Healthy beginnings, hopeful futures: how mother and child health drive lasting change
A child’s early years shape the foundation of their future. Good nutrition and hygiene play a vital role in ensuring healthy development, strong immunity, and opportunities for a brighter future. Yet, in many parts of East Africa, children and mothers face high rates of malnutrition and preventable diseases, limiting their potential and exacerbating the cycle of poverty.
At Ripple Effect, we believe that healthy beginnings create hopeful futures. By investing in maternal and child health – through nutrition, hygiene, and sustainable solutions – we can drive lasting change.
In this blog, we explore the urgent challenges facing families in East Africa, share Ripple Effect’s impact in Burundi and Ethiopia, and highlight how empowering communities leads to healthier, more resilient futures—one child at a time.
The first 1,000 days: a critical window for lifelong health
The period from conception to a child’s second birthday – often called the first 1,000 days – is a crucial window for growth and development. During this time, proper nutrition and hygiene are essential in shaping a child’s physical health, brain development, and future capabilities. When mothers receive the right nutrients during pregnancy, they are more likely to have healthier pregnancies and safer births, reducing the risks of complications such as low birth weight and preterm delivery.
However, in many communities across East Africa, food insecurity, poor maternal nutrition, and lack of access to clean water put both mothers and children at risk. By focusing on improved diets, safe hygiene practices, and maternal care, we can ensure that children not only survive but thrive, giving them the best possible start in life.
The impact of malnutrition and poor hygiene on children and pregnant women
Malnutrition and inadequate hygiene have devastating effects on both children under five and pregnant women across East Africa. In countries like Burundi, Ethiopia, and Uganda, chronic malnutrition leads to stunting, affecting 54% of children under five in Burundi in 2019. Stunting not only hinders physical growth but also impairs cognitive development, reducing a child’s ability to learn and succeed later in life.
Malnourished children have weakened immune systems, making them more vulnerable to life-threatening infections such as diarrhoea and pneumonia, both of which are exacerbated by unsafe water, poor sanitation, and inadequate hygiene. Diarrhoea alone remains a leading cause of child mortality, with undernutrition contributing to nearly half of all deaths in children under five.
For pregnant women, malnutrition increases the risk of anaemia, a condition that heightens the likelihood of maternal mortality and complications during childbirth. Poor hygiene practices further expose expectant mothers to infections, endangering both maternal and infant health. Inadequate maternal nutrition is also a major cause of low birth weight, which is associated with higher neonatal mortality and long-term developmental challenges for the child.
Breaking the cycle of poverty: why mother and child health matter
In rural East Africa, malnutrition and poor hygiene continue to trap families in a cycle of poverty and ill health, making it difficult for communities to build a stable and prosperous future. Ensuring proper nutrition and healthcare for mothers and children is crucial to breaking this cycle, allowing children to grow, learn, and thrive, while enabling mothers to lead healthier, more secure lives.
How poor maternal and child health perpetuate poverty in rural East Africa:
- Limited educational opportunities: malnourished children often face cognitive delays, leading to poor school performance and a higher likelihood of dropping out. In Ethiopia, studies show that undernutrition in early childhood can result in lower IQ scores and reduced earning potential later in life.
- Lower economic productivity: stunting and developmental issues caused by malnutrition impact physical strength and mental capacity, reducing productivity in adulthood. In Uganda, it’s estimated that child undernutrition costs the economy 5.6% of its GDP annually due to lost productivity and healthcare expenses.
- High healthcare costs: frequent illnesses linked to malnutrition and poor hygiene place a financial burden on rural families. Repeated hospital visits drain limited resources, making it harder for families to invest in education, farming, or small businesses that could lift them out of poverty.
- Intergenerational poverty: undernourished mothers are more likely to give birth to low birth weight or malnourished infants, increasing the likelihood of poor health, stunted growth, and developmental challenges. Without intervention, this cycle continues across generations, making poverty even harder to escape.
Solutions that work: Ripple Effect’s impact in Burundi and Ethiopia
Ripple Effect’s work takes place at the heart of rural communities in East Africa, supporting those facing extreme poverty. While most aspects of our work include elements of nutrition and hygiene, some programmes implement specialised solutions for mothers and children facing malnutrition. The following two projects have been funded by UNICEF, and will be explored further in this section:
- ‘Thriving and Resilient Communities through Integrated Nutrition’ project, located in Dawro, Ethiopia. Working directly with 2,250 households.
- ‘No Time to Waste’ project, located in Mwaro and Muramvya provinces, Burundi. Working directly with 6,298 households.
Different regions, shared challenges
Despite being in different locations, the communities in these projects face similar challenges:
- Limited access to nutritious food, leading to poor diets and undernutrition.
- Inadequate food storage and preservation, reducing dietary diversity and essential nutrient intake.
- Lack of improved sanitation facilities, increasing the risk of disease.
- Limited screening and treatment for malnutrition and disease, due to insufficient healthcare access.
These common challenges have allowed Ripple Effect to implement proven, community-led approaches, ensuring impactful and sustainable solutions.
Measuring nutrition levels
The first step in the projects would be to work with project participants to measure nutrition levels. Community health workers and mothers are equipped with a colour-coded Mid-Upper Arm Circumference (MUAC) tape, which they use to identify whether children under five have Moderate Acute Malnutrition (MAM) or Severe Acute Malnutrition (SAM).
MAM, with a measurement between 11.5 cm and 12.5 cm – i.e. smaller than a standard golf ball – requires further monitoring or supplementary feeding, while SAM, with a measurement of less than 11.5 cm needs urgent medical attention.
Tackling malnutrition and hygiene
Ripple Effect’s programmes focus on community-driven, sustainable solutions that last beyond project completion. Self-help groups (SHGs) bring together affected families and community health workers (CHWs) to raise awareness of malnutrition and disease prevention. Local experts provide training in sustainable farming, enabling families – even those with limited land – to grow nutritious food using keyhole gardens, mandala gardens, and bag gardens, tailored to their environment.
Many families in East Africa rely on low-nutrient staples like maize, so nutritional education is key. In Ethiopia, Ripple Effect has provided vegetable seeds (cabbage, beetroot, carrot, Swiss chard, onion), pulses (haricot bean), and chickens, alongside training in sustainable vegetable production, food preparation, and poultry management. These skills empower families to improve their diets long-term.
For severe acute malnutrition (SAM) cases, urgent intervention is needed. Children are referred to therapeutic feeding programmes, often using Ready-to-Use Therapeutic Food (RUTF) like ‘Plumpy’Nut’ (a peanut-based paste), before transitioning to a balanced diet. Alongside nutrition, families learn about hygiene and sanitation, with Ripple Effect supporting the construction of tip-taps for handwashing, dishwashing stations, and clean latrines – essential for preventing disease and improving overall health.
Making a difference, one child at a time
These projects are designed with specific nutrition and hygiene-based health targets for children under five, pregnant women, and lactating mothers. This ensures that the solutions and methods used by our local teams are carefully tailored to maximise impact for these groups.
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