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close this book Community Nutrition Action for Child Survival
close this folder Part I - Community nutrition problems and interventions
close this folder Unit 4: Introducing weaning practices in the community
View the document Session 1: Changing weaning practices
View the document Session 2: Making improved meaning foods in the home
View the document Session 3: Weaning food practice
View the document Session 4: Case study: Village weaning food projects in Thailand
View the document Session 5: Weaning foods - Village production techniques

Unit 4: Introducing weaning practices in the community

SESSION 1: Changing Weaning Practices

SESSION 2: Making Improved Weaning Foods in the Home

SESSION 3: Weaning Food Practice

SESSION 4: Case Study: Village Weaning Food Projects in Thailand

SESSION 5: Weaning Foods - Village Production Techniques

Session 1: Changing weaning practices

Weaning practices are often the most important causes of malnutrition in children from six months to three years of age. Habits of child feeding are based on the quantity and quality of food available; on beliefs about what is and isn't good for young children; on time available for food preparation; and on custom. Recommendations for changes in weaning practices must be practical and they must be acceptable to the community.

Purpose:

In this session, participants analyze common weaning practices in their regions and develop strategies for changing the current practices that result in malnutrition of weaning-age children.

Time: 1 1/2 - 2 hours

Materials:

- Flipchart and marking pens

- Handout - "Guidelines for Weaning"

- Handout - "Changing Weaning Practices"

To the Trainer:

Before this session, write a short description of the common weaning practices that are detrimental to the nutrition of weaning-age children. The problem statement can be written directly on the Handout - "Changing Weaning Practices,. or it can be copied and distributed separately. An example is provided on the handout.

Steps:

1. Distribute the Handout - "Guidelines for Weaning" and review with the trainees.

2. Ask trainees to think of the common weaning practices in their areas by answering the following questions:

- At what age are the first foods other than breast milk given to children

- What foods are routinely given to children six months to two years old (daily)

- What foods are never given

- How many times a day are young children fed

- At what age do most women stop breastfeeding their children

3. Conduct a discussion of common weaning problems by asking trainees to compare the practices in their areas to the "Guidelines for Weaning. "

4. Ask trainees to explain why they think families follow the current weaning practices. Summarize their responses giving emphasis to the following points:

- Foods are sometimes not available

- Mothers (and fathers) do not have enough time to prepare food and feed young children

- Beliefs about foods for young children restrict the foods they are given to eat

- Customs or habits of feeding

- Lack of knowledge about food and nutrition

5. Divide trainees into small work groups (5 - 7 persons from the same region if possible). Distribute the Handout - "Changing Weaning Practice" to each trainee. In this activity, work groups will develop plans for improving weaning practices in a village. A problem statement describing the specific weaning behaviors that they have been asked to improve should be given to each group.

6. Tell work groups that their plans should describe what they will do and how they will do it. Plans should be:

- Practical or "doable" with the resources of most families

- Acceptable to the families

7. When work groups finish, ask each group to describe the changes in feeding practices they would recommend and their plan for helping families in the project area change these practices.

8. Point out similarities and differences in the plans. Make a list on the flipchart of the types of activities proposed by the work groups. Add other activities that might be appropriate.

9. Congratulate trainees on their efforts and remind them that every plan for change will be slightly different based on the experience, training and perceptions of the group members as well as the information they have about attitudes and practices in the community. As community project managers, we should be ready to change our plans as our information and experiences increase and as conditions change in the community.

HANDOUT

Guidelines FOR WEANING

Weaning is the period when new foods are introduced to a child's diet while breastfeeding continues. The weaning period begins between four and six months and may continue until about three years of age.

1. Breastfeeding alone is normally sufficient until an infant is 4-6 months of age.

2. From 4-6 months, soft foods should be added gradually to the diet.

3. When foods are first introduced they should be mashed smoothly; by about nine months, foods can be finely chopped; by two years, most children can manage adult foods.

4. From six months to two years, a child should be fed four to six small meals each day in addition to breastfeeding.

5. After six months, an infant should be eating body-building, energy and protective foods plus breast milk every day.

6. Food for young children, once prepared, should never be stored without refrigeration for more than two hours.

7. The hands of both mother and child should be washed before handling food.

8. Use a clean cup and spoon for feeding young children never use feeding bottles!

HANDOUT

Changing MEANING PRACTICES

1. Problem Statement

Example: 40 % of the children ages 1-3 years in our project area are suffering from malnutrition. Mothers breastfeed until their children are 2-3 years, but in most villages, other foods are not given regularly until children are 9-12 months old. Young children are fed a constant diet of maize porridge, banana, cassava and other starchy foods. Even though body-building foods like beans and eggs are produced by most families, they are rarely given to young children. Since it is customary to eat two meals a day, young children are fed in the morning and again in the evening when their parents finish work in the fields.

2. What changes in feeding practices would improve the nutrition of weaning-age children in this project area?

3. What actions could be taken to help families change their current weaning practices?

Session 2: Making improved meaning foods in the home

High quality weaning foods can be made from the foods found in most homes. Individual and group education activities in the community should include practical recipes and demonstrations of improved weaning foods made from locally available ingredients.

Purpose:

Using the Weaning Food Square, trainees will develop improved weaning mixes from foods available in their regions. They will discuss alternative methods for home preparation of weaning foods and answer a simple set of questions to predict acceptance of new weaning food recipes.

Time: 1 hour

Materials:

- Flipchart and marking pens

- Handout - "Making Improved Weaning Foods Using the Weaning Food Square"

- Handout - "Why Add Energy Supplements to Weaning Foods? "

- Large drawing of the Weaning Food Square - Samples or pictures of local foods

Steps:

1. Introduce the session topic. Emphasize the need to give families practical advice about improved weaning mixtures that can be made from foods found in the home, with little or no extra work.

2. Post a large drawing of the Weaning Food Square at the front of the room, and explain that it can be a useful tool for planning improved weaning recipes from foods in their regions.

3. Describe each section of the Weaning Food Square and the types of foods belonging in each one. Ask trainees to name the foods grown or sold in their regions that belong in each section of the square. Write the names of the foods mentioned, or attach pictures of the foods, to the correct section of the large Weaning Food Square.

4. Distribute the Handout - "Why Add Energy Supplements to Weaning Foods?" and discuss with trainees.

5. Distribute the Handout - "Making Improved Weaning Foods Using the Weaning Food Square." Divide trainees into work groups of 3-4 persons each. Each work group will develop at least three improved weaning foods by completing the steps on the handout.

6. Review the steps on the handout one at a time, allowing work groups 5-10 minutes to complete each step before proceeding to the next.

7. When you reach Step 3 - Preparing Ingredients, make the following points, There are three principal ways of preparing improved weaning foods:

- Using foods from the family's meal

- Adding one or more new ingredients to the traditional porridge or gruel fed to infants

- Combining ingredients that are not typically used for child feeding in a new recipe

Simple methods of preparation that are the same as those used in every day food preparation are most likely to be accepted.

Methods of preparation that reduce extra cooking time will also guarantee that a weaning food recipe is prepared often.

8. Concerning Step 4 - Calculating Amounts of Ingredients: Nutritionists familiar with the nutrient values of local foods should calculate average portion sizes for each commonly available ingredient. Trainees should be given portion sizes for raw and cooked foods in terms of volume (ml) and common household measures (i.e., tea cup, eating spoon), as in the upcoming Example. The basic goals for a weaning food serving for one child, for one meal are:

- 300-350 kilo calories;

- 5-6 grams of reference protein;

- 200-300 ml volume.

A table showing the approximate raw weights and proportions of staple and protein supplements to achieve these goals is provided as a trainer's reference on page I-4,9.

9. When work groups finish Steps 4 and 5, ask them to write their completed recipes on newsprint and to present them to the group.

10. Use page 6 of the handout, to give each of the recipes a score for predicted community acceptance. Discuss the advantages and disadvantages of specific recipes with the group.

Look for recipes that build on traditional methods of food preparation and those that require little extra time for preparation!

11. Ask work groups to select 1-2 of their recipes for demonstration. (In some cases, the trainer may want to choose recipes to assure that a variety of weaning mixes are made.) Work groups should plan their demonstrations, listing and, in some cases, collecting needed supplies and cooking utensils.

Go on to Session 3!

EXAMPLE

STANDARD PORTION SIZES FOR WEANING FOOD INGREDIENTS

Ingredients

Raw Volume

Cooked Volume

Staple

   

Rice

100 ml (1/2 tea cup)

200 ml (1 tea cup)

Maize

100 ml (1/2 tea cup)

300 ml (1 1/2 tea cup)

Protein Supplement

   

Legume

30 ml (2 tablespoons)

60 ml (5-6 table spoons, 1/4 cup)

Milk

180-200 ml (1 tea cup)

same

(whole, liquid)

   

Vegetable Supplement

   

Leafy green

-

20 ml (1-2 table green spoons)

Squash/Carrot

-

 

Energy Supplement

   

Oil, Fat

5-10 ml

same

 

(1-2 teaspoons)

 

Sugar

10-20 ml

 
 

(1 tablespoon)

 

 

A table of this type should be developed locally to be included on page 3 of the Handout - "Making Improved Weaning Foods Using the Weaning Food Square. "

TRAINER'S REFERENCE

Table 22. Calculated amounts of ingredients for Basic Mixes - using edible portions of raw foods

Staples (g)

Supplement (g)

Oats

Wheat

Rice

Sorghum, millet

Maize

Potato

Sweet Potato

Yam

Taro, Cocoyam

Banana

Plantain

Cassava,
Flour, gari

                         
 

75

80

65

75

55

320

125

165

150

105

85

40

Legume (g)

5

10

25

10

35

20

50

40

45

55

55

55

 

60

60

55

55

50

250

150

175

150

140

115

50

Soybeans (g)

10

15

20

15

25

20

25

20

20

25

30

30

 

65

65

65

60

60

280

175

190

180

165

150

60

Dried skimmed milk (g)

5

10

15

15

15

15

20

15

15

20

20

20

 

55

55

45

45

40

220

100

115

115

100

90

35

Dried whole milk (g)

10

15

25

20

25

20

30

30

25

30

30

30

 

65

65

65

65

65

300

180

210

195

185

160

70

Chick or lean meat (g)

10

20

25

25

35

25

35

35

30

40

45

45

 

65

70

70

70

70

310

210

240

220

210

180

75

Fresh fish (g)

15

30

30

25

20

25

35

35

40

40

45

50

 

65

65

65

60

65

300

180

220

190

190

150

60

Egg (g)

10

25

30

30

25

25

35

25

25

30

45

50

1. The basic mixes have been calculated to give the best possible protein value (i.e. amino-acid score). The least amount of protein food is used to supplement the staple to provide the basis of a meal for a child of about two years of age.

2 To each of these basic mixes 10 g of oil OR 5 g of oil and 10 g of sugar OR 20 g of sugar should be added.

3. Each mix then provides about 350 kcal (approximately one-third of the daily needs of a two-year-old child).

4. Each mix has the same protein value and provides the approximate equivalent of 5-6 g of reference protein.

5. The weights given for the staple and the supplement are for raw foods. See Chapter 15 for variations for the supplements.

6. The volumes of most of the basic mixes are between 200-300 ml when the water absorbed by the food is taken into account.

Cameron, M; and Hofvander, Y. Manual on Feeding Infants and Young Children, Oxford Press, 1983, p. 119.

HANDOUT

MAKING IMPROVED WEANING FOODS USING THE WEANING FOOD SQUARE

Breast milk

A

B

Energy Foods

Body-Building Foods

Cereal grains

Legumes

Tubers

Animal foods

Roots

 

C

D

Protective Foods

High-Energy

(Vitamins and Minerals)

Supplements

   

Vegetables

Fats

Fruits

Oils

 

Sugar

Breast milk is in the middle of the Food Square because it is a complete food until a child reaches 4-6 months of age.

By the time a growing child is six months old, he needs breast milk plus foods from each of the other parts of the Food Square every day.

Recipes for improved weaning foods can be made by combining at least one food from each part of the Food Square. Recipes should include:

An Energy Food: This is usually a cereal grain like rice, corn, wheat, sorghum, millet or oats. It can also be potato, cassava, yam, banana or plantains, and other starchy roots.

A Body-Building Food: All legumes and animal products such as meat, milk, fish, eggs, chicken, etc., are included in this box. Choose a low-cost food that can be found in most homes. This will usually include legumes, eggs and fish.

A Protective Food: These include all leafy green vegetables and fruits.

A High-Energy Supplement: All oil, fats, natural and processed sugars including honey.

Breast milk

A

B

Energy Foods

Body-Building Foods

C

D

Protective Foods

High-Energy

(Vitamins and Minerals)

Supplements

To make your own recipes for improved weaning foods, follow these steps:

Step 1. Classifying Local Foods: In each of the parts of the Weaning Food Square above, write the appropriate foods available in the homes of most families you work with. Use the description on the first page of this worksheet to decide in which part (A, B. C, D) the foods belong.

Step 2. Choosing Ingredients: Choose at least one food from each of the parts of the square. Practice making different combinations from the available foods by completing the exercise below:

Recipe 1

Recipe 2

A.

A.

B.

B.

C.

C.

D.

D.

Note: Unless animal foods are produced by the families or available at very low cost, they should be not included in your recipes. Always choose foods that most families grow or produce or those that you will help them produce as part of your project.

Step 3. Preparing Ingredients: On the worksheet that follows, describe how you will prepare the foods for each recipe. First, write the ingredients for your recipes in the spaces provided, then describe how they will be prepared and how much time it will take. (Page 5)

Preparation should be simple, involving as few steps as possible. It should not take too much time. Preparation of foods for children from six months to one year requires mashing and straining. For children 1-3 years, it may include chopping or mashing. Foods may be cooked together or cooked separately and then combined in the meal. The simplest and most successful recipes are usually those that use foods from the family meal, which are separated once cooked, and are prepared according to the ages of the children.

Step 4. Calculating Amounts of Ingredients: The amount of each food in a recipe depends on the number of children to be served, the ages of the children and whether you are using foods that are raw or cooked.

Use the following chart when figuring how much of each food to use in your recipe. These amounts are based on the needs of one child age 1-2 years, for one meal. For younger children use less of each ingredient, but make sure they are in the same proportions. For older children, add a little more of each.

Standard Portion Sizes for Weaning Food Ingredients*

* To be developed by local nutritionist prior to training.

 

Raw Volume

Cooked Volume

Staples

   

Protein Supplements

   

Vitamin/Mineral Supplements

   

Energy Supplements

   

Step 5. Meals for More Than One Child: Calculate how much of each ingredient will be required to prepare the recipe for several Children. Do this by writing the amount of cooked or raw ingredient you will use for one child, on the worksheet. Write this amount in local measurements, i.e., 1 handful, 1 1/2 tea cups, 1 eating spoon, etc. Multiply by the number of children the recipe will serve to find the total amount of each ingredient needed.

You have now developed several recipes for improved weaning foods using the foods available in most of the homes in your area. Once you learn the approximate amounts and types of foods to use, you will be able to develop improved weaning foods without the help of this guide.

REMEMBER:

Improved weaning foods include at least one food from each of the sections of the Weaning Food Square.

Successful recipes for improved weaning foods are simple and require little extra time.

Ingredients for improved weaning foods must be those available in every home.

WORKSHEET:

Recipe 1

Ingredients

Amount for
One Child

X

Number of Children

X

Amount Needed

A.

 

X

 

X

 

B.

 

X

 

X

 

C.

 

X

 

X

 

D.

 

X

 

X

 

 

Describe the preparation and cooking time and other ingredients.

 

 

Recipe 2

Ingredients

Amount for
One Child

X

Number of Children

X

Amount Needed

A.

 

X

 

X

 

B.

 

X

 

X

 

C.

 

X

 

X

 

D.

 

X

 

X

 

Describe the preparation and cooking time and other ingredients.

 

 

 

PREDICTING THE ACCEPTANCE OF A NEW WEANING FOOD

First, calculate the cost for four or five servings of the new weaning food $ __________.

Then answer the following questions for each new recipe:

 

Yes

No

- Is the cost of the weaning food reasonable when compared to the resources of poor families?

   

- Are all of the ingredients required available in most homes?

   

- Are the ingredients that are not available in most homes available at low cost in the community market?

   

- Is total preparation time 10 minutes or less? (If the weaning food is cooked with the family's food, mark yes.)

   

- Is the weaning food prepared the way that most foods are prepared or together with the family's food?

   

- Are all of the ingredients believed to be good for children?

   

- Does the weaning food taste and look like the food eaten in the community?

   

Give each recipe a score:

Each "No" receives 0 points. Each "Yes" receives 1 point. Now, add the total score.

TOTAL: __________.

A perfect score of 7 means that we can predict good acceptance of the new weaning food. Lower scores may mean that a recipe will need extra promotion to gain acceptance in the community.

A score of 5 or less, may mean that a recipe is not likely to gain the acceptance of the community.

If the cost of the new weaning food is too high, it will not be accepted by the community.

HANDOUT

WHY ADD HIGH-ENERGY SUPPLEMENTS TO WEANING FOODS?

A small child can only eat a small amount at one time: about one and a half cups of food by one year of age. In order to get maximal energy, a child must eat several small meals during the day, and those meals must include as much energy as possible.

Oils, fats and sugars contain large amounts of energy. For example, 1 tablespoon of oil contains the same amount of energy as 3 1/2 tablespoons of uncooked maize flour, or more than 7 tablespoons of cooked maize flour.

By adding a little oil, fat or sugar to a child's food we can increase the amount of energy without increasing the amount of food.

Adding oil also reduces the amount of food to be eaten because less water can be added to porridges and gruels when they are cooked. A little oil keeps porridge smooth, with less water.

The following examples show how energy supplements improve the nutrition quality of weaning foods.

EXAMPLE 1

1/2 cup maize flour (uncooked) + water = 235 energy units

1/2 cup maize flour (uncooked) + 1 teaspoon oil + water = 315 energy units

EXAMPLE 2

To get as much energy as he needs from one meal during the day, a child of one year must eat:

- more than 2 cups of porridge if it is made with only maize flour and water


More than 2 cups

- 1 1/2 cups of porridge if it is made with maize flour and a high-energy supplement


1 ½ cups

QUESTION: What will happen to a child who is fed porridge without a high-energy supplement?

ANSWER: Because the child can only eat about 1 - 1 ½ cups of porridge at one meal, if he is fed porridge without a high-energy supplement he will not get the energy he needs from three meals a day. He will become malnourished.

SOLUTION:

- Encourage the addition of high-energy supplements to all weaning foods.

- Encourage four to five small meals for children during the weaning period. Feed small children frequently with high energy weaning foods.

Note: A little bit of oil or sugar is enough! Be careful not to add too much. Mothers will tell you that too much oil can cause diarrhea in young children.

Session 3: Weaning food practice

Purpose:

Trainees prepare and demonstrate the preparation of improved weaning foods appropriate for introduction to the community .

Time: 2-3 hours

Materials:

- Handout - "Conducting a Community Weaning Food Demonstration"

- One set of cooking utensils and equipment for each work group including cups, bowls, spoons of various sizes, cooking stoves, grinders, sieve, etc. All utensils and equipment should be similar to those used in most homes in the community

- Foods to be used in the preparation of weaning mixtures

- Space for work groups to cook and demonstrate their recipes

- Water

- Flipchart and marking pens

Steps:

1. Arrange the training area and equipment so that each work group has a space for cooking.

2. Review the characteristics and steps of an effective cooking demonstration. Include the points on Handout - "Conducting a Community Weaning Food Demonstration. "

3. Allow work groups to prepare their ingredients.

4. Each group should demonstrate preparation of at least one weaning food recipe. If time is limited, work groups can be paired. In this case, one group presents its demonstration for the other's comments and vice versa.

5. Encourage trainees to learn from the reactions of families in their communities to the new weaning recipes. Women often make modifications in new recipes to reduce preparation and cooking time. They may also vary ingredients to improve taste and color according to local preference. Incorporating the changes made by women in the community will often make the new weaning recipes more appropriate and acceptable .

HANDOUT

CONDUCTING A COMMUNITY WEANING FOOD DEMONSTRATION

1. Choose a recipe that calls for no more than 3 or 4 foods that can be found in most homes at the time of the demonstration.

2. Use utensils and cooking stoves that are like those in most homes.

3. Begin the demonstration by explaining why it is important to prepare improved foods for weaning-age children. Review the types of foods young children need, when soft foods should be added to the diet and the importance of frequent feeding for young children.

4. Show the ingredients you will use. You may also make a poster or handouts with the ingredients and instructions printed on them.

5. Wash your hands and the cooking utensils to demonstrate good hygiene.

6. Prepare only enough food for two or three children so that the amounts and proportions of ingredients are clearly understood. (If you wish to have many people try the new food, prepare a larger quantity before the demonstration.)

7. Show each step in the preparation; speak loudly and talk about what you are doing - always face your audience!

8. Get the audience involved - they can help prepare ingredients and, of course, they will want to sample the finished food!

9. Ask the group what they liked or disliked about the new food. Will they try it? Why? Why not?

10. Ask those who say they will try the new food to let you know if their children like it. How can they change it to make it better?

Session 4: Case study: Village weaning food projects in Thailand

Purpose:

Trainees will review a description of Thailand's village weaning food and nutrition education projects. They will also discuss whether this type of community self-help activity would be appropriate in their regions.

Time: 1 1/2 hours

Materials:

- Flipchart and marking pens

- Handout - "Case Study: Village Weaning Food Projects in Thailand"

Steps:

1. Introduce the session by explaining that villagers can improve weaning practices and child nutrition if they work together. During this session, participants will read a case study about community weaning food projects in Thailand.

2. Distribute the case study, and ask participants to read it silently.

3. Write the discussion questions on the flipchart, and work with participants to answer each of the questions.

OR

Divide into small groups, asking the groups to write and present their answers to the discussion questions.

4. Summarize the session by pointing out that projects of this type require:

- commitment by the village;

- training for villagers in techniques of food production; nutrition education and financial management;

- careful selection of grinders and other utensils;

- quality control and adequate hygiene to make sure that weaning foods are not contaminated;

- on-going technical advice and assistance.

HANDOUT

CASE STUDY: VILLAGE WEANING FOOD PROJECT IN THAILAND

Introduction

Preparation of special foods for children during the weaning period (six months - two years) takes extra time and effort. In many countries, women are responsible for working in the fields, fetching water, collecting firewood, preparing food for the family and caring for small children. They often do not have time to make special meals for their young children.

In this case study, we will learn about several different programs in Thailand that are addressing the problem of malnutrition in weaning-age children. There are over 100 villages in different parts of Thailand with the type of self-help project described below.

Case Study

Thailand is a rural country of over 47 million people. Agriculture is the main source of income in rural villages, and rice is the main crop and the staple of the Thai diet. It is estimated that over two-thirds of Thailand's infants and pre-school children are affected by malnutrition.

Several years ago, a number of organizations in Thailand began working with rural villages to improve the nutrition and health of their children. Most of the villages involved were first visited by motivation teams responsible for promoting cooperative village action. These teams emphasized self-reliance and used games and discussions to learn more about village problems and "felt needs. " They also presented information to the villages about appropriate health and nutrition technologies and low cost food production.

As a result of the work of the motivators, many of the villages formed cooperatives or committees responsible for village health and nutrition activities. In most cases, cooperatives collect a small contribution from each cooperative member to start a revolving community health fund for village projects.

Cooperatives select nutrition and health volunteers who receive training from a district health team. Village volunteers then become responsible for monthly weighing of all children under three years old in the village and for nutrition education with mothers and school children. Growth cards are given to all mothers for children under three years old in most of these villages.

Village nutrition cooperatives are also introducing improved weaning foods as well as foods for the treatment of malnourished children. Different mixtures of rice, legumes and seeds or nuts are produced, packaged and distributed by the village cooperatives using local ingredients and appropriate village technology.

Members of the nutrition cooperatives generally take turns preparing the improved weaning foods. The ingredients are first cleaned; then legumes, seeds and nuts are roasted until they are fully cooked. Rice is heated for only a few minutes to kill harmful bacteria. After roasting, the weaning mixtures for young children are ground to a fine flour. For older children, mixtures are ground to a coarse flour, or they are left in their original form. Because the ingredients are roasted, the amount of time required for cooking the weaning mixtures is reduced.

Village nutrition cooperatives use utensils commonly found in the village as well as appropriate, low-cost grinders and roasters to make the improved weaning foods. Several different types of grinder are being used depending on the resources of the program and the availability of electricity. These include the common village grinding stone, the hand grinder and a low-cost electric grinder.

Families with malnourished children are assisted by the village nutrition cooperatives and their weaning food projects. If a child is suffering from severe malnutrition, weaning mixtures are given to the family at no cost. In cases of mild and moderate malnutrition, a reduced price may be charged, or raw foods may be traded for the packaged weaning foods.

The sale of weaning foods to families in their own and other nearby villages is another goal. The prices charged to the families of healthy children vary from village to village. Unfortunately, few villages keep detailed records of their expenses and sales, so it is difficult to know if cooperatives are making a profit from this activity. Income from the sale of weaning foods is reinvested in producing more of the same. Excess profit can be used by the cooperatives for projects they decide to carry out to improve the health of their villages.

Because these village projects are relatively new, it is too early to evaluate their impact. We know that villages have responded enthusiastically to the program and, in several of the first villages to establish health/nutrition cooperatives, there are reports that severe malnutrition has been eliminated.

Questions for Discussion

1. What is the problem the rural villages in Thailand are working together to solve?

2. What have the villagers done to solve this problem? List their activities.

3. What resources did the villagers need to carry out their activities? (Remember resources are people, materials, equipment, interest, money, etc.)

4. Would this type of project be feasible in the communities you work with now? Why or why not?

Session 5: Weaning foods - Village production techniques

When weaning foods like those described in the Thailand case study are available, women need much less time to prepare frequent, high-quality meals for their weaning-age children. Packaged weaning foods can be distributed or sold at a reduced price for the rehabilitation of malnourished children. They can also be sold by community groups and individuals as an income generating activity.

Purpose:

Trainees are introduced to the technologies and locally developed recipes for village production of weaning foods. They practice making several weaning mixtures, then analyze the production process in terms of village resources and feasibility.

Time: 2 hours

Materials:

- Village-appropriate grinders. Two types of grinders are often required: a corn grinder for coarse grind and a coffee grinder for fine flour grinds.

- Village cooking utensils, including roasting pans, spoons for stirring and measuring, cups, sieve, winnow, charcoal cooker, etc.

- Handout - "How to Make Flour from Cereals, Tubers and Legumes"

- Handout - "Recipes for Village-Processed Weaning Foods"

- Handout - "Planning a Village Weaning Food Project"

- Small plastic bags and a candle for sealing

Prior to the Session:

Investigate the techniques and ingredients that have been or could be used to make mixed cereal and legume flours in your country. A description of the process and recipes developed in Indonesia are included for your information.

Steps:

1. Introduction - Tell trainees that they will practice using equipment and recipes for making packaged weaning foods. The techniques they will use in this session might be used in a village for production of weaning foods for sale or distribution.

2. Describe the Production Process

a. List the possible ingredients for cereal and legume mixtures that are grown in the trainees' regions.

b. Distribute and review the Handout - "How to Make Flour from Cereals, Tubers and Legumes."

c. Demonstrate the use of roasters and grinders.

3. Practice

a. Divide trainees into work groups. Assign each work group the preparation of one of the ingredients. Prepare sufficient quantities of each flour so that they can be used in several different combinations. Also prepare different consistencies of each ingredient: coarse grind for older children, fine flours for infants, etc.

b. Distribute the Handout - "Recipes for Village Processed Weaning Foods."

Assign each work group the preparation of one of the recipes. Groups should prepare one portion for sampling and one portion for packaging.

4. Discussion: Discuss the time and labor required to produce the weaning mixtures. Compare the tastes, consistencies, etc. Ask trainees what changes could be made in the process, ingredients, etc. to improve the production and the results. Ask them if, after trying the production of mixed weaning foods themselves, they would recommend this type of village weaning food in their areas.

5. Distribute the Handout - "Planning a Village Weaning Food Project. Review the questions on the handout with participants. Ask them individually or in their work groups to answer each of the questions. Review the results of this exercise in a group discussion.

6. Summary

The process used for weaning food production in this session can be modified to fit local needs and resources.

Projects started in several countries are experimenting with alternative ways of obtaining and processing the necessary raw ingredients for weaning mixtures.

For example:

- Raw ingredients are contributed by families (Indonesia)

- Families bring one or more of the roasted ingredients for grinding. (Nepal)

- Ingredients may be roasted and packaged for grinding later at home by the family. (Thailand)

In these cases, the community project is providing partial production and ingredients; the families are providing the remaining labor and raw ingredients for the weaning mixtures.

The type of project discussed in Sessions 4 and 5 makes a high-quality weaning mixture available to the community. The weaning mixture can be used for treating malnourished children, for making quick meals for weaning age children, and as an ingredient in snacks and meals for older children and adults.

If properly managed, this type of project can be self-sustaining. It may also provide added income for community self-help activities.

Before undertaking a village weaning food project, interested managers and groups should seek advice from local experts.

HANDOUT

HOW TO MAKE FLOUR FROM CEREALS, TUBERS AND LEGUMES

Green Gram
(Mung Beans)



Clean


Wash


Dry Roast slowly until cooked


Grind while hot
(coffee grinder)


Sieve


Fine flour

Beans
(Red, White)



Clean


Wash


Dry Roast slowly
until cooked


Grind coarse
(corn grinder)


Winnow


Grind fine
(coffee grinder)


Sieve


Fine flour

Maize
(dried, whole kernel)



Clean


Grind coarse
(corn grinder)


Winnow


Grind fine


Sieve


Grind


Sieve


Fine and
coarse flour

Sorghum



Clean


Dehusk


Winnow


Grind fine


Sieve


Fine flour

Cassava
(whole)



Peel


wash


Soak in lime water for about 5 minutes (2 grs. Lime to 1 liter water)


Dry with a clean cloth


Grate with metal grater


Dry about 5 hours in the sun or on a solar dryer


Grind

Sieve


Fine flour

HANDOUT

PLANNING A VILLAGE WEANING FOOD PROJECT

Production of weaning foods for distribution and sale requires special equipment and knowledge of production techniques. The people who will make the weaning mixtures must be trained and supervised. Distribution and sale of the mixtures require careful recordkeeping and financial skills.

Individuals and village groups who are interested in starting weaning food production should consider the following before they begin:

GOALS

- What are our goals for this activity?

PRODUCTION

- What ingredients will we use?
- What equipment will we use? Types of grinders, roasters, etc.?
- Where will we produce the weaning foods?
- Who will produce them?
- How will the weaning foods be packaged?

RESOURCES

- How will we obtain the raw ingredients?
- How will we obtain the equipment and the space we need?
- Who will train group members, workers, etc., to make and control the distribution of the weaning foods?

DISTRIBUTION/SALES

- Will the weaning foods be sold?
- Will the weaning foods be given free? Under what circumstances?
- What records and reports will we need to control inventory and sales?

COMMUNITY

- How will we introduce the weaning foods to community members?
- How much would most community members be able or willing to pay for the weaning foods?

HANDOUT

RECIPES FOR VILLAGE-PROCESSED WEANING FOODS

Indonesia

 

Raw Weight

Local Measure

   

Package

Maize flour (fine)

50 grs.

1/2 plastic cup (100 ml.)

Green gram flour (fine)

25 grs.

2 1/2 tablespoons

Sugar

15 grs.

1 tablespoon (15 ml.)

Salt

1 pinch

 

Coconut oil or
Groundnut paste

5 grs.
15 grs.

1 teaspoon
1 tablespoon

Water

400 ml.

2 plastic cups (400 ml.)

Cook for about 10 minutes. Makes 1-2 servings. Add 50 grs. (2 handfuls) of finely chopped green leafy vegetables about 5 minutes before porridge is ready.

Indonesia

 

Raw Weight

Local Measure

   

Package

Maize flour (fine)

50 grs.

1/2 plastic cup (100 ml.)

Green gram flour (fine)

25 grs.

2 1/2 tablespoons

Sugar

10 grs.

1 tablespoon (15 ml.)

Salt

1 pinch

 

Coconut oil

5 grs.

1 teaspoon

Water

400 ml.

2 plastic cups (400 ml.)

Cook 10 minutes. Makes 1-2 servings. Add 50 grs. finely chopped green leafy vegetables.

Nepal

"Sarbottam Pitho" (Super-flour)

Cereal grain

2 kilos

(1 kilo of 2 of the following: maize, rice, sorghum, millet)

Legume

1 kilo

(soybeans, green gram, beans)

Roast legume and cereal grains together. Grind to fine flour. Makes 3 kilos or 40-50 servings. Cook in boiling water. Add salt, sugar, oil to taste.

Thailand

"Kow Tip"

Rice

3 kilos

Mung Bean

1 kilo

Groundnut

1 kilo

Sugar

(optional)

Roast mung beans and groundnuts for 5-10 minutes. Roast rice for 3-5 minutes. Combine and grind. Makes 50 packages of 100 grams each. Can be cooked as porridge or in cakes for snacks.

REFERENCES

Cameron, M. and Hofvander, Y. Manual on Feeding Infants and Young Children. Oxford University Press, 1983.

Gibbons, G. and Griffiths, M. Program Activities for Improving Weaning Practices. World Federation of Public Health Associations, Geneva, 1984.

Nabarro, D., Gordon, G., Verney, J. and Wijga, A. "Finding Out How Children Are Weaned. " Save the Children Fund (U.K.), 1984.

Valyasevi A. "Home and Village Prepared Weaning Foods Project." Paper prepared for the Workshop of Weaning Foods Projects. MIT, Cambridge, Massachusetts, 1982.