Feed the Future

From afar, Shadia Murungi, seems like a normal baby clinging to her mother as they brave the scorching sun on their way to a shop in Ishaka, a town in the Bushenyi District of southwest Uganda. But, at the slightest touch, Murungi cries out. Her limbs are stick-like and her hair is yellow. The 1-year-old is smaller than her age mates. These are tell-tale signs of malnutrition.

According to her 37-year-old mother, Naume Atuhaire, Murungi was born premature, at 7-and-a- half months.

“Whenever she was sick, I would take her to the hospital, but they never told me my baby was suffering from malnutrition. I thought it was the normal childhood illnesses,” says Naume.

Naume only came to know that Murungi was malnourished when she arrived at Kitagata Hospital to take care of her sick mother. Her father, a village health team member, noticed that Murungi was thin and small for her age.

Kitagata Hospital is supported by the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), as is the village health team. Team members counsel community members and link HIV-affected individuals to services at the hospital. They have also been educated about childhood malnutrition.

The first 1,000 days of life—from pregnancy to 2 years of age—is a critical period for health and survival. Adequate maternal and child nutrition during this period is crucial for both cognitive and physical development. Stunting, in particular, affects brain development and is associated with lower cognitive abilities, poor school performance, and lower earnings throughout life.

EGPAF has led research into the interaction between food and HIV and has found that proper nutrition is crucial for children living with HIV. HIV-positive children have a harder time gaining weight, and antiretroviral medication is less effective for a child who is underweight. A malnourished child living with HIV is more likely to die. For this reason, the World Health Organization recommends that nutritional assessments be integrated into the care of HIV-positive children.

Murungi’s grandfather recognized the signs of malnutrition and measured her arm. “The mark indicated red for severe acute malnutrition,” says Apophia Ahabwe, a peer educator at Kitagata Hospital. “He immediately referred her to the nutrition unit.”

In the unit, Ahabwe discovered that Murungi weighed only 14.33 lbs. and that her body was lacking vitamins and minerals. Ahabwe counselled Naume about the signs and symptoms of malnutrition and seeking professional help. She advised Naume to prepare nutritious foods such as potatoes, silver fish, eggs, porridge, and chicken for her baby.

Naume took the intervention seriously and has changed her routine. She now plans and cooks healthy meals for her family. Murungi is slowly recovering.

Ahabwe says poverty might play a role in poor nutrition, but for the most part people in the region lack knowledge on breastfeeding and on what foods to feed young children.

At the hospital, Ahabwe and her colleagues continue to receive malnourished children. Every week, she helps train staff on how to spot malnutrition and assess the 300-400 clients who visit the outpatient department daily.


“EGPAF has improved my skills to handle malnutrition cases better,” says Paul Kakwangire, the district nutritionist. “The nutrition unit was not operating [previously], but with this funding from USAID (U.S. Agency for International Development), things are getting better.”