Personalized Home Visits in Coastal Kenya Increase Knowledge on the Importance of Consuming Fish
This post is written by the Samaki Salama project team of the Feed the Future Innovation Lab for Fish. The project is focused on securing small-scale fisheries for healthy nutrition and ecosystems in Kenya. The post originally appeared on the Feed the Future Innovation Lab for Fish website.
Like many women in her community of Uyombo, Kenya, Maria, a mother of 10 children, worries about her children’s nutrition. Maria is a homemaker and mainly depends on her fisherman husband to provide for all of their needs. She is able to generate a small amount of income by selling mahamri (a coconut milk-enriched doughnut); any that are left over she serves to her children with tea when they return from school. She has tried to diversify her farm by planting mangoes, paw paws, cassava, and amaranth, but many plants have dried up due to the increasingly hot climate. Her family raises some livestock—chickens, ducks, goats, and one cow— but she is unsure of how best to use the foods on her farm to ensure that she feeds her children nutritious meals.
Coastal communities in Kenya like Uyombo are dominated by small-scale fisheries and are among the poorest and most malnourished globally. The Samaki Salama (“fish security” in Kiswahili) project team has been working to address these challenges through the implementation of an integrated social marketing strategy that targets caregivers and fishers with information about child nutrition, health, diet diversity. It emphasizes the importance of catching mature fish for fishery sustainability and improved income.
Incorporating fish into a balanced diet
Home visits are a key component of the project’s social marketing strategy. During visits, the team’s nutrition/education specialists engage with the caregiver and child or children to build a positive relationship, understand their individual needs, and enable change. To date, the team has conducted 100 home visits in the intervention sites of Mayungu and Uyombo in Kilifi County.
In addition to discussing and diagnosing illnesses and child feeding and hygiene habits, the team helps caregivers identify next steps and agree on actions geared toward improving feeding practices and better health care. The overarching message caregivers receive is that fish can be a critical source of nutrients for their child and that paying special attention to their child’s growth and development now has lifelong benefits.
Caregivers have been extremely receptive to the visits, advice, and support. Maria expressed how she was happy to have a home visit because it was an opportunity to learn new things about the health of her children and family. She noted the importance of receiving and using nutrition information, particularly guidance on infant and young child feeding, as two of her children are under the age of five. Maria now understands the importance of earlier advice she received from the local health clinic and her peers. She can see the difference in growth and better health of her youngest two children, whom she exclusively breastfed. She worries about her third to last child because he is a poor eater, and his health is not as good as she would like.
Diversifying diet key
The home visit and discussion with the nutrition educator have helped Maria feel empowered to make changes to how she feeds her children and to share the information she received with other mothers. She plans to continue diversifying her family’s diet, especially that of her youngest children. The plan is to use what she has locally on her farm so her children eat more than just ugali (a stiff polenta-like maize cake) and coconut milk soup. Her children enjoy eating fish, but she has until now not given them fish heads because she was afraid of the bones. Since learning about the importance of fish in child nutrition, Maria said, “I will start feeding my children the fish head and eyes that I wasn’t giving them before.”
Pendo, another mother in Uyombo, was also glad to receive a visit and noted that many other mothers would likely want to be given the information provided by the nutrition educators. She explained that her second child has had several health issues and been hospitalized for malnutrition. The child’s condition has improved since the mother started following nutrition guidance she received from the hospital. This experience highlighted to her the importance of proper feeding, and she was eager to learn more about additional ways to improve her child’s health. Pendo was particularly interested in the best way to prepare fish for her child, noting that she has "a better understanding on shallow frying fish and its benefits.”
Many households give children deep fried fish or the broth of fish soup, which does not provide as full a range of nutritional benefits as shallow fried fish. Pendo also appreciated the information she was given about different options for healthy snacks.
Home visits ongoing
The project team will continue to visit intervention households over the course of the project to follow up on agreed actions and provide support and advice for any new challenges that caregivers face. They will also be training local community health volunteers to conduct the home visits, so caregivers will have a reliable source of information and support even after the project is complete.
At the end of Maria’s home visit, she thanked the Samaki Salama project for the nutrition education saying, “I’m grateful because the education is nice. What I didn’t know, now I have learned.”
Note: Maria and Pendo are pseudonyms out of respect for the participants’ privacy.