Farai Shawn Matiashe (Lead Writer)
Barbara Chabanda, 34, still recalls when her baby fell sick during last year’s El Niño-induced drought in Buhera, 222 kilometres from Harare, the capital city of Zimbabwe. Her baby, who was 12 months at the time, had significant weight loss, fatigue and reduced appetite. She had no idea what it was at first, “I thought it was malaria,” the mother of seven said. “I was so confused and stressed. I was wondering what could be wrong with my baby.”
Image credit: Farai Shawn Matiashe
It was during one of the home visits of a Village Health Worker (VHW) responsible for her village that Chabanda’s baby’s ailment was identified. The VHW used a Mid-Upper Arm Circumference (MUAC) tape on the baby’s hand, which quickly showed red, indicating severe acute malnutrition (SAM). MUAC is a measurement tool used for diagnosing acutely malnourished individuals. It is an easy and quick way to identify SAM and moderate acute malnutrition (MAM) in children.
The VHW quickly referred Chabanda’s baby to a local clinic for treatment. Chabanda stated that the baby was given Plumpy’Nut, a peanut-based, Ready-to-Use Therapeutic Food (RUTF) effective in treating children with SAM.
Beyond the treatment, Chabanda was also given a MUAC tape to monitor the baby until he recovers. “It took about two months for my baby to recover. I used a MUAC tape several times. Other mothers also came to my house to use the tape to check their babies for malnutrition,” Chabanda said.
Image credit: Farai Shawn Matiashe
Family-driven MUAC measuring is part of the interventions implemented by World Vision, an international humanitarian organisation and Zimbabwe’s Ministry of Health, with funding from the United Nations Children’s Fund (UNICEF) during the drought in 2024, which left 580,000 children living in severe food poverty.
As part of the nutrition surveillance, World Vision Zimbabwe had two major lines of screening, the first done by VHWs every month and a family-driven MUAC approach.
According to Takudzwanashe Chiketa, a project coordinator at World Vision Zimbabwe, “under the family-led MUAC, caregivers of under-five [children] would come and attend [trainings] where VHWs explain and demonstrate how the MUAC works,” he said.
Kudakwashe Zombe, the national coordinator of Zimbabwe Civil Society Organisations Scaling Up Nutrition Alliance (ZCSOSUNA), said early detection is critical to prevent health deterioration and authorities have introduced a family-driven MUAC screening approach to achieve this.
“This innovative method empowers family members, particularly mothers and guardians, to use a colour-coded tape to identify early signs of malnutrition in children. When signs are detected, families, supported by VHWs, refer cases to nearby health facilities for timely management and treatment.”
Zimbabwe’s El Niño induced drought
The drought caused by El Niño, left more than half of Zimbabwe’s 15.1 million population facing acute hunger. The unprecedented drought led to crop failure in 60% of the country. In April 2024, authorities declared a drought as national disaster to mobilise resources from the government, international humanitarian agencies and the private sector to support millions facing hunger.
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In semi-arid Buhera, where Chabanda lives, maize, the staple food, did not grow as expected. Despite sowing drought-resistant crops like millet and sorghum, her crops withered because of the punishing weather.
Children bore the brunt. According to UNICEF, about 1.7 million children required food assistance. Delilah Takawira, a technical advisor for FHI 360 in Zimbabwe and a nutritionist, explained that there is a clear link between drought and malnutrition, food insecurity in children, “children [become] food poor if they do not consume the required type and quantity of foods.”
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In April 2024, which was the harvesting period for many farmers in the country, Chabanda was already struggling to feed her family. They had to cope with one meal a day to avoid sleeping with an empty stomach. “We [were] seeing a significant decline in household cereal, maize, reserves and dependence on markets for household food needs,” Takawira noted.
The emergency response project to El Nino-induced drought, which started in February 2024 to February 2025, aimed at improving nutrition surveillance to ensure that they detected cases of malnutrition early.
Chiketa said the target was to screen children at least once in the five districts where they were operating in the southern part of the country which had higher cases of malnutrition because of the drought. “Our reach on average was 45,000 to 50,000 children who were being screened per month in the five districts,” he explained.
The family-driven MUAC approach
Takawira of FHI 360 explained that to respond to community demands, there is a need to have a two-pronged approach for treatment and prevention of childhood malnutrition. “Critical treatment efforts include active finding and treatment of severe and moderate wasting and training of mothers and fathers on MUAC for scaling up community-based management of acute malnutrition in areas most affected by the drought,” she said.
Due to the lack of access to health facilities and many families having to travel up to 15 kilometres to get to the nearest clinic, caregivers are usually discouraged from seeking healthcare. Hence, the decision to give caregivers MUAC, allowing them to monitor their children’s growth in their homes and go to the clinic when the MUAC reads yellow or red.
Zombe of ZCSOSUNA noted that this approach enables early detection, improves health outcomes, and enhances child nutrition during emergencies, “given the healthcare system’s heavy workload burden [at the time of disasters].”
Not enough
During the project year, the initiative only focused on identifying malnourished children and referring them to the clinic for treatment, leaving out an essential need for families to be assisted with food or cash-based transfers to address the root causes of malnutrition.
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This left some of the children treated who had recovered at high risk of becoming malnourished again during drought.
According to Chiketa of World Vision Zimbabwe, the organisation intentionally avoided providing food rations as part of their initiative to prevent caregivers from becoming reliant on these provisions. He explained that while food rations may initially encourage participation in screening activities, once the project is concluded and the food supply runs out, caregivers might discontinue screenings.
However, World Vision Zimbabwe encouraged mothers within those care groups to venture into poultry projects and savings clubs to sustain themselves and their families with support from other partners.