Special Features
Nalugo’s gospel: Proper nutrition starts at the breast
Publish Date: Sep 02, 2013
Nalugo’s gospel: Proper nutrition starts at the breast
Nalugo (left) discussing with mothers the advantages of breast feeding in Nkokonjeru Town Council Picture By Agnes Kyotalengerire
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By Agnes Kyotalengerire

As part of its annual series, Ugandans Making a Difference, New Vision will, until October 3, publish articles on individuals and organisations that have dedicated their efforts to fighting malnutrition in the country. The articles will highlight the causes, discuss solutions and recognise the efforts of those working to avert the problem that affects up to 54% of childrenunder the age of 18 years in Uganda.

She carries one baby in her arms, while the other is strapped to her chest with a baby carrier. She walks in just in time for the village breastfeeding mother support group meeting. As she sits down, she struggles to balance the weight of the two-month-old twins, but is relieved of one baby by a mother sitting next to her. “The twins look healthy. Nnalongo (a name given to a mother of twins in Buganda) must be doing a good job,” I compliment. But before I could add, Hassifa Sserwada, a village team member and a resident of Namalili village in Nkokonjeru town council quickly intercepts.

She narrates how the twins were at the verge of getting malnourished because they were taking cow milk when they were as young as one month. Jackline Wanyama 19, a mother and a resident of Namalili village, in Buikwe district, says she had given up breastfeeding a week after birth and was already feeding her babies cow milk.I thought I could not produce enough breast milk,” Wanyama recalls. As a result of not breastfeeding adequately, the babies cried a lot and were not gaining weight. This went on until the village health team members (VHTs) from Children in Africa Breastfeeding Support Group, a non-profit community-based organisation supporting Nkokonjeru mothers to breastfeed visited their home. “The VHTs taught me how to clean the breasts and massage them to stimulate milk production.

I also learnt how to hold, position and breastfeed the babies at ago,” she testifies. Wanyama also learnt how to eat the right foods to produce enough milk for the twins. The babies gained weight and would sleep soundly allowing her time to do her house chores and also get enough rest. Wanyama is one of the many breastfeeding mothers reaping from the training of Children in Africa Breastfeeding Support (CHAIBS) Group, a brainchild of Josephine Nalugo.

The organisation supports mothers to breast-feed exclusively, teaches them about complementary feeding (introducing semi-solid foods after six months and the right foods to eat for sufficient milk production). Inadequate breast-feeding and failure to introduce the right solid foods after six months are some of the major contributors of malnutrition in the country. According to the Uganda Demographic and Health Survey 2011, the percentage of babies who are breastfed exclusively stands at 63%, while initiation in the first hour of birth stands at 56% and complementary feeding at 24%.

According to a research study; Newborn Survival in Uganda; A decade of change and future implications by Dr. Anthony Mbonye, Miriam Sentongo, each year in Uganda 141,000 children die before reaching their fifth birthday; 26% of these in their first month of life.


Conception of the project
Nalugo’s project idea was conceived in December 2004 when she visited her village with intentions of understanding the experiences of rural mothers on breastfeeding. Her parents Mr and Mrs. Nsawo allowed her use their compound as a meeting place. Her mother helped in mobilising the women and only five women turned up for the first meeting. But word went round and in the second meeting the number rose.

During the meetings, Nalugo discovered that mothers lacked adequate food, especially a balanced diet, had financial constraints and lacked information about breastfeeding. She continued researching until 2006 when she learnt of the World Alliance for breastfeeding Action (WABA). She wrote a proposal requesting for funding and was awarded a seed grant of $2,000 (sh5m). Nalugo decided to use the funding to tackle the challenges that breastfeeding mothers faced. At some point she ran out of funds, but did not give up

She continued counselling mothers. She would sacrifice her salary to buy mothers soap and sugar. Later in 2007, Nalugo became member of the US-based organisation, International Lactation Consultant Association (ILCA). She travelled to USA and Austria to further her education on breastfeeding. In December 2007, Nalugo organised a two-day exhibition at the main post office parking lot in Kampala to educate and counsel breastfeeding mothers. Months later, Nalugo started visiting breastfeeding mothers in urban areas during her free time.

The demand for the services increased and Nalugo realised that she could not continue working as an individual. In 2010, she resigned her job at a community-based Rehabilitation Alliance (a children’s organisation) to focus on helping breastfeeding mothers. In 2011, she registered the project– Children in Africa Breastfeeding Support Group. Currently, Nalugo partners with local leaders, Nkokonjeru Hospital and two VTHs in each village. At the national level, she works with International Baby Food and Nutrition (IBFAN) and International Lactation Consultant Association.


Community benefits
Operating in 12 villages in Nkokonjeru town council in Buikwe district, CHAIBS project is helping over 300 mothers. Ruth Bayiga, the community development officer Nkokonjeru town council, says the project has driven the breast-feeding message deeper. Mothers can now breast-feed exclusively and up to two years. Patricia Nakitende, a 19-year-old mother of two has benefited a lot from the breastfeeding support group.

“My first baby became malnourished because I introduced him to porridge mixed with milk at one month. In just one week he had developed diarrhoea and was losing weight.

But when I got my second baby, the VHTs advised me to breastfeed exclusively for six months before introducing any foods and drinks. Complementary feeding is another area CHAIBS focuses on with emphasis on how to prepare ekitobero (mixture of foods).

Esther Nansubuga, a mother of two, says she did not know about ekitobero until she started attending breast-feeding support group meetings. Nansubuga now prepares ekitobero for her children using foods like beans, mukene, groundnuts. Nalugo believes proper nutrition starts before conception, continues during pregnancy, after birth and throughout breastfeeding and complementary feeding.


Happy Baby Project
To facilitate the bonding between parents and babies as well as increase the duration for breastfeeding, Nalugo established the Happy Baby Project. Happy Baby is a non-profit community-based organization which makes and distributes baby carriers to breast-feeding mothers. Before the project was established, Nalugo did a survey in Nkokonjeru; Buikwe, Kasese, Lira and Kampala in 2012.

She discovered that mothers could not practice exclusive breastfeeding because they left the babies at home, while they went to the gardens or work. As a result caretakers would introduce them to solid foods at an early stage. The baby carriers cost between sh18,000 and sh20,000.

But Nalugo says about 20% of the mothers, who cannot afford to pay cash are allowed to pay in three instalments. Others exchange their crafts like mats and baskets for baby carriers. As a result many mothers are able to move with their babies and breastfeed on demand. Aside, the project has created employment for 15 mothers who stitch the carriers.


Sustainability
Apart from the two VHTs from each village who carry out home visits Nalugo has brought on board the town council leaders and at the moment is working with Nkokonjeru Hospital to make it baby-friendly by establishing a breastfeeding corner basing on the World Health Organisation guidelines. She is optimistic the corner will start functioning in September.


Challenges
Nalugo says many challenges still lie ahead. Initiating breastfeeding in the first hour is still lacking because some mothers deliver at home assisted by traditional birth attendants. The knowledge gap about benefits of breastfeeding, how to do it and what to feed is still big. Very few men are committed to supporting their wives. Mothers’ expectations are high yet the project lacks enough resources, the reason why at the moment she is only operating in Nkokonjeru town council.

Do you know any individual or organisation focusing efforts on improving nutrition in communities? Write to the Features Editor, P.O. Box 9815 Kampalaor e-mail features@newvision.co.ug giving name, telephone contact of nominee and reasons for nomination. Type food, the nominee’s name and SMS to 8338

 

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