Fighting malnutrition in Burundi: Mothers of Light are rays of hope

Despite the fertile soil in Burundi, it is unfortunate to see that one in every two children under the age of five suffers from chronic malnutrition (stunting). However, I have witnessed that the community is tackling this issue directly and is determined to put an end to stunting using a multisectoral approach.

Malnutrition during the first 1,000 days of children’s life can have severe and long-lasting consequences. It can halt a child’s growth, weaken the immune system, impair cognitive development, and even increase the risk of mortality. Malnutrition deprives children (and countries!) from reaching their full potentials. However, the good news is that various interventions and programs tackle these nutrition and health issues.

During my recent visit in the Bubanza province, the western part of Burundi, I met with two groups of amazing women knows as Mamans Lumières or “Mothers of Light”. They are actively engaging in various initiatives to combat malnutrition, from prevention to rehabilitation. groups of amazing women knows as Mamans Lumières or “Mothers of Light”. They are actively engaging in various initiatives to combat malnutrition, from prevention to rehabilitation.

These dedicated women are elected at the community level thanks to their exceptional connection with the local population and nutritional behaviors despite modest socio-economic situations, making them true role models. They run nutrition education programs to teach other mothers and caregivers the importance of a balanced diet for their children, as well as promotion of community gardens, where they grow nutrient-rich vegetables.

From pregnancy to rehabilitation
The Community Health Workers of the area explained that the process of fighting malnutrition starts when the woman is pregnant. In every commune of Bubanza, they support and guide women so that they can receive the right treatment during their pregnancy and follow a healthy and appropriate diet.

After birth, the newborn baby is examined, measured, and weighed to determine if s/he is healthy. Regular weight and height checks are conducted for children and an additional measurement of the Mid Upper Arm Circumference (MUAC) helps quickly determine if the child is malnourished (red zone on the tape indicates severe malnutrition, yellow moderate, and green adequate nutrition). Children at yellow zone on the measuring tape) are sent to the learning and nutrition rehabilitation center, managed by Mamans Lumières. Severely malnourished children (MUAC red color) are referred directly to the health facilities.

A community health worker measuring the weight of a child in Bubanza.  Photo: World Bank

The learning and nutritional rehabilitation center that I visited was modest but full of life and joy. The center welcomes around 12 children at a time, and each child stays for 12 days. During their stay, the children receive intensive nutritional support and are expected to leave in good nutritional status, having gained at least 200 grams weight. This is the recovery criterion set by the National Integrated Food and Nutrition Program.

During the session at the center, Maman Lumières were teaching mothers how to prepare balanced meals that include proteins, fats, and carbohydrates. All those nutrients are locally produced and can be found in the market in Bubanza. After this session, food fortified with micronutrients was brought for the kids.

Maman Lumières are trained to identify malnutrition in children and to refer them to health centers when necessary and they also participate in raising community awareness to help ensure follow-up.

Community and Government Collaboration
The success of this strategy relies on both government support and community involvement. Through the IDA-financed, Nkuriza Project, which focuses on investing in early years and fertility in Burundi, the capacities of Community Health Workers and the Mamans Lumières are being strengthened. The project raises awareness about nutrition and provides these role model mothers with seeds to plant nutrient-rich vegetables.

In all the provinces where the project is active, over 4,127 Community Health Workers and 3,000 Mamans Lumières have been trained. Their mission is simple yet profound: to give every child the opportunity to grow up healthy and strong.

The 2024 Standardized Monitoring and Assessment of Relief and Transitions (SMART) Survey’s results indicate that the stunting rate declined by 4.9% in the project's provinces compared to 0.8% in the rest of the country. This success is largely due the Mamans Lumière who collaborate with Community Health Workers and leaders to combat stunting. We can see their work to maintain kitchen gardens, promote nutrition and hygiene, and support family planning is having an impact. Other assistance they provide, such as a safe space for early stimulation and parent education, are equally impactful and crucial for socio-emotional development in malnourished children.

The success in Bubanza is also thanks to a multisectoral approach. In addition to the learning and nutritional rehabilitation center, the Maman Lumière has started to cultivate and sell vegetables, allowing them to feed their family and have money for their other needs.

Building on the success

Mamans Lumiere washing hands before serving fortified meals. Photo: World Bank

Addressing malnutrition requires a collective effort. Community Health Workers and Mamans Lumières are tackling malnutrition among children, pregnant women, and breastfeeding mothers using local resources. Their work demonstrates that community-led initiatives, supported by the government and partners, can lead to significant improvements. As the government considers a strategy to enhance incentives for community health workers and implements a multisectoral approach to combat malnutrition, I am confident that further progress can be made in Burundi, ensuring that children can reach their full potential.