Senegal: A successful community-based strategy to improve child nutrition

In the rural district of Tivaouane (Department of Thies, Senegal) baseline studies in 2003 determined that child malnutrition, defined as underweight, was 24% (national average was 19%). Plan Senegal (an international, humanitarian, private organization) formed a partnership with the Cellule de Lutte contre la Malnutrition (CLM, Government of Senegal with funding from the World Bank) and the Municipality of Tivaouane, to implement the Nutrition Reinforcement Program (PRN in French) from 2004 to 2011. This program currently covers more than 95% of the under-five children in this 10,000-inhabitant district.

This project relied on 13 community-based organizations (instead of health facilities) to bring together several community leaders for joint action planning in the delivery of the project's information and services: neighborhood delegates, Mothers' Committees, community leaders. A Communal Coordination Committee was formed to lead these efforts. The activities were carried out by community health workers (young local volunteer men and women) chosen after a selection process and trained in the execution of the essential tasks of the PRN: taking a census of the target population; monthly weighing of children to detect inadequate growth; cooking demonstrations and nutritional education highlighting the nutritive value of local recipes and foods; distribution of vitamin A, deworming, and insecticide-treated bednets; promotion of iodized salt consumption; and the orientation of pregnant women in health structures for prenatal consultation and iron supplementation. Behavior change communication activities were organized around the sites (theater, songs, discussions, home visits).

In June 2008, the coverage rate for children's growth monitoring in Tivaouane was 97.2% while the rate of malnutrition there was 5%. The percentage of households which consumed iodized salt rose from 58.8% to 78% in June 08; the utilization of insecticide-treated bednets went from 54.8% to 87%; children receiving vitamin A supplements rose from 30.2% to 90.9%; and dewormed children went from 23.3% to 100%.

Plan Senegal has used this experience to expand its child nutrition program to other communes and with World Bank funding, currently covering a total of 100,000 people.