GBARNGA-TA, 4 December 2009 (IRIN) - Most communities have individuals or groups whose exceptional approaches to problems help them find better solutions than their peers, say behavior change experts, who call such individuals 'positive deviants'.

Two years ago NGO Catholic Relief Services (CRS) set out to find such entities in Liberia to see if they could shed light on why among children in the same village and socioeconomic bracket some were well-fed and others malnourished.

The answers varied across the three counties studied - Nimba, Lofa and Bong - but in several Bong County villages the answers came down to chicken, fish, eggs and yams, according to CRS nutrition and health adviser Daniel Dharmaraj.

The majority of Liberian children are fed a uniform diet of rice mixed with sauce and a smattering of vegetables, according to nutrition specialist Cherie Fulk with NGO Action Contre La Faim. "Fruit and vegetables are not highly valued among many communities – rice is the thing," she said.

But some women - which CRS calls "lead mothers" - were taking more risks, said Dharmaraj. "There are some women or groups of women who are very experimental in comparison to others who are not risk-taking."

Some of these mothers fed their children yams which they found growing wild in the forest. Some shared their backyard poultry or fish they caught in local rivers with children instead of only among the adults, as is customary.

Others fed their children eggs, disregarding a widespread myth that this will turn children into robbers. These small dietary changes could spell the difference between undernutrition and adequate nutrition, according to CRS.

Malnutrition causes 44 percent of under-five deaths in Liberia, and 39 percent of children in that age group are chronically malnourished, according to the government's 2009 nutrition policy.

All villages targeted in the project – funded by US Agency for International Development – had infant malnutrition levels of over 30 percent.

While carbohydrates are usually available throughout the year in these three counties, children's diets often lack micronutrients and proteins during the rainy season when it is difficult to fish, and when cowpeas – a common source of protein – are not available.
The positive deviance approach works because the knowledge comes from within the community, Dharmaraj said. "We do not provide food from outside...Other mothers can see that children are flourishing when eating yams, for instance, and that encourages them."

Fathers must also be brought on board; for the most part men control who eats what in a household, say nutrition experts.

Foods familiar but new

Goramah Bangah is a mother of two in Gbarnga-ta village, 15km from Bong county capital, Gbarnga. One in three children here were malnourished in 2007, according to CRS.

Since then Bangah has changed her feeding habits: "I never used to know about cabbage or carrot greens, but we all eat them now," she told IRIN. "I feed my two-year-old child chicken and eggs. I never knew I could do that before."

A mid-term evaluation earlier this year showed under-five malnutrition rates in targeted villages had dropped on average from 30 percent to 12 percent; and diarrhoea cases were dramatically down.

Access to healthcare also played an important role in the drop, as the project was set up only in villages that had access to health services through an existing nearby clinic or by establishing a community outreach programme, Dharmaraj said.

Malnutrition is a problem of overall health, not just food, nutritionists say.

In an extension of the project aimed at promoting food diversity among adults, CRS partner Caritas identifies "lead farmers" who display good farm management practices, are open to crop diversification and can encourage others to follow suit.
  More of Gbarnga-ta's farmers now grow a wider variety of crops than they used to, stagger their crops for year-round production and produce crops not only to eat but also to sell, farmer Alfonso Daookatar told IRIN.

Bangah grows aubergine – known locally as bitter ball, as well as carrots, cabbage, okra, hot red peppers and cassava on her small plot. Okra fetches US$1.15 per bucket in local markets, and red peppers $2 per kilogram, she said.

But thus far the project is small scale. Expanding such nutrition-promotion projects is intensive and long-term and many aid agencies and government health teams do not have the capacity to take them on, experts told IRIN.

And improving infant feeding practices is just one piece of the nutrition puzzle, UN Children's Fund nutrition adviser in Liberia Kinday Samba said.

Samba said vital first steps are: Proper antenatal health and nutrition to ensure would-be mothers do not contract malaria or become anemic, exclusive breastfeeding for babies up to at least six months and malaria protection for infants.

Source http://www.irinnews.org/