6 months.
3. Breast milk is best because:
It contains all the nutrients needed for the baby to grow and stay healthy.
It comes already prepared and at the perfect temperature.
It is free, so the mother will save money on bottles and expensive formula.
It is safe and can help to provide the baby with some immunity against infections.
For feeding when the mother and baby are apart, breast milk can be expressed and stored in a clean container in cool place for up to 8 hours. The milk can be stored in a fridge for 24 hours. This breastmilk can be fed to the baby in a cup or spoon.
4. The mother should breastfeed as soon as possible (within 30 minutes) after birth because:
It help the uterus to shrink and to stop bleeding after birth.
It encourages the baby to suck, which stimulates the flow and production of breast milk.
The first milk that comes from the mother's breasts for 2 to 3 days after birth, called colostrum, is a rich food which contains Vitamin A and prevents illness and deficiency in the first 6 months of the baby's life.
5. It is important to make sure that the baby sucks properly from the breast. The whole nipple and dark surrounding area should fit well into the baby's mouth, but avoid blocking the nose, so that the baby can breathe.
6. Mother and baby should be close at all times, even at night, as this is good for the growth and development of the baby. It also means that the baby can be breastfed when needed ("demand feeding").
7. If the baby is fed often, or the milk is expressed, this will make sure that the mother always produces milk. Her supply of milk will then not "dry up".
8. Baby's first Foods
At about 6 months, it is important that the baby begins to eat other foods.
Start with one food at a time so that the baby gets used to it.
Give only one small meal a day in the beginning, such as mahangu or other porridge. Add a little oil and a pinch of sugar.
Breast feeding should continue.
9. Personal Hygiene for both mother and baby is important to prevent infections. Also practice good Food Safety when preparing or storing food and in keeping utensils clean.
|
|
Mother and baby should make regular visits to the clinic to have their health monitored. It is very important that the baby has all immunisations. |
Notes
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
|
Project skill: |
To understand the need to introduce foods for babies as they grow older. |
|
|
|
|
Life skills: |
Recognising self-worth |
|
|
|
|
|
Food Guide Posters |
|
|
|
|
Preparation: |
Make enough copies of the Handout for everyone in the group. |
|
6 - 12 MONTHS
1 - 2 YEARS
|
Display the Food Guide Poster where everyone can see it.
Make your Workpad poster by taking a sheet of your Workpad and writing down the list of the KEY WORDS as shown on the right. Save this Workpad poster to use again when doing this activity with other youth groups.
If you think it is a good idea, rather write these key words in your own language, so that group members may understand them better.
Introduction
1. Use points or guidelines on the Food Guide poster to explain to your group that Healthy Eating from the 4 Food Groups is important when introducing solid foods for babies as they grow older.
Experience
2. Lead a group discussion about why a Balanced Diet or Healthy Eating Plan is important for the growing baby. Encourage group members to talk about what they may have already learned about the topic from school, family members or other sources.
Process
3. Put up your Workpad Poster on this topic for easy reference by the group members.
After the end of this activity, some people in the group may wish to copy down the information from the poster in their own language.
6 to 12 Months
4. Give out the Handouts. If you do not have enough, let members form small groups so that 2 to 4 people can share.
5. Read out (or let a group member read) the section on 6 to 12 Months to the group members. Let the group members discuss each point, making sure everyone understands the information.
Explain to your group members that foods that we give to babies from the age of about 6 months should be given in addition to (NOT in place of) breast milk. Point out that it is very important that the mother continues to breast feed, so that the baby gets all the nutrients it needs.
1 to 2 years
6. Read out (or let a group member read) the section on 1 to 2 years in the Handout to the group members. Let the group members discuss each point, making sure everyone understands the information.
Apply
7. Divide the members into smaller groups.
Let them review this Activity by working in their groups to discuss and think about traditional or locally available foods that have been used in their families for feeding growing babies.
Encourage them to look at the Food Guide Poster as reference to think about the Food Groups in the traditional or local foods.
8. When all the groups are ready, let them have turns to present and share their information with the other group members.
9. End by leading a discussion based on the following questions:
Do you think that you learned enough from this activity? If not, why?
Do you think that good nutrition for babies and small children would be improved if the communities had this information? If so, how can you as Rural Youth Club members help to give them this information?
Are there enough foods locally available either in the veld or cheaply in shops to make good nutrition possible for these small children? If not, how could the situation be improved? (example: encouraging vegetable growing).
Handout: Nutrition for Ages 6 months to 2 years
6 - 12 Months
Breastfeeding is important and should continue, as much and as often as before.
Feeding of solid foods should start with 1 meal a day and rapidly increase to 2 or 3 meals by the age of 7 months.
It is important to try to include foods from all 4 Food Groups in the baby's daily Eating Plan.
All foods should be mashed well until they are soft. Good foods to try are pumpkin, potato, banana, egg yolk (yellow). A little soup, sauce or gravy from meat dishes may be added to the mashed vegetables. Fruit juice can be added to porridge or fed to the baby with a spoon.
At about 8 to 9 months, the baby may begin having mashed or strained adult food. Nuts and seeds, which are finely chopped or crushed, can be added to meals.
1 - 2 Years
If possible, breastfeeding should continue until the age of 2 years.
When the baby is 1 year old, it should begin to eat from the family pot, but the food should be finely mashed.
If breastfed, the child should be having 3 meals a day by the age of 12 months, with nutritious snacks between meals (egg, banana, bread, etc).If not breastfed, the child should have 5 meals a day.
Increase energy foods like mieliemeal and mahangu porridge, with milk, a little oil, fat or butter, finely chopped nuts or sugar added.
Add mashed green and yellow vegetables and yellow fruit, such as spinach (or wild spinach) sweet potatoes, carrots, paw paw, etc.
Add soft, finely chopped meat, chicken, fish or liver.
Increase meals to 5 or more a day. If breastfeeding is to be stopped, then the child should have 2 extra small meals added.
Try to make sure that daily meals include a variety of different foods.
Make sure that the child gets enough food when it is sick.
Remember to give the child lots of extra liquids and ORS when it has diarrhoea.
Practice good hygiene habits by keeping the child clean to avoid infections.
Good Food and Water Safety habits are important.
|
|
Take the child to the clinic regularly for growth monitoring and immunisation. |
|
Project skill: |
Understanding the signs of a child who is getting enough
food |
|
|
|
|
Life skills: |
Acquiring knowledge |
|
|
|
|
|
Your Workpad "Poster" for this activity |
|
|
|
|
Preparation: |
Make your Workpad poster by taking a sheet of your Workpad and drawing out the poster as shown on the right |
Get someone at home or a friend to help you read through and practice steps 4 to 7 of this Activity so that you understand the information well before presenting this Activity.
Note: There is no Handout for this Activity. So advise your group members to bring pencils and paper in case they wish to makes notes to remember what they have learned.
Introduction
1. Explain to your group that this Activity is about understanding the signs of a child who gets enough food to eat. It is also for learning how big a child's stomach is and how much food older babies and small children need to eat every day, and how the food needs of the growing child increase as the child gets older.
Experience
2. What are the signs of a child who gets enough food?
Ask your group members this question and lead a discussion from which you expect the following answers:
Happy and enjoys playing
Bright-eyed and alert (notices things around him/her)
Grows taller
Grows out of clothes
Puts on weight, later becomes heavy to lift or carry
Has energy
Does not often get sick(colds, diarrhoea, etc) and gets better quickly
|
|
It is very important that your group members know and understand these signs! So depending on this discussion, and if you feel it is necessary, read out and discuss these points to the group. |
Process
What is Enough Food for a Baby or Child?
3. Divide your Club members into 4 groups.
Explain that each of the groups stands for a different age of the growing child.
Give the spoon to Group 1 (6 months)
Give the yoghurt tub or cup to Group 2 (7 months)
Give the 1 litre milk carton or bottle to Group 3 (12 months/1 year)
Let Group 4 (1 to 2 years) wait for their turn
Put the cardboard beer trays where all groups can see them.
Make sure that everybody gathers around and can see what each group is doing.
4. Ask someone from Group 1 to hold out their hand. Ask the person with the spoon in Group 1 to scoop 3 heaped spoons of sand or gravel into the other person's hand.
Explain to everybody that: this is how much a baby can eat in 1 meal when it first begins to eat food at about 6 months of age. This baby should have one meal and as much breastmilk as it will drink in a day.
Let the person holding the sand empty their hand into a corner of the beer tray so that everyone can see the amount of sand.
5. The person with the spoon should give it to someone in Group 2. While the Group 2 person holds the cup or yoghurt tub, ask the person with the spoon to scoop 9 heaped spoons of sand into the cup or tub.
Explain to everybody that: this is how much babies of about 7 months old can eat in 1 day. Point out that this amount of food is 3 times the amount needed by the younger baby. Each meal is the same size as before (3 heaped spoons of food per meal) but the child should now have 3 meals in the day, totalling 1 cup of food. The baby should also continue to have breastmilk.
Let the person holding the sand empty their hand into a corner of the beer tray so that everyone can see the amount of sand, but make sure that the 2 heaps of sand do not touch.
6. The person with the cup or yoghurt tub should give it to someone in Group 3. While the Group 3 person holds the 1 litre milk carton or bottle, ask the other person with the cup or tub to scoop 3 full cups or tubs into the carton.
Now explain that this amount is what babies of up to 12 months can eat in 1 day. Point out that each meal is now about 1 cupful of food and this baby should have 3 meals in 1 day as well as breastmilk. (The child which does not have breastmilk should have 5 meals in a day).
Let the person holding the carton of sand empty it into one side of the second beer tray so that everyone can see the amount of sand.
7. The 2 people with the cup or yoghurt tub and carton or bottle should give them to 2 people in Group 4. While one person from Group 4 holds the 1 litre milk carton or bottle, ask the person with the cup or tub to scoop 5 full cups into the carton.
Explain that this amount is the most that children of up to 2 years can eat in 1 day. This child should have about 1 cupful of food for each meal and eat 5 meals in 1 day in addition to breastmilk.
Let the person holding the carton of sand empty it into one side of the second beer tray so that everyone can see the amount of sand.
Children older than 2 years
9. Explain to your group members that children from ages 2 to 5 years:
Should be able to eat all family meals.
The mother should be advised to give the child 3 or more extra meals between family meals.
By now the child will have enough teeth to be able to chew, so it is no longer necessary to mash food, but rather to chop the food in small pieces.
Breastfeeding would be stopped by now, so the child may become more thirsty and need liquids between meals.
When the mother stops breastfeeding and foods slowly replace the breastmilk in the child's diet, it is very important to make sure that foods contain enough nutrients for the child to grow and be healthy.
10. Refer to the points or guidelines on the Food Guide Poster and explain that the child should now eat according to these guidelines, just like other family members.
11. A good way to work out and remember how much the child can eat in a meal is to use the 4, 3, 2, 1 system. This is:
4 spoons from the cereals group
3 spoons from the fruit and vegetables group
2 spoons from the meat and beans group
No more than 2 half spoons each (which makes 1 full spoon) of fats and sugars
12. Put up your Workpad Poster for this Activity where everyone can see it.
Explain to everyone that on the poster, the cup is for measuring the meal, and the bowl means 1 meal.
13. Using the poster as a guide, let everyone review what they learned in steps 4 to 7 of this Activity by having each of the 4 Groups explain the food quantities they demonstrated for each age group:
Group 1 explains the food quantity for 6 months
Group 2 explains for 7 months
Group 3 explains for up to 12 months
Group 4 explains for 2 years
Ask a volunteer from the group members to explain the food quantities for 2 - 5 years
|
|
Make sure everyone understands the information on your Workpad poster before moving on to the next step. If you think it is needed, read out the information point for each of Steps 4 to 7, pointing each one out on the poster as you do this. |
Apply
16. Let everyone come together again in one large group.
17. Explain that:
not all children eat the same amounts.
Some children grow well on smaller amounts of food, while others of the same age need more.
Because all children are different, the quantities given in this Activity should therefore be seen only as a guide.
The best way to tell if a child is getting enough food is by the signs discussed in step 2. Read out these signs again.
Remind everyone of the importance of snacks between meals.
18. Let the group discuss these signs again to help them remember.
19. Lead a discussion by asking the following questions:
Why do you think it is important to know how much a child can eat in one meal?
Answer: To know how big the child's stomach is and learn how much food to give them.
Why do you think it is important to know how much a child should eat in one day?
Answer: To try to make sure that the child gets enough food to grow and stay healthy
What did you learn from this Activity?
What can you do to help others at home and in the community to learn from you?
Let those who wish to copy and draw the information from the Workpad Poster do this now.
|
Project skills: |
Identify the information that should be recorded on the
Child's Growth Chart. |
|
|
|
|
Life skills: |
Acquiring knowledge. |
|
|
|
|
|
Pencils. |
|
|
|
|
Preparation: |
Make copies of the Growth Chart. |
Introduction
1. Explain to everyone that this activity will help them learn the basics of how to monitor children's growth so that they can recognise early signs of malnutrition.
They will identify possible causes of the malnutrition and become aware of the ways to handle malnutrition as recommended by health workers.
Experience
2. Ask everyone to review the signs of a child who is getting enough food as they learned in Activity 4.4:
Happy and enjoys playing
Bright-eyed and alert (notices things around him/her)
Grows taller
Grows out of clothes
Puts on weight, later becomes heavy to lift or carry
Has energy
Does not often get sick (colds, diarrhoea, etc) and gets better quickly
3. Ask everyone to form groups of 3 or 4 and give a Growth Chart to each group.
4. Ask your group members if any of them already know something about the Growth Chart. If so, ask where they have seen them and/or how they have used them.
5. Ask the groups of three to carefully look at the Growth Chart so that they become familiar with its different sections.
6. Lead everyone through the sections of the Growth Chart. Explain that this is the Chart that healthworkers use to record the information about the growth of a child, which is the good way of telling if a child is getting enough food and is growing well.
7. Point out that:
The top left corner indicates the immunisations of the child in the first year.
Across the form at the bottom, from left to right, are blocks showing the ages of the child as it grows in months and years.
The weight of the child at various ages between birth and age 5 are in the horizontal columns from the bottom to the top.
At the bottom right is a block marked "Important Milestones", and inside it indicates things should be able to do at around the age of various months. Now read out the small note at the bottom which says: "Check the milestones on each visit and refer to the doctor in cases of delayed milestones".
8. Let the group members briefly discuss these words by asking the questions:
Why do you think these Milestones are important?
What do you think they show about the growth of the child?
Why do you think that the child would need to see the doctor if it does not meet these milestones?
9. Now point out the small block at the top of the Growth Chart which is labelled: "DIRECTION OF GROWTH". Ask them to look at the 3 different lines and their directions. The lines are labelled: GOOD, BEWARE and DANGEROUS.
Explain that the thick lines across the page are the average growth curves.
Process
10. Explain to your participants that you will now ask each group to plot the growth of three children on the growth chart.
Tell the group members that they will do this by making a dot as you give them the weight and age of each child and then join those dots with a line to plot the child's growth curve.
Explain that normally only one child's growth is plotted on a chart, but that they will use one chart to plot the growth of three children so that they can save paper and more easily compare the children's growth patterns.
· Hangula is 3 years (36 months) old and weighs 12 kilograms. At 4 months, he weighed 5.5 kilograms
At 8 months, Hangula weighed 7.5 kilograms
When he was 1 year (12 months) old, he weighed 8.5 kilograms.
At 18 months (1 1/2 years), he weighed 9.5 kilograms
At 30 months (2 1/2 years) he weighed 11.5 kilograms
When he was 2 years (24 months) old, he weighed 10.5 kilograms.
Plot Hangula's growth on the chart by placing a weight dot at each point in time when he was weighed. Join the three dots and write his name on the line.
· Julia is 2 years (24 months) old and weighs 8 kilograms.
At 4 months, Julia weighed 5 kilograms
When she was 8 months, she weighed 6.5 kilograms
She weighed 8 kilograms at age 1 (12 months).
At 18 months (1 1/2 years) Julia still only weighed 8 kilograms
Plot Julia's growth on the chart by placing a weight dot at each point in time when she was weighed. Join the two dots and write her name on the line.
· Andries is 5 years (60 months) old and weighs 11 kilograms.
At 4 months, he weighed 7.5 kilograms
When Andries was 8 months, he weighed 10 kilograms
He weighed 11.5 kilograms at age 1 (12 months).
At 18 months (1 1/2 years) Andries weighed 12.5 kilograms
He weighed 13 kilograms when he was 2 years (24 months) old,
At 2 1/2 years (30 months) Andries weighed 13.5 kilograms
He weighed 14 kilograms when he was 3 years (36 months) old,
At 3 1/2 years (42 months) his weight was 13 kilograms
When he was 4 years (48 months) old, he weighed 12 kilograms.
At 4 1/2 years (54 months) Andries weighed 11.5 kilograms
Plot Andries's growth on the chart by placing a weight dot at each point in time when he was weighed. Join the five dots and write his name on the line.
Check the group members' Growth Charts with the correct sample given on page 96. This sample shows the growth of three children so that you can compare their different growth curves.
11. Remind everyone that normally, the growth of only one child would appear on one chart.
Also explain that the way the group members have marked their Growth Charts has been as an exercise only. In reality, children must be weighed much more often than what has been marked as the weights given in this exercise.
For instance, in the first 3 years of life, a child should be weighed every month. If a healthworker only weighed the child as often as what the group members have marked on their charts, it would not be possible to monitor the child's growth properly, and serious problems would not be noticed in time.
12. Explain that the next step is to interpret the growth lines for the three children. Ask questions such as:
According to what we can see from the growth chart, which child is growing best?
Hangula.
How did you come to decide this?
Hangula's growth curve is climbing upwards in the same direction as the middle curve. This means he is growing well = GOOD.
Is it possible for a child to be growing well even if his or her weight is not following the top growth curve?
Yes.
Why?
Some children have a small build. If they are healthy and active, there is no reason to worry about their growth.
What does the growth chart show us about Julia's growth?
Julia was at a healthy weight when she was 1 year old, but she has not gained weight over the past year. A horizontal growth curve means the child is not putting on weight = BEWARE.
This is serious and means that a health worker should talk with Julia's caregiver to find out what has been happening with Julia's health and then advise the caregiver about how to help Julia gain weight. The growth lines of children who are malnourished like Julia normally lie between the middle and the lower growth curve, as group members would have drawn on their charts. These children need help as soon as possible.
What do you think of Andries's growth?
Although Andries's growth over his first three years of life was quite good, he has been losing a lot of weight over the past two years. The space between the middle and lower weight lines means moderate malnutrition, but even though Andries's weight has not yet fallen below the lower growth curve, this is very serious and Andries needs to see the doctor urgently, because as we can see, his weight is falling rapidly and will soon be below the bottom weight line, where his malnutrition would be DANGEROUS.
Apply
13. Ask the following questions about what has been learned in this activity:
What did you learn from this activity?
What could happen if a child's growth is not recorded accurately and regularly?
What is likely to happen if caregivers and health workers don't recognise or ignore signs of moderate malnutrition in a child's growth curve? What could happen if they neglected severe malnutrition?
Why is it important to keep a record of a child's health problems and how they were handled?
How can you use what you learned in this activity?
14. Suggest that the youth talk with their family members about the importance of monitoring young children's growth by making regular visits to a health facility.
15. Ask if they would like a health worker to come to future meetings to explain more about growth monitoring and child growth.
Sample Growth Chart for checking work done in this activity
|
Project skill: |
Identify signs of malnutrition. |
|
|
|
|
Life skills: |
Communicating. |
|
|
|
|
|
Copies of Goraseb, Nangula and Linus: Three Case
Studies. |
|
|
|
|
Preparation: |
Make enough copies of Goraseb, Nangula and Linus: Three Case Studies so that every group of three members may have a copy. |
Tell your youth group members that they will need to bring pencils for this activity
Introduction
1. Explain to everyone that in this activity they will be reading case studies (short stories) about three school-aged children and asked to identify the signs of possible malnutrition from the case studies. They will use what they have learned in previous activities and asked to suggest ways to solve the malnutrition problems.
Experience
2. Ask your group members to explain the meaning of the word malnutrition. If necessary, explain that malnutrition is a word that describes health disorders or problems due to either not enough food energy and/or nutrients, or too much of them.
3. Explain the following to your group members:
All forms of malnutrition affect the body and the child's learning behaviour.
They may have long-term effects on the brain, or cause illness and school absences.
They may make children tired, irritable and unable to concentrate.
Even mild hunger during the school day affects attention and a child's ability to learn.
The health of children may seriously affect their education. Hungry children find it hard to learn.
Process
4. Ask everyone to form groups of three and to have their pencils ready.
5. Give to each group at least one copy of Goraseb, Nangula and Linus: Three Case Studies.
6. Ask the groups to read the three case studies and underline the signs and symptoms that might indicate that the children are having problems in school because they are not receiving the proper nutrition.
Or, rather than have all the groups look at all the case studies, you might want to give each group only one and so that they learn about the others when the other groups report.
7. When the groups have worked through the case studies, let them come together as a whole group to discuss the signs of malnutrition that they identified in the stories. Explain to your members that only health workers who have studied nutrition have enough knowledge to be experts about nutrition.
All that everyone can do in this activity is make some guesses about signs of malnutrition and how to solve problems. Then, ask questions such as:
Let's begin with the case study about Goraseb.
What words did you underline in this case study that tell us that Goraseb might not have a healthy diet?
If Goraseb's mother asked you for suggestions about how Goraseb's diet could be improved, what suggestions would you make?
Make sure he eats breakfast and takes food with him to school to eat at lunch time.
What words did you underline in Nangula's case study?
If Nangula's aunt asked you how to help Nangula improve her school performance, what suggestions would you make about Nangula's eating habits?
Be sure that Nangula is getting iodized salt in her diet; try to help Nangula have a more varied diet including vegetables, fruits, and more foods rich in protein.
Aside from giving Nangula a bigger variety of foods and being sure that she is getting iodized salt, what could help Nangula feel more energetic and attend school more regularly?
Perhaps the family could talk about how they could get some of their homestead work done in a different way so that Nangula would not be spending so much time during the school days working at home. For example, could Nangula do more work at home on the weekends so that she wouldn't have to do so much during school days. Could the other children do some of the work that Nangula has been asked to do?
Looking at Linus's story, what words did you underline?
What seems to be Linus's most serious problem in school? Not seeing well.
How could this problem be improved with better nutrition?
Making sure he gets Vitamin A capsules from the clinic. Including more foods in Linus's diet that are rich in Vitamin A, such as liver, milk, dark green and yellow vegetables and fruits.
Apply
8. Explain that everyone will end this activity by summarising what they have learned.
Ask your youth group members:
What are some physical signs of malnutrition in school-aged children?
Tiredness, underweight, swollen throat, poor eyesight, etc.
What are some learning signs of malnutrition in school-aged children?
Lack of concentration, falling behind or not coping with school work, problems reading and writing, etc.
How can you use what you have learned in this activity?
Would you like it if we could ask a healthworker to come to a meeting and tell us more about this topic?
Goraseb, Nangula and Linus: Three Case Studies
Case 1
Goraseb is always tired at school. He hates learning because he does not understand what the teacher is saying; he would much rather be outside, lying under a tree. Goraseb never eats before he leaves for school at seven in the morning. There is never any time because he likes to sleep late. He has a five-kilometre walk to school and he has to hurry to be sure he is not late. He drinks only water at school because he does not take anything with him to eat. By the time he gets home in the afternoon he is very hungry. However, he does not look sick or underweight and he doesn't miss school. His teacher was worried about him and suspected that he might not have proper eating habits. She thought it was worth investigating, and so she visited the family one Saturday afternoon to discuss the problem with Goraseb's mother.
Case 2
Nangula is twelve and has lived with her aunt and uncle since her mother died four years ago. She has two sisters and her aunt has three children of her own, so the homestead is crowded and there is a lot of work to do. Nangula misses school regularly and has missed ten days in the last six weeks. Nangula's teacher thinks that Nangula is not growing properly and is underweight. Nangula's uncle says she should stay at home and help her aunt, but her aunt wants Nangula to have some schooling. There is not much variety in what Nangula eats. Mostly, her meals are mahangu and milk. When she gets to school, she looks tired and she can be irritable and aggressive with the other children. She never does her homework because she says she doesn't have time. She doesn't seem to concentrate in class. Her teacher is worried because Nangula's work is falling behind that of the other children in her class, and Nangula's throat is swollen.
Case 3
Linus is eight years old and finds it difficult to follow the lessons in school. He is a shy child and sits at the back of the classroom of 40. He can't write the things the teacher puts on the chalkboard because he can't see them well. He is the oldest in his class. The teacher noticed he has difficulty reading and that he never writes anything in his book. He rarely plays with other children and often seems unhappy. The teacher asked a nurse from the clinic to test Linus's eyes. The nurse found that Linus couldn't see well and she asked if he ate foods like liver, milk, eggs, fruit or yellow and green vegetables, but Linus felt shy and didn't answer.
|
Project skill: |
Volunteering to work at a clinic where infants and young children are examined by health workers and given their vaccinations. |
|
|
|
|
Life skills: |
Communicating. |
|
|
|
|
Preparation: |
Visit your local health facility or clinic to talk with the health workers about the possibility of having youth volunteers at the clinic to help with child growth monitoring. Explain that your group members have had basic training in nutrition for pregnancy, breastfeeding and children of up to 5 years old, and have had a basic introduction to recording information on the Growth Chart. |
If you think it would help, take this Handbook to your meeting so that the health workers can see the level of training in these Activities.
If the health workers are interested in having volunteers and are willing to give the training which volunteers will need to work with them, continue with the steps below.
Introduction
1. Based on what you noticed about your group members' performance during the previous activities, encourage those who showed good understanding of the topics to volunteer at the local clinic to work with the health workers.
|
|
When choosing volunteers, please make sure to choose group members who have done ALL the previous activities, in this section (4.1 to 4.6). This is very important knowledge that will be needed for helping at a clinic. |
Experience
2. Take your chosen group members to the clinic and introduce them to the staff. Explain to the health workers that these are the group members who want to volunteer their time and talents to be helpful in child growth monitoring and advising mothers and caregivers on good nutrition.
3. After the volunteers have worked at the clinic a few times, talk with them about how their work is going. Also, talk with the health workers at the clinic to find out how they think the volunteers are doing. If there seem to be problems, talk with the volunteers and/or staff about how the situation might be improved. This process of helping the volunteers and health workers to communicate better could be challenging, but most likely it will have positive outcomes for everyone.
Process
4. At meetings of your youth group, ask the volunteers to describe their experiences to the other participants. Ask them questions such as the following:
What do you do at the health facility/clinic?
In what ways do you think you are being helpful to the clinic staff? To the adults and children who come to the clinic for medical attention?
What do you like best about volunteering at the clinic? What do you like the least?
What are you learning about growth monitoring?
What are you learning about how children's growth is related to nutrition and other factors in the children's lives?
Have you seen some success stories at the clinic - that is, children who first came to the clinic with poor nutrition and over time have begun to grow in a healthier direction because of improved nutrition?
Would you like to get a paying job at a health facility? If so, would you need additional education and training? Where could you get that education and training?
Apply
5. Encourage the group members to ask the volunteers additional questions that are of interest to them.
6. Ask the whole youth group to discuss the following questions:
Are there other places in our community where some of us could volunteer to use our knowledge and help others?
Why is it important for us to volunteer in our community?
Suggestions f or other volunteer activities
It is not unusual for small children to not want to eat. This can be a problem when they are not well or even when the weather is hot, which may suppress their appetites. The problem may be worsened in families with several children or in a hospital or day-care centre when health workers or day mothers must see to the needs of a lot of children.
An idea for the Youth Club members may wish to try is to volunteer to help and encourage children in these places to eat their food. Sometimes all that is needed is to give the child some special attention and encouragement, while other times volunteer work may include feeding those children who are too weak or sick to feed themselves.
Another volunteer activity may be for Club Members to write or plan a children's song and dance about eating good food, as practised in Activity 1.3. When the group has practised their show very well (perhaps with advice and opinions from family members, a school teacher, etc) they may present their show to schools, day-care centres and in hospitals. It may be a good idea to first consult health workers and day mothers about what the biggest problems are when encouraging children to eat, so that these topics can be built into the story.
This activity may need 2 meetings to complete
|
Project skill: |
Knowing how to make puppets and prepare and present puppet shows that illustrate food and nutrition practices to encourages people, and especially children, to eat healthy food. |
|
|
|
|
Life skill: |
Acquiring and sharing knowledge. |
|
|
Scraps of material, paper, cardboard, plastic bags, plastic
bottles, string, wool, wire, crayons, glue, etc. to make
puppets. |
|
|
|
|
Preparation: |
Collect materials to make puppets and/or ask the group members to bring materials to the meeting. |
Make a sample puppet so that your participants can see how it works. Keep it safely in a packet or envelope inside your Kit for use with other youth groups when doing this activity.
Show your sample to the group at the end of another activity and tell your group members that they will be making puppets in the next meeting. That way, they will be prepared and will know what materials they want to bring.
The Puppet Pattern has been supplied at the end of this activity. If you think it may be useful, take a page of your Workpad and a marker, and copy these pattern pieces out in a bigger size. That way you have a poster to display for everyone to see clearly and use as reference when making their puppets.
Introduction
1. Explain to your participants that in this Activity they will make puppets and create puppet shows to encourage people, especially children, to eat healthy food.
Experience
2. Ask everyone to form groups of three to five.
3. Ask the small groups to create a puppet show and plan the nutrition story they want to tell in their show. This way, they can plan how many puppet "actors" they need and how they should look: thin, fat, young, old, sick, healthy, boy, girl, and so on.
4. Before they start, let everyone join in a discussion about what is needed to make a good show and help people remember the messages. Some ideas for discussion are:
It should be interesting.
What's needed to make it interesting?
What has been good or effective about shows, plays and stories you've seen in the community or on TV?
Do you think songs would help to make the audience understand or remember what they learn in the show?
Do you remember a good story told to you when you were a small child that could be changed to use for your show?
Process
5. Let every group make their puppets. Some tips are:
Hair can be made by glueing on seeds, wool, string or small pieces of black plastic bag.
Beads, buttons, seeds and even small stones make good eyes.
Bright clothes may be made from pieces of plastic bag, pictures from magazines and small bits of cloth.
6. Let everyone have time to practice their shows. (You may find that this puppet making part of the activity should be the first part and presentations may have to be made at the next meeting).
7. Ask each small group to present its puppet show for the others.
Apply
8. When all the shows have been presented, ask the whole group to come together.
End this activity by asking the following questions:
Do you think a puppet show is a good way to teach or pass on information to others?
What did you learn from this activity?
What skills did you use as you worked with others to create the puppets and the puppet show? In what other situations can you use those skills?
How can you use what you learned in this activity in other situations?
Basic Puppet Pattern
Perhaps you can think of other ideas for food puppets?
How about Petrus Pampoen (pumpkin), Christa Cabbage, Mike Mahangu or Tshipo Chicken to get you started...!
Some Ideas for food puppets
Freddie Fish
Auna Apple
Norbert Noodles
Bertus Bread
Ottlilie Orange
){kind=link}
){kind=link}