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For low-income families of children with disabilities in Addis Ababa, Ethiopia, mealtimes can be stressful. But last month, 20 families learned about proper nutrition and feeding techniques. This empowered them to have confident, peaceful and healthy experiences with food. Julia Hayes, Holt’s nutrition and health services manager, just got back from this nutrition training in Ethiopia and shared about her experience!

The Child Nutrition Program Training Model

We started our days with a van ride through the busy streets of Addis Ababa. As we pulled in through the gates of the rehabilitation center, we were ready for a day of interacting with physical therapists, parents and the children in their care. Families and children were already lined up outside the therapy room. They were waiting for the opportunity to learn new skills to support and feed their child. Child nutrition program (CNP) training in Ethiopia had begun!

For many low-income families who have children with disabilities in Ethiopia’s capital city, mealtimes can be stressful. Diverse and nutrient-filled ingredients are often too expensive and out of reach, despite being so important. Most days, these families will feed their children the Ethiopian staple food, injera (sourdough flat bread) and shiro (a chickpea stew). Other fruits (papayas, mangos, avocados) and vegetables will sometimes be incorporated into their diet if finances allow. On top of limited resources, feeding a child with disabilities like cerebral palsy involves extra challenges in terms of safety and optimal nutrient intake.

These were the children and families we were here to help.

Display of local Ethiopian foods at the CNP training.

We were providing CNP training for physical therapists at a rehabilitation center in Addis Ababa. These physical therapists work closely with children who have severe disabilities and their parents or caregivers to improve everyday physical function. Our role was to share with these professionals the skills necessary to support safe feeding practices and optimal nutritional status of the caregivers and children they work with. In addition to four days of interactive classroom training, we arranged a hands-on practicum at the site and worked with over 20 families. This allowed us to find solutions to feeding challenges and conduct nutrition and health screenings.

There was never a dull moment! We worked through frustrations, laughs, tears and the oh-so rewarding “ah-ha” moments as children and parents experienced breakthroughs with eating and feeding.

The CNP brings nutrition, feeding and health education to caregivers and families all around the world. We know that proper nutrition and safe feeding greatly improve children’s health and quality of life. And the most efficient way to do this? Train the professionals who work with these children and families every day. By following this “Training of Trainers” (ToT) model, those trained in the CNP can pass their knowledge on to others. Then, they share with others, creating lasting change in nutrition and feeding practices for children!

Training Therapists and Parents

It was primarily mothers who brought their children to the center. But we also saw some fathers and grandmothers make the journey to the rehab center with their child to work with the team of therapists. We saw firsthand the love and dedication they all had for their children, as they made the extra effort for them to get the care and support they needed. As each session passed, it became evident that the trusting relationship between the physical therapist, caregiver and child was the main contributor to the success of each session. Therapists worked on providing individually tailored guidance for each parent, based on the child’s specific needs. They always collaborated with each other to improve their instructions. There was never a dull moment! We worked through frustrations, laughs, tears and the oh-so rewarding “ah-ha” moments as children and parents experienced breakthroughs with eating and feeding.

As if the weather was our timekeeper, each afternoon as we were wrapping up our long day of sessions, the clouds would roll in above us and let out a heavy rain. During our end-of-day meetings, we had to speak loudly over the roar of the raindrops on the therapy room’s metal roof. We learned two things that week: the rainy season came early this year, and no matter where you are in the world, the weather is always something to talk about.

Group Training

To finish up the four days of practicum, we held a half-day group caregiver training session. There we shared nutrition and feeding information with families who were just beginning their journey at the rehabilitation center. The day started with Holt Ethiopia staff members teaching about nutrition, health and meal planning. Parents showed what they had learned through an activity where they chose key foods and ingredients available in their communities to prepare a week’s worth of meals. It was clear to see that the families were excited to show what they knew and learned, choosing meals based on their personal food preferences.

The day concluded with feeding and positioning training led by the physical therapists. Along with the support of our feeding specialist, the physical therapists showcased their new knowledge by demonstrating and talking through the feeding practices. This was a true testament to the ToT model. Like the prior sessions, each parent’s deep desire to help their child be the healthiest they could be and reach their greatest potential was undeniable. Families also looked to each other for comfort and advice on the challenges they faced during mealtimes with their children.

A Lasting Impact

As we packed up our bags and prepared for our journey back to the United States, we took some time to reflect on the experience. Many of our nutrition and health programs were built to support families in rural areas. So, learning more about challenges for families in Ethiopia’s urban setting helps us strengthen the CNP training overall in Ethiopia. This, in turn, will allow us to reach more families in need of support. We look forward to seeing the impact of this training through the regular health screenings children at this center will receive. As more parents learn and practice improved nutrition and feeding practices for their children through our newly trained CNP trainers, more and more children will grow and thrive!

Support Holt’s Child Nutrition Program

Your gift to Holt’s child nutrition program will provide life-changing nutrition and feeding support to children living in poverty and in orphanages around the world.


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