First, successful application of the PD/Hearth approach in rural Cameroon

THE PROBLEM: Almost one in three under-five children in Cameroon (Central Africa) suffers from chronic malnutrition (32%) with 13% of them having acute malnutrition. Plan Cameroon, an international, humanitarian NGO, has partnered with the Ministry of Health, UNICEF and other local agencies to address child malnutrition, both at policy and at program implementation. Some traditional approaches such as growth monitoring and follow-up have proven not effective in significantly reducing its prevalence. Consequently Plan Cameroon piloted the first Positive Deviance/Hearth Approach project in the country during 2004. PROJECT RESULTS: In the four pilot, rural villages, 34 children were identified with mild (29 = 85%) and severe malnutrition (5 = 15%) after the women's groups weighed all the under-five children. All malnourished children (except one) took part in at least 8 of the 12 days of nutrition rehabilitation. Of the 34 children, all except one had adequate weight gain of at least 300g. Weight gain ranged from 300 – 2500g with an average of 1082g per child. One child lost 400g in spite of 12 day participation at the hearth reason being ill health. However, the same child after treatment participated at the next hearth and had adequate weight gain from 4.6 to 6.3 kg. In three children, reasons for discontinuation included travelling out of the village, continuation of rehabilitation at home and simply abandoning the activities for the third case. Even though this happened, their weight gain was 300 and 1300 for the 8 and 9 days participation respectively. Most importantly, community members were amazed to see that malnutrition, which they considered as due to witchcraft (and therefore cannot be cured), got cured just after a few sessions at the villages using locally available food items. The excitement solicited extensive community support for the hearths including the village chiefs, men, women and children. CONSEQUENCE: Given the tremendous success of this pilot project, Plan Cameroon and its government and community partners are scaling up the PD/Hearth approach in communities with high levels of malnutrition belonging to 11 districts of the country. The government has approved this approach and supports it both at the grassroots and the central level.