HIGHLIGHTS

• Childhood illness is common, and too little food during and after illness contributes to high rates of malnutrition, stunted growth and development, and mortality.
• Working with partners in the Democratic Republic of Congo (DRC), we designed solutions to help ensure that sick and recovering children receive adequate food.
• These solutions provide strategies and support for caregivers to feed their children well during the critical times of illness and recovery within the significant constraints they face.

The Challenge

For young children experiencing an illness, adequate nutrition is critical for recovery. However, children often don’t receive the recommended amount of food during and after an illness. In the Democratic Republic of the Congo (DRC), 70% of children under 5 receive less food than usual or no food during episodes of diarrhea. 

Childhood illness is common, and too little food during and after illness contributes to high rates of malnutrition, as children are unable to recoup lost weight. Malnutrition, in turn, leads to stunted growth and development and higher child mortality. While caregivers want to feed their child well during and after an illness, they understandably feel discouraged and at times powerless in the face of the myriad constraints, including food insecurity, they encounter. 

Our Approach

To understand the drivers of inadequate feeding during and after illness, we conducted qualitative research with caregivers, health providers, and community members in the South Kivu province of the DRC. Working through the Breakthrough ACTION project and in collaboration with USAID Advancing Nutrition and other stakeholders in the DRC, we designed solutions to help ensure that sick and recovering children receive adequate food. These solutions help caregivers to see how feeding their children contributes to recovery and good health, and provide strategies for caregivers to offer the nutrition children need within the significant constraints they face.

• In-the-moment reminders—stickers that health providers place on items they use or see during a sick visit emphasize a simple, actionable message that “every bite counts” and special foods are not needed for sick and recovering children.
• A food prescription elevates the importance of feeding, alongside medicine, in helping the child recover.
• Activities conducted during home visits with families of sick children—like a card-based activity that prompts caregivers to identify and consider all the foods their family has access to—support families to overcome the two main challenges to feeding sick and recovering children: finding available, affordable foods and overcoming the child’s limited appetite. The home visit reinforces the message that every bite counts, encouraging the family to celebrate small successes.
• A one-hour, in-person peer exchange of coaxing strategies workshop facilitated by community health workers builds caregivers’ skills and confidence in winning over the child’s appetite by teaching new tactics for encouraging young children to eat.

Solutions were refined through user testing, and we are supporting partners in the DRC to integrate them into programming.

Takeaway

Even when families face severe constraints, opportunities remain to support them in finding ways to feed their children adequately during the critical period of illness and recovery. Behavioral approaches can magnify the effects of efforts to improve access to nutritious, locally available foods and empower caregivers to see and celebrate the actions that are within their control to care for their children.

Interested in our work applying behavioral science to global health? Email gh@ideas42.org or tweet at @ideas42 to join the conversation.