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Puppets that Teach Good Eating Habits

By and - Dec 17 2014

Michiko Blog_Pic 1In El Alto, Bolivia’s District 8, a forthcoming IDB study reveals that 21% of children between the ages of 0 and 5 suffer from chronic malnutrition. This is not the case for Edysson and Joycy, two youngsters who are enjoying a happy and healthy childhood in the same predominantly Aymara neighborhood, a socioeconomically disadvantaged area 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). Lucy is responsible for teaching parents how to ensure proper growth and monitor chronic malnutrition risk factors in area households like Edysson and Joycy’s, which feature children under age two or 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, Lucy interacts with family members after the puppet show to see how much of the message they picked up, discuss potential obstacles to daily application of the concepts, and 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.

Michiko Blog_Pic 2

Link: https://www.youtube.com/watch?v=vQMfshvvKfM (video in Spanish)

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 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 grow as they should. This will result in greater cognitive development, an increased ability to learn in school, and a brighter future for these children and their communities at large.


Michiko Tamashiro is a consultant for the Japanese Trust Funds at IDB’s Grants and Co-Financing Management Unit.

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.

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