The Support for Nutrition Improvement Component (SNIC) project in Malawi's Ntcheu District aims to reduce high rates of child malnutrition and stunting. It does so by strengthening community nutrition services, improving maternal and child feeding practices, and increasing nutrition awareness. Through peer-to-peer care groups and nutrition education, the project has helped decrease malnutrition indicators and child stunting rates in targeted communities. Beneficiary stories illustrate positive behavior changes and health impacts on mothers and children from applying new nutrition practices.

1. Support for Nutrition
Improvement
Component (SNIC) -
Ntcheu District

2. THE CHALLENGE
Child malnutrition rates across Malawi rank as some of the highest in world. A number of
factors contribute to this:
• inadequate infant and young-child feeding practices
• limited availability and access to nutritious foods
• high disease rates
• inadequate maternal care
Only 20 percent of Malawian children aged six to 23 months are receiving the minimal
acceptable diet. The majority of babies are exclusively breastfed (94 percent) up to four
to five months old, but after this age the rate drops sharply to 41 percent. As exclusive
breastfeeding declines, the nutritious properties of the mother’s breast milk are not being
replaced with enough nutritious food for the infants.
These poor complementary feeding practices,
combined with a high disease burden, result in high
rates of malnutrition with over 47 percent of Malawi’s
children under-five stunted. One of the highest
in the Sub-Saharan Africa region, Malawi’s rate of
stunting averages 40 percent. Stunting is generally
caused by extended periods of malnutrition or
under-nutrition while the child’s body is developing.
The most rapid period of growth takes place during
the first 1,000 days of a child’s life, from conception
to age two. If the pregnant woman or young child
receives inadequate nutrition during this period,
growth can be permanently arrested.
In Malawi’s Ntcheu District, there is a high level of
stunting, at 40.4 percent, and low levels of exclusive
breastfeeding, at 68 percent, and only 14 percent
of children have a minimum acceptable diet. The
majority of under-five children, 62.5 percent, in
Malawi are anaemic. In Ntcheu that rate is 60.5
percent. Anaemia is concentrated among children
aged zero to two years old and it is a major factor
in compromised cognitive development. Nearly a
third of women of reproductive age (15-49 years) in
Malawi are also anaemic. Anaemia is associated with
higher maternal mortality rates, lower birth weight,
and reduced productivity.
MAKING A DIFFERENCE
To decrease malnutrition and anemia in women and
children, the Government of Malawi recommends
a number of high-impact interventions that are
promoted through the global Scaling Up Nutrition
(SUN) 1,000 Special Days Initiative.
In response, the Government’s Department of
Nutrition, HIV and AIDS, through Catholic Relief
Services’ (CRS’s) local partner, Dedza Catholic
Health Commission, began implementing the
Support for Nutrition Improvement Component
(SNIC) project in the Ntcheu District, in March 2014.
This was made possible with US$2million in funding
provided by the World Bank and the Canadian
International Development Agency (CIDA). The
project duration is from February 2014 to August
2017. In its first phase, from February 2014 until
February 2016, SNIC reached 36,556 households
in six of the 12 Traditional Authorities (TA) in the
Ntcheu District. By the end of the project, SNIC plans
to provide maternal and child health and nutrition
services to 127,244 households.
Through improved antenatal care, breastfeeding
and infant-feeding practices, the SNIC project helps
reduce child stunting and maternal and child anemia
in Malawi. The project focuses on enhancing and
scaling up maternal and child nutrition community
services, and strengthening existing local
development committees, who provide a backstop
on all nutrition, maternal and child health activities at
the community level.
Improving nutrition for pregnant
women, lactating mothers and children
under two

3. HOW WE DO IT
We aim to improve the nutrition of mothers and
children the first 1000 days of a child’s life, from
conception to two years. We do this by:
➤ Strengthening district and community
nutrition services through:
• Area and Village Nutrition Coordinating
Committees and other service providers
trained on nutrition interventions
• establishing care groups at the
community level
• conducting growth monitoring and
promotion at the community level
• encouraging iron intake among pregnant
women and children under two
• improving maternal feeding practices
• improving infant and young child feeding
practices
• improving community and home-based
care for common infectious diseases
(diarrhea, dysentery, pneumonia, malaria)
at the household level
• promoting early health-seeking behavior
➤ Increasing nutrition and childhood illness
prevention awareness among adults, by
reaching households through various
community channels with child nutrition
and maternal care messages
➤ Improving institutional coordination for
developing and monitoring nutrition policy
and community-based interventions, by:
• strengthening nutrition monitoring and
evaluation programs at the district level
• providing nutrition service delivery
HBENEFICIARY STORY: CHRISSY KAMASAMBA,
AONGA VILLAGE – CARE GROUP PROMOTER
Chrissy Kamasamba, 38, says her community in
Maonga Village has seen a dramatic decline in the
number of undernourished children since they
began participating in the SNIC programme, which
is implemented by CRS’s local partner, the Dedza
Catholic Health Commission, two years ago. “In
a recent three-day growth monitoring activity,
we could not find a single child suffering from
malnourishment in our village, but two years ago, we
would have found between five to ten malnourished
children,” she said. Chrissy, a mother of five, is a
care group promoter and looks after three care
groups across two villages. Each care group is made
up of between eight and 12 women, who are each
responsible for a cluster of up to 12 households.
Care group members are trained in nutrition and
health modules, which cover the following areas:
• infant and young child feeding practices
• child caregiving practices that promote
improved nutrition
• hygiene
• sanitation
CRS has established more than 3,000 care
groups in Malawi since 2005, reaching over
200,000 households. The model takes a peer-
to-peer approach. It has proven very effective
in disseminating health and nutrition messages
and affecting behavioral change in a targeted
community.
In recognition of time care group promoters give to
their role, SNIC provides them with bikes to expedite
travel between villages. Chrissy said, “I didn’t know
how to ride a bike before, so I taught myself. It has
decreased the time it takes to visit other care groups
and I’ve learned a new skill. The neighbours look a
bit envious when I ride past!”
The project functions as a safety net for more
vulnerable parents of children. SNIC provided
Chrissy with goats and seedlings, including beans,
sweet potato, pawpaw and oranges that, when they
reproduced, she shared with the most vulnerable
families for food security. Once it is weaned, Chrissy
is giving a goat kid to her neighbor, Patricia Kapito,
who is a single mother of three. “This will benefit
my children, because goat’s milk is more nutritious
Zande care group members assess child malnutrition rates
in their community during their monthly community growth-
monitoring meeting. The group uses this giant scoreboard to
monitor how many mothers and children are participating in
growth assessment and the health of children in the community,
particularly as it relates to malnutrition. They are beneficiaries of
SNIC (Support to Nutrition Improvement Component).

4. CATHOLIC RELIEF SERVICES
228 West Lexington Street, Baltimore, MD 21201, USA / CRS.ORG
Catholic Relief Services is an international aid agency with more
than 70 years of experience and 5,000 staff members worldwide.
We are one of the oldest and most trusted aid organizations
in the world, working in 93 countries and reaching 100 million
people in 2014. We work primarily in emergencies, agriculture
and health. For more information about our work in agriculture,
contact agricultureunit@crs.org.
than cow’s milk, especially for children under two,”
Patricia said. “We also use the manure for fertilizer.”
Chrissy says she has seen some dramatic changes in
the families she visits. “There have been big changes
in environmental hygiene. Every household that I
visit now has a toilet and hand-washing facilities with
soap,” she says. “It’s exciting, especially when I can
see the impact of sharing better hygiene practices.”
The new health and nutrition practices have also
made a positive impact in Chrissy’s own household.
Cooking every meal using the six essential food
groups has made her children stronger and less
prone to illness, Chrissy says. “My 10-year-old
daughter, Natasha, is physically stronger and is
preforming remarkably well at school. She is ranked
third out of 64 in her class. I see a very bright future
for my children.”
BENEFICIARY STORY: MARY AND FRANK BILIAT, ZANDE
VILLAGE, GANYA TRADITIONAL AUTHORITY (TA)
As the husband of a SNIC care group cluster lead,
Frank Biliat, 49, has learned a lot from his wife, Mary,
in the past three years, because she shared with him
many of the new health and nutrition practices she
was trained in. When a snake badly bit Mary’s hand,
Frank was able to step in and prepare nutritious
meals, clean the house and surroundings, and bathe
his four children. “We have learned a lot of good
child-feeding practices,” Frank said. “Mary was
just cooking a porridge mixture with salt and sugar
before, but the children love the new food. Around
the village, we are all cooking much better food.”
Mary’s porridge is now enriched with the foods from
the six different food groups, including green leafy
vegetables, groundnuts, sweet potato and eggs,
many of which they produce around their home.
Frank has also been busy constructing sanitation
facilities. He improved their outdoor toilet structure,
built a ‘tippy-tap’ stand for washing hands with
soap following toilet use, constructed an outdoor
dish-drying rack, and he set up a washing line, so
they no longer have to dry clothes over the fence or
shrubs. As a reminder for everyone in the family to
follow good hygiene and sanitation practices, Frank
inscribed, “Tizidya zakudya zamagulu asanu ndi
limodzi,” or “We should eat the six food groups” on
the outdoor kitchen wall, and he wrote “Ukliondo ndi
wabwino,” or “Hygiene is good” on the toilet block.
Mary said that since the SNIC program started, there
has been a dramatic decline in child malnutrition
in the village, which has dropped an impressive 46
percent in three years. “We introduced the program
to the families as a way to help reduce stunting.
Before that, we didn’t realize that stunting begins
in the womb and that our children were already
affected before they were born,” she said. “We have
worked hard to educated the community about the
importance of eating meals made from all six food
groups, so our babies are born healthy.” Mary added,
“This is a multi-sector project and we work closely
with the government HSAs (Health Surveillance
Assistants) and schools, so children are eating
nutritious porridge during their school day. Through
the promotion of growth monitoring activities, a
cluster lead in our community identified a severely
malnourished child, who became that way due to
food shortages in the non-harvesting months, and
she was referred to the hospital and placed on the
Ready to Use Therapeutic Foods (RUTF) feeding
program. SNIC has given hope to this community
and our prayers have been fulfilled. Our children will
have a good future.”
CATHOLIC RELIEF SERVICES
228 West Lexington Street, Baltimore, MD 21201, USA / CRS.ORG
Catholic Relief Services is an international aid agency with more
than 70 years of experience and 5,000 staff members worldwide.
We are one of the oldest and most trusted aid organizations
in the world, working in 93 countries and reaching 100 million
people in 2014. We work primarily in emergencies, agriculture
and health. For more information about our work in agriculture,
contact agricultureunit@crs.org.
Sautso Getso, 32, Group Village Head (GVH) in Zande, attends
the village care group’s monthly community growth monitoring
meeting. “I’m very happy having the scoreboard in our village
because we are able to see the nutritional status of all of our
children. SNIC has brought us knowledge and now we know the
health status of every child. We didn’t know this before. The
stunting will be eradicated in this area.”