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Headline
Reducing chronic malnutrition among children in Liberia
Over the past ten years, Liberia has made considerable progress in its development, striving to reduce poverty and improve access to basic services for its population, after years of crisis marked by the Ebola epidemic and, more recently, COVID-19.
Despite this progress, food insecurity and malnutrition remain a major concern in the country. To achieve its strategic country goal 2021-2025 “to improve nutrition, maternal, newborn and child health and WASH services in Liberia by 2025”, Action Against Hunger is working closely with national and local authorities, as well as international and local partners, to reduce chronic malnutrition.
Infant mortality, a national plague
The country ranks among the world’s worst nations for child health, with mortality rates for children under five, infants and newborns at 93, 63 and 37 per 1,000 live births respectively, among the highest in the world¹.
Rural areas are the hardest hit by this infant mortality due to inadequate access to health services, and the main causes of mortality are malaria, diarrhea and acute respiratory infections, diseases which are generally preventable and curable. More specifically, diseases related to water, sanitation and hygiene contribute significantly to undernutrition and reduce a person’s ability to meet their nutritional needs. In all, 37% of deaths in children under five are due to pneumonia or diarrhea, both of which are affected by water, sanitation and hygiene².
In addition, the World Bank’s 2020 report estimates Liberia’s national poverty rate for 2021 at 52.1%, while the 2019-2020 Liberia Demographic and Health Survey showed that 30% of children under five suffer from stunting, three (3) % from wasting and 11% from underweight. These data indicate that the country is experiencing high levels of food insecurity and poverty, as well as an alarming state of nutrition.
In addition, Liberia’s dependence on food imports is taking a heavy toll on the country, and is currently made all the more fragile by the rapid rise in world food, fuel and fertilizer prices, largely due to the ongoing war in Ukraine and the sanctions imposed on Russia.
A consortium to fight undernutrition
Through the Liberia WASH Consortium (LWC), establised in 2007, Action Against Hunger, Concern Worldwide and WaterAid, and with financial support from Irish Aid, are helping to reduce chronic malnutrition by tackling the main causes of undernutrition in Montserrado and Grand Bassa counties.
“This project really has a cross-cutting approach to tackling the root causes of malnutrition,” explains Laurence Gros, Country Director for Action Against Hunger Liberia. “Activities are very diverse, ranging from the rehabilitation or construction of water points or latrines, to the promotion of nutrition and care practices, advice for pregnant and breastfeeding women, nutritional screening of children under five and referral to the nearest health facility, identification and referral of preventable childhood illnesses (cough, diarrhea and fever) and raising awareness of various health, hygiene and sanitation issues”.
In 70 communities, the consortium is helping almost 80,000 people, with a focus on empowering people for long-term results. For example, through Village Savings and Loans Association (VSLA), the project supports the economic empowerment of women: from October 2023 to March 2024, 514 women in 28 communities collected more than 90,000 euros to buy food for domestic consumption, pay school fees for their children and cover healthcare costs for their families, as well as to launch their own income-generating activities.
“Thanks to these savings, I have invested in my business and am now a proud homeowner,” explains Esther Flomo, one of the people supported by the consortium. “I’m fully invested in the community, for which I contribute to decision-making”.
© Buta Visual Agency pour Action contre la faim
© Buta Visual Agency pour Action contre la faim
VSLA are also the driving force behind other projects, such as setting up vegetable gardens in the communities. Typically, 15 to 30 people work on a two to four hectare plot, growing a variety of vegetables ranging from cassava and potatoes to cabbage, eggplant, sweet potatoes and okra.
The food produced in these areas benefits not only those who have grown it, but also the community as a whole. Before the gardens were set up, the diets of the households supported by the project were extremely limited. Most families reported eating one meal a day, mainly consisting of rice or manioc. Today, these vegetable gardens give children the opportunity to eat fruit and vegetables on a daily basis.
They also generate income for community members, enabling them to save, cover school fees and pay for health services.
With the aim of meeting the needs and strengthening the livelihoods of the local population and farmers, the project has invested in and supplied cassava mills to the communities of Dogbalon, Montserrado and Meme Town, Grand Bassa, to improve the efficiency of cassava processing.
Traditionally, the production of cassava flour (known in Liberia as farina or gari) was a labor-intensive process. Without access to a cassava mill, it takes one person a full working day to produce a 50 kg bag of cassava, compared with around ten minutes with a cassava-milling machine.
The reduction in the cost of producing gari has encouraged more farmers in the community to grow cassava, enabling them to generate higher incomes.
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The challenge of access to drinking water
Lack of access to drinking water and adequate sanitation makes families particularly vulnerable to water-borne diseases. Nationwide, only 75% of the population has access to drinking water, and almost 38% of people practice open defecation³.
LWC is focusing its efforts on providing access to Water, Hygiene and Sanitation (WASH) services in urban and rural areas of Liberia. The project not only strengthens community structures and regional players to ensure the sustainability of WASH facilities, but also advocates public policies to improve the quality of these services in Liberia.
As part of the VSLA program, communities work closely with WASH committees to reduce open defecation by building household latrines. This is the case of the Kolleh-Long family, who have benefited from a new latrine in their garden. “These latrines have changed our daily lives. We realized that this sanitary installation has had a real impact on our health and dignity.”
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From October 2022 to March 2023, 21 wells were built or rehabilitated, giving over 17,000 community members access to clean drinking water. 275 households built their own latrines to combat open defecation, and 184 community health workers were trained.
[1] https://www.afro.who.int/countries/liberia/publication/who-liberia-2023-annual-report
[2] United Nations Millennium Development Goals
[3] 2021 Joint Monitoring Program (JMP) for Water Supply, Sanitation and Hygiene report
Liberia
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