by Julia Johannsen and Michiko Tamashiro

desnutricion cronica

In District 8 of El Alto, Bolivia, 21% of children between the ages of 0 and 5 suffer from chronic malnutrition, according to an IDB study to be published in 2015. This is not the case for Edysson and Joycy, who are enjoying a happy and healthy childhood in the same predominantly Aymara, socioeconomically disadvantaged neighborhood with little in the way of access to basic services.

What’s making a difference?

Every two weeks, they get a visit from Lucy, a facilitator from the Andean Rural Health Council (CSRA), who’s responsible for teaching the children’s parents how they can ensure Edysson and Joycy’s proper growth and for monitoring chronic malnutrition risk factors in area households like this one with children under age 2 or with pregnant women. The sessions are designed by a team of experts in child nutrition at the CSRA and the Inter-American Development Bank (IDB), with the intention of changing families’ hygiene and eating habits at home.

How does Lucy teach families?

With the help of a small portable stage, Lucy puts on a puppet show with culturally adapted characters, such as a girl with braids and a multicolored skirt and an Andean junk food monster. Through bilingual dialogue in Spanish and Aymara [link in Spanish], the puppets communicate nutrition and hygiene concepts in a fun way for the family and, particularly, caregivers.

As shown in the video below, after the puppet show, Lucy interacts with family members to see how much of the message they picked up, to discuss what could interfere with daily application of the concepts, and to answer questions. These home visits include counseling and support for parents and caregivers. In addition, the project partners with health facilities, which provide technical assistance with body measurements and the correct application of care protocols.

But just how effective are puppets when used for this purpose?  Several studies maintain that behavior change requires not only transmission of knowledge but also practical experience and an emotional bond with the topics learned. A puppet show, play, song or entertaining story can bring about positive emotions, and with them come the desired changes in daily eating habits and hygiene.

With funding from the IDB’s Japan Special Fund Poverty Reduction Program (JPO) and operational work by the non-governmental organization CSRA, this innovative intervention has been implemented in line with the Bolivian government health policy known as the Community and Intercultural Family Health (SAFCI) model. This includes the Integrated Management of Childhood Illnesses (IMCI) strategy with a specific nutritional component.

In a cross-cutting manner, the SAFCI policy also considers the cultural adaptation of services provided in communities. The intervention in El Alto is carried out in coordination with the central and local governments, and it’s focused on preventing chronic malnutrition and promoting proper growth in children.

Thanks to this initiative, children like Edysson and Joycy are better nourished, and they grow as they should. This will result in greater cognitive development and an increased ability to learn in school. Are there similar initiatives in your community that use innovative teaching methods? Share them in the comments section or through Twitter.

Julia Johannsen is a Social Protection Senior Specialist at the IDB’s office in Bolivia since 2010. Her work focuses on the design and supervision of conditional cash transfer programs, early childhood, and poverty measurement and targeting of social programs.

Michiko Tamashiro is a consultant for the Japanese Trust Funds at the Inter-American Development Bank.

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Showing 2 comments
  • U. Burrell

    Children learn through PLAY. The most effective method, of teaching concepts to young children is to involve them in interactive play activities that are enjoyable, funny and humourous. Various skills can be taught with the use of puppets. Thus when children are learning about good eating habits, incidental learning are taking place – social skills are being developed, emotional skills and confidence building skills as well. For the very young child fine and large motor skills are being used when they ‘take turn’ to manipulate the puppets.
    When parents/family members are involved, children enjoy playing with their parents as greater bonding occurs. Parents also get the opportunity to spend quality time with them.
    Having learnt the concepts through the play activities they (parents), will be in a better position to reinforce the concepts.

    • Julia

      Dear U. Burrell,
      I very much agree! In this case, the innovative aspect is indeed that the pedagogic methods that use a ludic, playful approach are directed primarily towards the parents and caretakers of the children, in order to enhance their parenting skills and support a favorable family environment for early childhood development. Not only children but also adults learn and change behavior more often and in a more sustainable way when they are emotionally engaged in a positive, playful way. Thanks a lot for your insightful comment.

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