Nutritious Meal Plan Intervention for Vulnerable Mothers and Children, (NUMEPLAN) project is a three-year (2019-2021) program that seeks to improve the nutrition of vulnerable mothers and children living in underserved communities in Lagos State. It pursues to ensure that they have sufficient intake of required nutrients and food for optimal growth, function and health. Target beneficiaries include pregnant women and teenagers, lactating mothers and under-five children affected by malnutrition, especially under-nutrition. NUMEPLAN goals are;
- To ensure a reliable and constant supply of adequate, safe and nutritious foods for the target beneficiaries.
- To reduce the morbidity and mortality rates associated with under-nutrition amongst under-five children.
- To prevent and control micro-nutrient deficiency among mothers and under-five children living in under- deserved communities.2The Vision To solve the problem of hunger and malnutrition in Teenage Pregnant Girls and infants in the slum communities in Lagos Nigeria.
The Mission To enable slums as well as Primary Health Care Centres (PHCs) to adopt and implement effective nutritional education programmes and affordable meal plans that help pregnant mothers/teenagers understand how nutrition is essential to maintain sound health at every stage of their pregnancy and their babies after delivery. Target beneficiaries include pregnant women and teenagers, lactating mothers and under-five children affected by malnutrition, especially under-nutrition.
The Outcomes of NUMEPLAN program are:
- Increased access to affordable meal plans and food security through the Lagos Food Bank.
- Increased community involvement in health and nutrition education activities.
- Strengthened capacity of PHCs within the slums to provide, manage and monitor affordable meal plans.
- Increased access of beneficiaries to resources like jobs that match their existing skills to sustain themselves through the on-going job placement program of the Lagos Food Bank Initiative
Journey So Far Since 2019, we have enrolled over 1520 beneficiaries into the program consisting of infants and under-five children, pregnant teenage girls and pregnant women and lactating mothers. A partnership exists over 30 Primary Health Care Centers (PHCs) in different Local Government Areas of Lagos. The PHCs refer cases of malnourished pregnant women/teenagers, lactating mothers and under-five children to Lagos Food Bank. When they arrive at the food bank, we conduct a series of nutritional assessments to determine whether the referred people will be enrolled into the program. The enrolled beneficiaries go through further assessments and counseling by our Nutritionists. Depending on the severity of the condition, we schedule the next consultation date on a weekly, bi-weekly or monthly basis. They are also provided with nutritious food items to ensure their adequate nutrient intake each time they visit the food bank. We have successfully enrolled, managed and discharged 107 malnourished beneficiaries from the NUMEPLAN program.
Impact Story Sarah Olowookere was 1 year 4 months when she was enrolled into the NUME-PLAN program on the 25th of February,2020. On her first visit, she weighed 6kg and her mid upper arm circumference (MUAC) was 10.8cm which indicated that she was -4SD of a normal child. Physical signs of malnutrition like; brittle hair, little muscle mass, flaccid skin and a bony frame were also evident. She was thereby diagnosed by our nutritionists to be suffering from severe acute malnutrition (under-nutrition). She suffered Bronchi pneumonia from child birth and this contributed to her ill-health. She was counseled by our nutritionists and provided with nutritious food stuff and baby supplement to aid the growth and improve the health of her baby After 5months of timely visitation, Sarah showed significant changes, we can celebrate huge milestones in her motor, speech, vision, hearing and social skills. Sarah was discharged on the 28th of July, 2020. On discharge, she weighed 7.5kg with her MUAC reading on 13.5cm transitioning from a malnourished baby to a healthy baby.
NUMEPLAN: APPROXIMATED COST TO FEED A CHILD, MOTHER OR BOTH PER MONTH
MONITORING AND EVALUATION
We have designed indicators to assess the NUMEPLAN program activities and also measure the effectiveness of the program.
1. Total number of beneficiaries enrolled: This entails the number of all beneficiaries enrolled into the NUMEPLAN project. This indicator is important to track the rate at which beneficiaries are been on boarded into the program. There should be a minimum of 20 new beneficiaries every 3 months.
2. Anthropometric assessment: This is a series of quantitative measurements of the muscle, bone and adipose tissue used to assess the composition of the body. The core elements of anthropometry used for NUMEPLAN
are weight, height/length, body mass index (BMI) and mid-upper arm circumference (MUAC). Z-score measurement is also used to express anthropometric values (converting measurements to indices) for NUMEPLAN beneficiaries, especially those under five years of age.
Z-score indices used include
i. Weight-for-height/length: this index is used to assess wasting (acute malnutrition). Wasted children are vulnerable to infection and stand a greater chance of dying. This is used for children under 5
ii. Weight-for-age: this index is used to assess underweight in children. This can be used for children up to 10 years
iii. Length/Height-for-age: this index is used to assess stunting (chronic malnutrition) in children. Stunted children have decreased mental and physical productivity capacity. This can be used for children (0-5years) and older children/teenagers (6-19 years)
3. Total number of beneficiaries successfully discharged: This entails the number of all beneficiaries that have successfully transcended from a state of malnutrition to optimum nutritional status, and therefore discharged from the NUMEPLAN project. Achieving an optimum nutritional status will take about 4-6 months, so there should be
a minimum of 30 successfully discharged beneficiaries every 6 months.
4. Dietary Assessment: This indicator involves looking at past or current intakes of nutrients from food by beneficiaries to determine their nutritional status. The family member or the mother and the child will be
asked some questions (e.g. what has been eaten in the past 24 hours) and this data is used to
calculate the dietary diversity score.