How Muthurwa’s young mothers are fighting child malnutrition with simple home-cooked meals

At just 11 months old, Mercy Awino’s* baby weighs only 6.2 kilograms—the size of a healthy three-month-old. Her frail arms and legs silently reflect the malnourishment Awino never imagined she would face.

Awino, 22, is a first-time mother living in a single-room house in Muthurwa with her mother and sister. With no crib or pantry, they survive on whatever food they can find. She thought she was doing her best—until health workers told her otherwise.

Most of the family’s income goes to rent and basic needs, leaving little for balanced meals. Nutritious food is a luxury. Survival comes first.

"Mostly, I feed her soup from whatever we've cooked. Sometimes with ugali or rice, depending on what's there. I thought it was enough."

She didn’t realise her baby was malnourished. She assumed the child was just small and believed that if she wasn’t crying, she was fine. That changed when community health workers visited, weighed the baby, and expressed concern.

Uncertain daily wages

Awino survives on uncertain daily wages—sometimes 300 shillings, other times as little as 150. It’s barely enough for food, let alone baby formula, fruits, or fortified porridge.

No one taught her about weaning or the right foods to introduce. Like many young mothers in informal settlements, she has been navigating motherhood alone, guided only by love and guesswork.

Reports show that many families in vulnerable communities struggle to maintain a balanced diet. A nutritionist-led survey in Muthurwa confirmed a sharp rise in the “triple burden” of malnutrition.

Rehabilitation programme

This led community health workers, with support from the county government and partners, to launch a food-based rehabilitation programme known as PD Hearth (Positive Deviance Hearth).

The approach helps families rehabilitate and prevent child malnutrition using affordable, locally available foods. Mothers are taught to prepare nutritious meals based on the principles of "Go, Grow, and Glow."

Elizabeth Osome, a Community Health Promoter (CHP) at the Muthurwa health unit, explains: "We target children between 6 months and 5 years old. We noticed a pattern—many children were visiting the health facility, but their feeding practices were not adequate. So, as CHPs, we decided to bring the solution closer to the community by preparing nutritious meals ourselves."

Cooking balanced meals

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After training from county nutritionists, the team began cooking balanced meals with simple, affordable ingredients. They were also given a menu and taught to measure portions using everyday items like cups and spoons. This knowledge is now passed on to mothers.

"We prepare a variety of foods like groundnuts, terere (amaranth), and cooking oil—all in one pot," she says.

The programme avoids costly foods like red and white meat, instead focusing on staples like kamande (lentils) and vegetables that are readily available in local markets.

When a child is enrolled, health workers measure weight and use MUAC (mid-upper arm circumference) to assess nutritional status.

"We cook and serve these meals for 12 days, monitoring the children's progress. The goal is to see improvement in both weight and MUAC measurements. Once a child shows progress, we make room to enrol more children," Elizabeth explains.

Beyond short-term feeding

She stresses that the programme goes beyond short-term feeding. It empowers mothers with skills to sustain healthy practices at home.

"We won't stop this programme, because our community is vulnerable. Our aim is to teach mothers how to sustain it at home—so they can keep their children healthy even after the 12-day programme ends."

The programme brings together about ten CHPs, each playing a role—some teach nutrition, others follow up with families or call to check on progress. Many even contribute money from their own pockets when caregivers cannot afford to.

Mary Gitonga, another CHP, says their key role is ensuring the community stays healthy by teaching mothers proper feeding practices.

"Nutrition is key, and we focus on three important types of foods—Go, Grow, and Glow."

She explains: "Go foods give energy and include staples like rice and maize, which keep children active and strong. Grow foods are rich in proteins that support growth; these include beans, ndegu, kamande, soybeans, millet, and groundnuts, which help build bones and add weight. Then there are Glow foods—fruits and vegetables packed with vitamins that make the skin healthy and give children a natural shine."

Healthy snacks

Healthy snacks such as oranges are encouraged, while sugary foods are limited to small portions.

"A mother must ensure that the food her child eats has energy, protein, vegetables, and vitamins. Salt should always be added last and in small amounts so that it doesn't overpower the meal." She adds: "Cooking everything together in one pot and mixing it well means the child can't pick and choose what to eat, ensuring they get all the nutrients."

Mothers usually attend in groups of about ten, choosing convenient times. The group setting helps them learn and share experiences.

The MUAC tool guides assessments: red (1–11 cm) signals severe malnutrition, yellow (12 cm) indicates moderate malnutrition, and green (13 cm+) means a child is healthy.

"As CHPs, we focus mainly on children in the red and yellow zones because they need our support most. Those in the green zone are doing well; they're usually breastfed properly and eat at least four times a day," Mary explains.

Porridge for children

She also advises including porridge in children’s diets: "For children in the yellow and red zones, it can make a big difference in their health."

Edna Omari, nurse in charge at Muthurwa Dispensary, says the programme was launched after county nutritionists noted a rise in malnutrition cases.

"When the county nutritionists visited, they noticed that many of the children presenting at the facility were undernourished," Edna recalls. "That finding pushed us to act."

At first, some caregivers were reluctant, but the use of affordable, locally available foods has won trust.

"It's a simple yet powerful approach. If fully embraced by the community, this programme has the potential to completely turn things around."

Malnutrition in children under five remains a serious issue in Kenya.

The 2022 Kenya Demographic and Health Survey (KDHS) found that 18 per cent of children under five are stunted, 5 per cent wasted, and 10 per cent underweight.

Although stunting has dropped from 26 per cent in 2014, malnutrition persists—especially in rural and low-income communities. In rural areas, 20 per cent of children are stunted compared to 12 per cent in urban settings, showing the gap in access to adequate food and health services.

The World Health Organisation (WHO) warns that child malnutrition, especially wasting, is a major public health issue when prevalence exceeds 5 per cent. Kenya is right at that threshold—underscoring the urgent need for continued intervention.