1. Jamiru Mpiima International Youth Empowerment Network PERCEPTIONS OF CARETAKERS IN LOW INCOME AREAS IN KAMPALA AND WAKISO ON COMPLEMENTARY FEEDING FOR CHILDREN 6-23 MONTHS

2. Content list ■Who we are ■What the problem is? ■Possible solution ■Formative research to guide campaign design ■Perceptions from the parents ■What we have done so far ■Conclusion and call to action

3. Who we are! International Youth Empowerment Network is a network of young professionals of nutrition who aim at creating social change.

4. What is the problem? ■Central region is ought to be one of the richest regions in Uganda and also the host of the capital city Kampala. ■Despite that, the rates of stunting are at 32.5%, 36%, 13.5% in Central 1, Central 2, Kampala respectively ■Wasting levels are 5.8%, 5.3%, 4.4% in Central 1, Central 2, Kampala respectively ■These are slightly higher or close to the national average of 33.4% and 4.7% respectively. (UDHS 2011)

5. What is the problem?

6. Possible solution Studies show that by adding two legumes to a cereal based diet, one can highly improve the quality of food given to children by completing the amino acid profile of these foods This can help address the challenge of mothers and caregivers failing to provide high quality protein and micronutrient rich diets for their rapidly growing children of age 6 months and above

7. Formative research to inform design of two legumes, one cereal

8. PERCEPTIONS OF CARETAKERS IN LOW INCOME AREAS IN KAMPALA AND WAKISO ON COMPLEMENTARY FEEDING FOR CHILDREN 6-23 MONTHS ■Focused group discussions ■Key informant interviews ■Data analyzed using grounded analysis Study area: Villages of Sebowa and Balintuma in Kiwatule parish, Kampala district and Kiwologoma-Kira parish, Wakiso district

9. Participants ■Primary: Mothers, fathers and caretakers for children of 6 months to 2 years ■Secondary: village health teams, health workers and local leaders

10. Survey Findings ■All caretakers were concerned about getting adequate food to feed their children as recommended. They complained of how expensive and demanding to feed the children yet they do not have that much money. ■ “Getting food for these children is always a hustle because foods like milk are expensive much as I try to grow my own food”, said the respondent in Kiwologoma ■Parents quoted a food weekly budget of UGX. 29,000 (USD.11) on average. ■Some mothers reported their children not liking to eat food especially vegetables.

11. Findings cont. ■Mothers feed their children of age 6 months to 2 years twice or thrice a day according to the meal schedule of the whole family. ■There is no special preparation of food for the children since they eat on the food prepared for the rest of the family ■The caretakers were also concerned about the common illness such as cough, malaria and flu that often disturb the children and make them not to eat well ■Some children also do not like eating, which makes it difficult for the caretakers to feed them. Some of those children are said to prefer breastfeeding to eating possibly because they do not have appetite for food.

12. Cont. ■Mothers consider consulting fathers about feeding and health of the children yet Men/fathers are seen as being less involved in child care in most places in Uganda (Reports from leaders and VHTs) ■Mothers and caretakers would love to prepare a blend of two legumes and a cereal for their children but they complain that it takes a lot of time and fuel to do it. ■Mothers have faith in VHTs and health workers. Thus passing information about nutrition through these VHTs at community level and health workers in health centres would ensure that it is got and followed.

13. A nutrition campaign in Kampala and Wakiso aimed at tackling increasing childhood stunting and wasting by helping mothers and caretakers through; Food demonstrations, health education and urban gardening to make a two legume—one cereal blend for their children from 6 months to 2 years

14. What is our model? ■The campaign aims to engage the Village Health Team members, local council leaders, mothers and fathers to influence knowledge, attitudes and practices on preparing and feeding children with a two legume—one cereal blend. ■Partnering with a local industry producing pre-cooked bean sauce to time and fuel constraints ■Active monitoring of uptake of the practice, learn from it, adapt and improve the strategy used.

15. Community food demonstrations

16. Community nutrition education

17. Involving local food manufacturers ■We visited Peak Value Industries Limited (a local manufacturer of a beans- groundnuts blend) ■They were willing to pack the instant blend in small affordable quantities for the mothers

18. Micro gardening Micro gardening; growing food in small spaces The food grown supplement the meal plan of 2 legumes and 1 cereal hence providing other nutrients essential for the well being and development of the child

19. Micro gardening demo

20. Lessons from survey and prototype ■Fathers are willing to play a bigger role in child nutrition and care ■Steaming complementary food for children saves time and fuel for mothers ■Legumes and cereals are affordable by the mothers and the fathers ■Introduction of cheap animal sauces ■Precooked bean and gnut sauce is liked by mothers and fathers

21. Cont. ■Recipe development and food budgeting ■Existence of deviants within the community: ■Need to develop interactive complementary feeding teaching materials for mothers and caretakers ■WASH and ECD should form part of complementary feeding ■Integrate participatory monitoring and evaluation for improved complementary feeding

22. Acknowledgement ■Openideo platform ■YEN: Team: Racheal Natumanya, Shakira Nabawanga, Ronald Kateregga, Anna Nyadoi, Nanyanzi Sheila

23. Conclusion ■Stunting levels high because of poor complementary feeding practices ■Different perceptions and misconceptions about child feeding ■Nutrition education, food demonstrations, urban gardening and multi sectoral involvement can make a difference CALL TO ACTION: SUPPORT FROM YOU

24. Thank you!