On routine immunisation days, parents gather at primary health care (PHC) facilities across Abakaliki, Ebonyi State, for routine immunisation for their children. Many now leave with more than vaccines; they leave with practical nutrition skills. They also learn how to feed children better using familiar staples such as rice, maize, and soya beans, which many households can access locally. In Ebonyi, as in many parts of Nigeria, treatment for severe acute malnutrition often relies on ready-to-use therapeutic food (RUTF), a peanut-based, energy-dense paste usually provided through donor-supported programmes. While RUTF saves lives, many families return to their previous feeding habits after treatment ends.
In response, Healthy Mama, Healthy Pikin, a youth-led community-driven nutrition programme, began responding to child malnutrition in the state. "When I was posted to the Ebonyi State Ministry of Health, I noticed that most nutrition support depended on donor-funded therapeutic foods," Enoch Akinade, a nutritionist serving under the National Youth Service Corps (NYSC) and the initiator of the programme, explained. "I kept asking myself, 'What happens when the donors leave?" That question became the foundation for a community-driven intervention focused not only on emergency feeding alone, but also on building long-term nutrition knowledge among parents and caregivers. "There were knowledge gaps, myths, and poor feeding practices that kept repeating the cycle," he added.
When treatment exists, but prevention is weak
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Healthy Mama, Healthy Pikin was designed to go beyond nutrition education by addressing access and household-level constraints. In partnership with organisations such as Slow Food International and the No Hunger Food Bank, the programme integrates food support, hygiene kits distributed through Slum and Rural Health Initiative (SHRIN), and practical nutrition training to help families translate knowledge into daily practice. Rather than relying on awareness alone, the model blends behaviour-change communication with hands-on gardening support, hygiene promotion, and community follow-up, reflecting evidence that multi-sector approaches are more effective than single interventions.
During outreach visits in Abakaliki communities, the team found persistent misconceptions. Some mothers discarded colostrum because they believed it was harmful. Others stopped breastfeeding when they became pregnant again, often because of cultural beliefs, cutting breastfeeding short well before two years. Chinelo Okoye, the project team lead, said a baseline assessment conducted from February-March 2025, among 261 mothers of children under five in the programme areas found that 87.7% scored as having 'adequate' knowledge of child feeding, yet misconceptions about herbal remedies and breastfeeding during pregnancy persisted. She added that 68.2% of households were classified as severely food insecure. The team also found misunderstandings about home-made complementary foods for children over six months, with incorrect ingredient ratios reducing nutritional value. Enoch added that the barriers were not only about food, but also about information and the ability to act on it.
Turning PHC immunisation days into nutrition classrooms
Working with the Ebonyi State Nutrition Department and local government health authorities, the team selected 10 PHCs in Abakaliki based on client volume and routine immunisation attendance. On immunisation days, trained volunteers deliver short sessions on breastfeeding, complementary feeding from six months, dietary diversity, and hygiene. Parents also join live cooking demonstrations, learning how to enrich pap and other common meals with affordable, locally available foods. "We don't teach foreign foods," said Ojeh Blessing, the youth coordinator. "We show parents how to make what they already cook more nutritious."
To improve access to fresh foods, the programme also distributes vegetable seeds and trains families on backyard gardening. Parents and caregivers are encouraged to grow leafy vegetables at home, reducing dependence on market purchases. "We realised that knowledge alone is not enough," Enoch said. "If vegetables are not affordable, people won't use them. So, we combined education with access." This model mirrors the outcomes of Nigeria Health Watch's 2018 national nutrition policy dialogue on local alternatives to malnutrition. Policymakers and partners pushed for practical food demonstrations, stronger nutrition advice at the primary care level, and community food production as the sustainability pathway when donor-funded support ends.
Early household changes, one year in
Since implementation began in November 2024, the programme says it has reached over 300 parents with children under five, as of November 2025, in its target communities in Abakaliki. More than 100 households have started kitchen gardens, enabling families to grow vegetables such as Ugu (fluted pumpkin leaf), okra, and other leafy greens that improve dietary diversity while reducing food costs. For many participants, these small backyard gardens have become a reliable source of fresh produce, particularly during periods of high food prices.
Achor Chinenye, a mother of one, said the gardening training changed what her family eats. "I never knew I could grow vegetables in bottles and old tyres. We used to farm mostly cassava and other staples, but now we can add vegetables to our meals," she said. On her part, Chioma Obasi, another mother, noted that her children now get more nutritious meals, "and I feel confident that they are growing healthy and strong." She added that she now prepares Tom Brown, a home-made blend used for complementary feeding, with better proportions. "I knew about it, but I didn't know the right proportions, and I often diluted it. After the training, my child, who used to reject food, is starting to eat better."
Health workers also report early changes. In some facilities, parents say they now add vegetables and, when they can, eggs or other protein to children's meals, including staples such as pap, maize, rice, and garri. Some families have established small backyard gardens using the seeds provided. Mrs Kalu Christy Ikechukwu, officer-in-charge of Unagboke PHC in Abakaliki, said the change is noticeable. "Before, many parents fed children plain pap. Now, they ask questions about fortifying meals and bringing vegetables from home."
Training health workers to drive sustainability
To avoid dependency on volunteer visits, the programme held a training session for frontline health workers in nine of the 10 PHCs, equipping five staff per facility, including the officer-in-charge (OIC), nurses, and midwives, to deliver consistent nutrition counselling during routine clinic sessions. "These nurses and community health workers are here every day," Enoch said. "If they continue the conversations, the impact becomes sustainable." Health workers were taken through refresher sessions on infant feeding guidelines, hygiene practices, and nutrition counselling, in line with global infant and young child feeding (IYCF) guidelines. This ensures consistent messaging even after the project cycle ends.
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Implementation has come with challenges. Language differences required local volunteers who could teach in indigenous dialects, while transport for volunteers and supplies remains difficult with limited funding. Enoch said the work relies on passion and small, project-focused grants that arrive in phases, and volunteers sometimes cover transport costs themselves. In under-resourced health facilities, cooking demonstrations often require improvisation, with facilitators adapting recipes to available ingredients and working with limited space and basic tools.
Why this model matters
Despite constraints, organisers believe the model remains scalable because it builds on existing health infrastructure and uses low-cost interventions. Nigeria's nutrition response still depends significantly on external funding, including support from partners such as UNICEF, the World Food Programme, and the World Bank. When funding cycles end, community-level services can weaken unless states and LGAs sustain them.
By focusing on behaviour change, local foods, and clinic-based education, Healthy Mama, Healthy Pikin offers a complementary approach that can reduce relapse and strengthen prevention. It does not replace therapeutic feeding for severe acute malnutrition; it aims to reduce how often families return to crisis treatment. "If parents understand nutrition and can apply it with local foods, they don't have to wait for handouts," Enoch said. For communities in Ebonyi, the programme is not just about feeding children today; it is also about building the knowledge that determines what children eat tomorrow.
