Susan Onyango is a nutritionist working at the Marindi Sub County Hospital in Homa Bay County, western Kenya, where some 2500 people living with HIV regularly seek care. Among her patients and especially among women, she started to see a trend from undernutrition to overweight and obesity, often caused by an unbalanced diet.
Venturing into the surrounding communities, she discovered most women were unaware that an unhealthy diet, overweight and obesity are major risk factors for hypertension, heart disease and type 2 diabetes. While providing the HIV/AIDS treatment regimens, the health services did not pay enough attention to nutrition, healthy weight, and preventing noncommunicable diseases.
Many of the women that Susan spoke to had no say over their family’s farmland, as it was mostly men who decided on the use of the land prioritizing the more lucrative sugarcane farming. The women were missing the knowledge and opportunity to grow healthier produce, including different vegetables and fruits.
Together with a small team from the hospital and a group of trained peer educators, Susan decided to tackle the issue through health education and hands-on training.
“We use a multipronged strategy to address a complex problem with several root causes,” Susan reveals. “Once a month, we organize community health literacy sessions that equip women with knowledge on obesity, diabetes and hypertension prevention and management. In our community demonstration garden, we also teach women how to grow various crops in their own backyards and how to incorporate them into a healthy diet,” she explains.
Susan’s project “The Healthy Woman” operates with the slogan “being proactive everyday, keeps obesity at bay”. With her support, a group of 30 women was able to better understand how to avoid unhealthy weight gain and associated health risks. They discuss and learn about energy, sugar and salt intake, physical activity as a part of their workday, and balancing meals with fruit, vegetables, legumes, and other healthy foods.
The Healthy Woman used a unique, innovative strategy. It addressed the issue of unequal gender roles, closed gaps in integrated HIV and NCD services, diversified the local food systems and substantially improved the limited health literacy among local communities.
In its pilot phase, the project notably enhanced the nutrition and food security of participating households, and several local health professionals and organizations now support scaling the activity to nine more groups in the community by contributing funds, seeds or farming expertise.