Driving through Liberia, one is struck by how green and lush the countryside is.  Much of the land at an initial glance looks to be full of deep, rich soil.  Despite these attributes, the country imports the vast majority of its staple crop, rice.  As a result of the 14-year civil war that ended in 2003, people are no longer interested in farming and are migrating to cities in hopes of employment opportunities.  In addition, health and nutrition practices are poor:  39% of children under five are stunted (meaning they are chronically malnourished, exhibited by low height for age); 19% are underweight and less than 50% of all births are conducted by a skilled birth attendant.  Standard daily meals consist of eating a small breakfast of bread or fried plantains, followed by one large meal served in a bowl shared by all family members of fish or chicken soup with palm oil.

 After about an hour and a half drive down a bumpy dirt road in Nimba-one that is not always passable during the rainy season- a group of women are sitting in a circle, dressed in their brightly colored wraps known as “lapas”, laughing and talking.  Pictures on laminated sheets of paper are presented to the group by a project staff and the women take turns explaining and discussing it.  These women are members of a Care Group; a community based approach for improving health and nutrition behaviors. Care Groups are unique in that they create a multiplying effect to reach every targeted household through the work of community volunteers.   Victoria Moses and Ester Sedeah, pictured below, are two Care Group volunteers known as lead mothers at this particular meeting.   As lead mothers they were elected by their community because they showed a spirit of volunteerism, demonstrated positive health behaviors, and were respected by the community.

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Twice a month Victoria and Ester, along with eight other lead mothers, meet in their Care Group.  Here, they learn key health and nutrition information targeted to pregnant women and children. They in turn, meet every other week with ten neighbor women, teaching what they have learned, using pictures to illustrate their messages.  For example, in Liberia, only 29% of children are exclusively breast fed during the first six months.  Seven out of ten infants are given water and other foods as early as two months.  Behaviors such as these contribute to the high rates of malnutrition in Liberia.  During her household visits, Victoria is ensuring women are committed to giving “tay tay” water (i.e. breast milk) exclusively up to six months.   Ester laughed as she explained how lively her neighbors become when talking about the important role men play in supporting women during pregnancy by allowing rest and providing nutritious food.

Both women look forward to their Care Group meetings.  The Care Group provides a safe space where they feel free to ask questions.  This is also a time to share with one another the positive changes they are seeing in their community as a direct result of the work they are doing.   Victoria believes that one day her daughter, along with other children in her community, will grow up to be a doctor or a teacher.  Addressing health and nutrition behaviors through the Care Groups creates community leaders and local responsibility for the health of the women and children.  With devoted women like this in the communities we work in, PCI is making lasting changes to reducing global malnutrition, one household at a time.