By Amy Ostrander
Kou, a mother of seven, lives in Nimba County, Liberia, and like the rest of the nation, her community struggles with high rates of poverty and child malnutrition.
Mothers in Kou’s community share stories about children being small and failing to thrive, suffering from frequent diarrhea, and others who have reddish hair (a sign of malnutrition). Kou recalls that even though she followed traditional ways to feed her children with rice and cassava paste, her children were often sick. This posed significant challenges for her family given that the nearest health center is more than an hour away. Kou worries about feeding her youngest daughter, Korto, born just last year.
In a country ravaged by years of civil war, pervasive poverty, widespread food and nutrition insecurity, keeping children well-nourished and healthy has been a constant struggle for Liberian families.
In 2013, the latest nutritional survey showed that only four percent of Liberian children met the minimum standards for three basic infant and young child feeding practices. And in 2014, when Ebola roared into Liberia, families suddenly faced another life-threatening challenge. Already food insecure villages saw quarantines and roadblocks limit or close markets, further restricting the availability of and/or access to food. Even though there were no Ebola cases in her community, the local markets that Kou and her neighbors relied on either closed or severely reduced their operations for almost three months. A food shock like this could easily have spelled disaster for children in Kou’s community, but it did not – in part thanks to a nutritious porridge recipe from the LAUNCH program.
The Liberian Agricultural Upgrading, Nutrition, and Child Health (LAUNCH) program, funded by Food for Peace of USAID, is a five-year Title II program focused on improving the food security of vulnerable people in six districts of Liberia. ACDI/VOCA leads the program as the primary implementer, and Project Concern International (PCI) is responsible for maternal and child health, nutrition, and education programming.
Through LAUNCH, PCI trained a cadre of “Mother Leaders” who teach their peers about breastfeeding, complimentary feeding, preparing nutritious food, hygiene, and other important practices to ensure children receive the nutrition they need to grow, thrive, and be healthy. Mother Leaders worked together with Community Health Volunteers and PCI staff to help Kou and her community ward off malnutrition. Together they employed a powerful tool to prevent malnutrition in children under two – a highly nutritious porridge made from local ingredients. Overall, the collaboration yielded amazing results.
Porridge is a common food in Liberia, though it generally consists of only starches like cassava, rice, or plantain. Starch-based porridges provide calories but lack the essential protein, fat, and micronutrients that children need for optimal nutrition, growth, and overall good health. Building on the premise that feeding children porridge is widely practiced, PCI’s team in Liberia partnered with a community-based organization called Trauma Aid International and with input from local communities developed several tasty and nutritious porridge recipes.
The goal was that the recipes be: affordable; completely sustainable; made from a combination of foods readily available; and easy to prepare. Several simple and straight- forward recipes were created consisting of: a dried starch; crushed protein; a source of fat; green leafy vegetables; and seasoning for taste. The recipes are flexible, with three starch and three protein options each so that mothers are able to swap out one ingredient for another as needed. This not only allows for some interesting variation in taste for the children, but more importantly it means that when faced with challenges to food access and availability – such as seasonality, price increases, or restricted market access – mothers can continue preparing healthy food with what they have on hand.
The porridge has been extremely popular with mothers and children alike. Mothers in Kou’s community proudly demonstrate how to crush ingredients and prepare the porridge, eagerly sharing their experiences. One woman tells the group that she appreciates how the size of the recipe can be adjusted. When she has enough money she prepares porridge for two weeks or more given that it has a shelf life of up to a month. When she does not have sufficient resources, she makes a smaller batch. Another mother shares how she uses peanuts instead of sesame seeds when the seeds become expensive. With a smile, yet another woman explains how her children love the taste and that between the porridge, health, and sanitation practices they have learned from LAUNCH, their children “are fat, healthy and sick less often.” Community members agree that, overall, their children are better nourished, healthier, and have had fewer signs of malnutrition since they started feeding children the porridge.
An analysis of the porridge has shown that it is highly nutritious. A half cup of the ‘plantain and peanut’ variety of porridge, for example, provides between 82% and 225% of average daily complimentary calories (depending on the child’s age between 6-23 months), well over 100% of average daily protein needs, and 21% of average daily fat needs for children under two years of age. In terms of micronutrients, again depending on the age of the child, a half cup of the porridge provides between 64% and 73% of vitamin A needs, and between 12% and 19% of daily iron needs.
The porridge is designed to be a complimentary food provided to children under two years of age who continue to breastfeed. This in combination with the fact that there are ways to increase macronutrient and micronutrient content of the porridge – such as adding more oil to increase fat content, cooking the porridge in an iron pot and/or adding chopped up green leafy vegetables to increase iron/vitamin A content, etc. – help to ensure that children are reaching 100% of their required daily nutrient intake. Indeed this is evident in the “fat baby phenomenon” that USAID and Ministry of Health and Social Welfare Officials have repeatedly commented on when visiting LAUNCH communities. Sumoiwo Miller, a LAUNCH Health and Nutrition Coordinator says, for example, that having seen the results, “County Health Teams in other areas have asked for the recipe [because] they want to spread the practice.”
The power of the porridge recipe is in its simplicity. The porridge empowers families to take control of their child’s nutrition with ingredients that are readily available, highly accepted in Liberia, affordable, and completely sustainable in the local context. Moreover due to the versatility of the ingredients, mothers can adjust to whatever shocks they might face.
Kou started using the porridge to feed Korto when she reached six months of age, in addition to continuing to breastfeed. Kou happily reports that at nine months of age, “Korto is sick less often [than her older siblings were] and is very active.”
She glances at Korto, who has chubby cheeks and is indeed full of energy, happily wriggling about in the arms of the PCI staff member paying a visit. “My husband also thinks the new porridge is fine because the food has made the baby healthy and active.
Article written by: Amy Ostrander, Associate Technical Advisor, Food and Nutrition Security, PCI
 Names in the story have changed to protect beneficiary privacy.
 The three IYCF practices referenced are: breastfeeding; having an adequately diverse diet; and being fed a minimum number of times per day according to age. Liberia Institute of Statistics and Geo-Information Services (LISGIS), Ministry of Health and Social Welfare [Liberia], National AIDS Control Program [Liberia], and ICF International. 2014. Liberia Demographic and Health Survey 2013. Monrovia, Liberia; pg 169.