Community Health Workers Combat Malnutrition with Aheza Fortified Foods
Nutrition is an essential component of adequate primary care. Yet, health centers have long struggled with stock outs of fortified porridge, and commercial products are often too expensive for rural families to access. TIP Global Health recognizes that food is medicine for families living in poverty. That is why in 2015 TIP launched Aheza Fortified Food, a social enterprise that provides uninterrupted supplies of fortified porridge to hospitals, nongovernmental organizations, and community members.
A single serving of Aheza provides nearly 100% of the daily recommended quantities of micronutrients for children under 5 — preventing chronic malnutrition, strengthening the immune system, and improving cognitive development. The porridge is made of maize, soy, and a small amount of sugar and is fortified with vitamins and minerals in order to prevent stunting and to foster healthy childhood development.
Based on previous success of reducing childhood malnutrition rates by providing Aheza Fortified Food porridge, TIP Global Health staff began looking for other effective ways to distribute the lifesaving solution.
In May 2021, a pilot program was launched in Ruli Health Center’s catchment area. This area is where TIP works with 120 Community Health Workers (CHWs), offering necessary skills and tools to eliminate malnutrition among children under 5 years old. Up until then, most of our interventions had been focused on improving health outcomes through strengthening CHWs ability to educate the community about disease prevention, offering spaces for care and providing digital tools that will improve the quality of data, reporting systems, reducing the workload.
The new strategy began with eight CHWs and provided them Aheza to share and sell in their communities, while also giving them a way to profit from its sales and boost their own incomes. The CHWs also tracked nutrition indicators using E-Heza Data Solutions in order to provide timely, accurate data reporting for their community and for the families. Since the program began, it has seen significant growth and success. Malnutrition rates in the children consuming the porridge have been significantly reduced. The CHWs selling the porridge have seen their incomes rise, as they are able to increase their wages through the profit they make from selling Aheza.
TIP Global Health works closely with the CHWs selling Aheza, providing support and guidance as-needed. They have shared with us that they appreciate the extra income they earn, but most of all they are happy to be able to provide a product that families in their village can benefit from. One CHW, Alice, shared that she had a mother in her village, Rose, with a son who had a moderate case of malnutrition. After providing Rose a sample of Aheza fortified porridge, Rose continued making purchases of the porridge from Alice. Today, Rose’s son is in good health and back in the healthy growth range. Rose told Alice that she is thankful that she began selling the Aheza, as it makes Aheza porridge easily accessible to her family and others in the village when they need it.
We conducted an anonymous survey and 100% of the CHWs selling Aheza reported that they were “very satisfied” with the program and “extremely likely” to continue. They reported that the populations buying Aheza were mainly in Ubudehe 2 and Ubudehe 3, groups that are often left out of typical government assistance programs due to not being at the lowest poverty levels, but who are often still at high risk of malnutrition due to economic constraints.
Today, the program has expanded to 22 CHWs across Gakenke District selling Aheza fortified porridge in their communities, mostly to mothers with children under the age of five like Rose. We are proud to be able to support CHWs by providing them a resource for their community while also assisting them in supplementing their own incomes. Based on the program’s success, TIP Global Health is working to further expand the program into more Districts in Rwanda.
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