1/11/2024 0 Comments Rainbow bookends target![]() The reduction of child malnutrition remains a national public health priority in Zambia. Community-based management of acute malnutrition in the Zambian context ![]() The Rainbow Project shows the potential benefits of providing a continuum of care that prevents and treats multiple forms of malnutrition in situations where community-based management of acute malnutrition is not fully covered or scaled up, with the need to integrate health and nutrition activities for both child malnutrition prevention and treatment in food-insecure areas with high burdens of malnutrition and HIV infection. Significant predictors of mortality were found for HIV infection, oedematous SAM and severe underweight. Individual nutrition counselling significantly improved dietary diversity, meal frequency and drinking water treatment. Retrospective analysis of outcomes post-programme changes showed statistically significant improvements in recovery, death and defaulter rates, reduced length of stay and average weight gain, and increased diagnosis of HIV children. Published evaluation researches (2012-2017) informed developments to improve programmes’ effectiveness, involving continuous monitoring, building capacity, better referral systems for HIV cases and improved nutrient provision. ![]() In addition to MAM children, children with SAM were admitted to SFPs due to shortcomings in delivering local outpatient therapeutic programmes, as well as underweight children. What this article adds: The Rainbow Project is a supplementary feeding programme across 11 sites in Zambia, delivered by community-based organisations and community volunteers. Children who are underweight are not routinely managed in treatment programmes. What we know: Acute malnutrition is typically managed through separate programmes for severe acute malnutrition (SAM) and moderate acute malnutrition (MAM). The authors also thank the Ndola District Health Office, the Nutrition Provincial Office and Hospital Nutritionists and the Department of Biomedicine and Prevention of the University of Rome Tor Vergata for their support and guidance. The authors acknowledge the work of Zambian non-governmental and community-based organisations and their staff, including Maxilda Mushoke (Kanyala Nutrition Nkwazi Nutrition) Daisy Kumwenda (Rainbow Pamodzi) Chibesa Chiti (Nsansa Nutrition Club) Maria Agape Thindwa (Rainbow Merciful Aid Care Centre) Julius Pezulu (Sukumuna Orphanage and Destitute Centre) Stanley Malwa (SADTI) Mwelwa Mwelwa (Little Angels) Elina Mukokili (Kawama Nutrition) Philip Bwalya (Kaoloko Emmaus) Tina Banda (Maria Cimona Love and Grace). The findings, interpretations and conclusions in this article are part of the PhD thesis of the main author. Leonardo Palombi is a Professor of Hygiene and Public Health and former Director of the Biomedicine and Prevention Department, University of Rome Tor Vergata and Scientific Director of the DREAM Programme of the Community of Sant’Egidio. Gloria Gozza is the Country Coordinator of the Rainbow Project in Zambia and representative of the Association Pope John 23rd in Zambia.Įrsilia Buonomo is an Associate Professor of Hygiene and Public Health, University of Rome Tor Vergata and an expert in child malnutrition and HIV/AIDS in low- and middle-income countries under the DREAM Programme of the Community of Sant’Egidio. She designed the Rainbow Project as a model of care for orphans and vulnerable children in Zambia. Giulia is a representative of the Association Pope John 23rd at the United Nations in Geneva, working on advocacy for human rights, particularly the right to health.Įlisabetta Garuti has a degree in Economics and is a member of the Association Pope John 23rd. She is the former coordinator of Rainbow nutrition programmes in Zambia. Giulia Amerio is a paediatrician with a Diploma in Tropical Medicine/Hygiene and a Master’s degree in Public Health. ![]() She is a Research Fellow in Nutrition and Public Health at the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy and coordinates Rainbow nutrition programmes in Zambia. Stefania Moramarco is a nutritionist with a PhD in Public Health and many years’ experience of programming and research in community-based programmes in Zambia. With technical input from Giulia Amerio, Elisabetta Garuti, Gloria Gozza, Ersilia Buonomo and Leonardo Palombi ![]()
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