Implementing Care Groups for improved maternal and child nutrition: Critical factors for success from the Amalima program in rural Zimbabwe

Abstract

<jats:p>Over the last decade Zimbabwe has made noteworthy progress in reducing both underweight and wasting in children under the age of five years, however one in four children in Zimbabwe is stunted. The rate in the decline of the number of children stunted still falls short of meeting the World Health Assembly target, and it goes without saying that effective, innovative community-based strategies are required by the government and development partners to accelerate the rate of stunting reduction. This paper presents experiences from using the Care Group approach for promoting improved maternal, infant and young child nutrition (MIYCN) and care based on lessons from the Amalima program, a seven-year United States Agency for International Development (USAID) Office of Food for Peace intervention. The Amalima program has been promoting Care Groups as a community and family centred approach to improve maternal and child nutrition in Zimbabwe. Care Groups are an innovative community-based strategy that has been rolled out as part of the Amalima program activities in four food and nutrition insecure districts in Zimbabwe. The final programme evaluation suggested the program succeeded in increasing the exclusive breastfeeding rate and reducing levels of nutritional stunting among children under two years. In the present discussion paper, we present the key lessons learned and strategies we believe may have contributed to making Care Group implementation effective; we highlight the modifications that we made in Care Group implementation to ensure a context appropriate approach; and we discuss how Care Groups can be integrated into the Ministry of Health and Child Care structure. The critical factors for successful Care Group implementation have been grouped into five broad categories: conduct formative research; ensure context specific approaches &amp; adaptive management; leverage on social capital and cohesion; invest in human capital; prioritise quality assurance &amp; reviews.</jats:p>

A qualitative investigation of adolescent participation in Care Groups for improved maternal and child nutrition: experiences from rural Zimbabwe

“…Despite such innovative activities, the participation of adolescent mothers in Care Groups remained low. An earlier article in the journal World Nutrition summarized the critical factors for success in general from the Amalima program in rural Zimbabwe (Ncube-Murakwani et al, 2020). The research reported here explores the enablers and barriers specifically for adolescent mother participation in Care Groups.…”

Is participation in Care Groups associated with enhanced diet quality amongst women and children? Experiences from Zimbabwe

“…Care Group participants also receive a recipe book to encourage the preparation of meals promoted during the cooking demonstrations. The Amalima Care Group experience is described in more detail in Ncube-Murakwani et al (2020).…”

Care groups and community-based approaches for improved maternal and child survival and development

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A recent discussion paper published in World Nutrition has once again confirmed the importance of "Care Groups" for improving maternal and child undernutrition (Ncube-Murakwani et al 2020). The critical factors considered responsible for the 7 percentage point reduction in young child stunting in rural Zimbabwe due to the Care Groups of the Amalima program included 1) conducting formative research; 2) ensuring context specific approaches and adaptive management; 3) leverage on social capital and cohesion; 4) investing in human capital; 5) prioritising quality assurance and reviews.

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