Djibouti’s “mother counsellors” are agents of change

They guide women through all the steps of caring for a child – from conception and pregnancy to birth and the critical first years of a child’s life. Although this description might call to mind doctors, nurses or specialised health workers, it also includes another category of care provider that must not be overlooked – mother counsellors.

When access to health care is lacking or limited, rural women often turn to their families or elderly women for advice on how to take care of themselves and their newborn babies. Although these mother counsellors cannot entirely replace skilled care providers, as they often have no formal training, they nevertheless provide essential services to women during pregnancy and lactation. For this reason, their role is highly respected among local women and their capacity to influence is high.

IFAD, too, recognizes these women as agents of change and local influencers and engages them to advocate for women’s health and nutrition in the places where they’re needed most. The communities of rural Djibouti, in particular, have held some of these women’s greatest challenges – but also represent just one of their many success stories.

Djibouti sits on the Red Sea, a bridge between Africa and the Middle East. Despite this strategically beneficial position, almost 80 per cent of the country’s rural people live in poverty. Food insecurity and malnutrition are endemic, especially among women and children.

Djibouti is also one of the world’s most water-poor countries. Until recently, women in many rural areas had to walk over 20 km – a journey of 12 hours – to carry water home. Sadly, this arduous task, combined with the poor quality of water it yielded, often led to health problems like fatigue, miscarriage and tuberculosis.

Fatima Hassan Mohamed, a Djiboutian mother of five, experienced these difficulties first-hand. Four of her children suffered frequent illnesses early in life, resulting in malnutrition and delayed growth.

Fortunately, all that is changing. The Government of Djibouti, in conjunction with IFAD and WFP, has sponsored a programme called PROGRES to address the challenges of the nation’s food insecurity and water scarcity – and it has called on mother counsellors to bring their unique skills to the front lines of women’s and children’s health and nutrition.

Perhaps one of the programme’s most immediate benefits is the improvement in water infrastructure. PROGRES has constructed multiple cisterns and reservoirs throughout the region, reducing the travel time for fetching water to only 2 hours and providing communities with plenty of safe water for consumption.

PROGRES has also given 40 of the region’s mother counsellors the opportunity to infuse their traditional knowledge with life-saving practices learned from health practitioners. Through the programme, they have received extensive training in the prevention of maternal and child malnutrition, as well as in water, sanitation and hygiene practices. They have also received teaching aids to help them promote these practices. Armed with these new tools, the mother counsellors have shared these teachings throughout 20 local communities.

Mother counsellors have always had the ability to convey vital health information to families in culturally appropriate ways. With help from the PROGRES training, they can now promote ideal nutrition through optimum caregiving practices for the first thousand days of a child’s life. They can also help women recognize potential danger signs during pregnancy and early childhood – and to know when and where to go for help.

Women like Fatima and their children have already seen improvements in their health.

“The project has helped me understand much more about nutrition,” Fatima says. “My last child benefitted from the practices I learnt such as exclusive breastfeeding for 6 months. It has also helped us avoid certain diseases, especially diarrhoea. I appeal to all the mothers in my village to make the most of this opportunity.”

A mother counsellor shares health information with Djiboutian women. © IFAD / Abdelhamid Abdouli

In addition to their work with families, the mother counsellors have organized 1,600 culinary demonstrations and set up 250 kitchen gardens. The gardens are already yielding tomatoes, green peppers, onions, potatoes and moringa – a selection that contains all the necessary micronutrients for a balanced diet.

“Thanks to our cooking demonstrations, women are now preparing diversified meals from vegetables produced in their own gardens,” says Andahi Harroun Bila, a mother counsellor from the Tadjoura region.

Andahi and her fellow mother counsellors are agents of change within their communities, helping children and their mothers fight malnutrition. Their accomplishments demonstrate that engaging the community, especially women, can be successful in promoting healthy practices, consequently reducing maternal and child mortality.

Read more about IFAD’s efforts to ensure nutrition security in the countries where it operates.

Read more about IFAD's operations in Djibouti.

Publication date: 11 March 2020