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Guyana: A healthy future, one sprinkle at a time

By Leticia Ramjag and Joylin Greaves

Bibi Ramcharran registered at the Herstelling Health Centre when she learnt she was pregnant. She then continued to visit the clinic with her daughter, Aneisa, who is now a healthy 14-month old girl.

Bibi and Aneisa are both beneficiaries of the Basic Nutrition Program in Guyana, which aims to reduce the incidence of malnutrition in young children in depressed communities, where approxiamately 50 percent of pregnant women and children under five years old suffer from iron deficiency anemia.

Since 2002, the Inter-American Development Bank (IDB) has supported the Government of Guyana’s efforts to reduce early childhood malnutrition through a $5 million program. Malnutrition in Guyana is high by international standards, particularly among children between 6 months and 2 years old. Low birth weight and stunted growth are relatively high in Guyana compared to other countries. This is especially true in rural Amerindian communities, where rates of chronic malnutrition are higher.

The program consists of the distribution of micronutrient supplements and food coupons, retraining of health center staff in basic nutrition and communication skills, and an information and communication campaign. Evaluation studies found that the distribution of micronutrient supplements reduced overall cases of anemia by around 30 percent to 40 percent.

The program focused on the importance of nutrition in early childhood. Malnutrition, even in its milder forms, increases morbidity and mortality rates in children and may have irreversible effects on learning abilities.

“Using the sprinkles prevented me from becoming anemic during my pregnancy and after breastfeeding Aneisa for six months, I began mixing the sprinkles with her porridges,” said Bibi, who believes that the sprinkles have “opened up the appetite” of her baby and that her baby is very active and healthy because of this.

Coupon distribution and other program activities reduced the prevalence of wasting by about 30 percent. Also the incidence of moderately and severely stunted growth in the group in the program was nearly 21.3 percent lower than the national average.

Bibi explained that the coupon, valued at GY$1000 ($5), was adequate for her baby. In fact, she said the milk and porridge ingredients she collected allowed her to save money. The money she saves is used to purchase diapers for Aneisa and food items for the home.

Improvements in breastfeeding rates with the program averaged 12 percent, with the most significant changes found in coastal communities. The information campaign also heightened awareness of anemia, the consequences of disease, and also helped identify foods that contain iron.

The complementary feeding practices she learned through the program also enabled her to feed Aneisa properly. “I learned the importance of only breastfeeding Aneisa for the first six months of her life,” Bibi said, “and what to feed her as she grew older.”

For Bibi, the program has been very beneficial, particularly as she is a young mother and Aneisa is her first child. “The brochures, posters, messages on television have helped me understand why I should be feeding her certain foods and how important her nutrition is as she grows up into a healthy person.”

The program has raised the profile of nutrition in public health in the country and on February 17, 2010, the government signed another $5 million loan with the IDB, the purpose of which is to assist in implementing priority areas of the National Nutrition Strategy by strengthening implementation capacity of the Family Health unit, which is currently implementing the program. The program is being expanded from 79 to 126 health centers and the country has developed a comprehensive nutrition strategy and the framework for a national food and nutrition surveillance system.