Protecting Babies with Play Yards
Environmental Enteric Disorder
Reducing Childhood Exposure to Fecal
Contamination
Almost one third of babies born in Sub-Saharan Africa
suffer from malnutrition with lasting cognitive and
developmental impacts. While the lack of nutrient-rich
food is a contributing factor, another likely reason is the
proximity of babies to livestock. When crawling babies
accidentally ingests feces, it can critically affect growth
and brain development. The resulting stunting and
anemia are associated with impaired cognitive
development, poor school performance, reduced lifetime
earnings, and the perpetuation of the intergenerational
cycle of poverty. This is a key development challenge that
affects not only the child but also whole communities as
they struggle to maintain healthy and productive
households.
In some rural communities, up to 40% of stunting among
children under 2 years old may be caused by a sub-clinical
condition of the small intestines known as Environmental
Enteric Disorder (EED). EED is caused by children ingesting
feces, mostly from small livestock, and can prevent the
absorption of nutrients in the intestine.
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Environmental enteric disorder poses a key challenge for
rural communities in maintaining the benefits that small
livestock provide while protecting children’s growth and
development. To respond to this need and to identify a
clear pathway to EED, CARE and Cornell, through the One
Health for Babies and Livestock Project, engaged families
in six communities in the Lundazi and Chadiza districts of
Zambia to design and test locally acceptable solutions to
reduce children’s exposure to fecal contamination. The
team worked to:
Educate mothers about the health hazards of babies
ingesting fecal matter and the benefits of proper hand
washing and sanitation practices, and
Test the viability and acceptability of commercial and
community designed play yards to separate crawling
and toddling infants from feces and contaminated soil
in their environment.
A Homegrown Play Yard
Findings from the study suggest that when mothers or
caregivers have adequate information about the risks that
fecal exposure pose to their children, they proactively
propose and implement solutions. Participating families
constructed locally appropriate play yards modeled on
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imported plastic play yards. These play yards separated
babies from livestock and effectively eliminated the
ingestion of feces by babies in the community.
Although only 23 households fully participated in the
study, numerous community members outside of the
study participants decided to replicate the community
designed play yards to separate their own infants and
toddlers from livestock. Even after the close of the
program, community members continue to advocate to
health center staff on the importance of separating
Educating in Zambia and Beyond
CARE has adapted the education modules developed by
Cornell for use in the One Health Study in Zambia. The
module is an interactive tool geared towards addressing
the risks associated with Environmental Enteropathy. It is
envisioned that this module can be used in multiple ways:
as sessions in a training, as sessions in a Nutrition Action
Group, or as individual sessions in other contexts and
settings. This module is being mainstreamed across
CARE’s Nutrition and the Center (N@C) Program, which is
a ten-year program to develop, document, and
disseminate highly effective and efficient integrated
approaches that improve nutritional outcomes for
mothers and children. The N@C Program is being
implemented in Benin, Ethiopia, Zambia and Bangladesh.
What’s in a Woman’s Workload?
Commercial/Imported Play Yards
Community Built Play Yards
children from feces. Women have advocated for inserting
this topic into antenatal care visits for pregnant women
and their partners. Health center staff are also exploring
ways to support families in their coverage areas to build
play yards after learning the importance of reducing the
risk to developing EE. The benefits of working closely with
the MOH and local leadership structures continue to
multiply the impact from this project.
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In addition to preventing children from ingesting
contaminants that cancause EED, the study offered the
opportunity to closely study the main pathways to EED
as well as methods to reduce women’s workloads by
providing children with a safe place to play while women
are working. Additionally, the study observed a change
in gender roles by encouraging men and boys to assume
more care responsibilities. This finding led CARE and
Cornell to jointly design a study on Women’s Workloads
to assess how the introduction of play yards and the use
of EED educational modules add to women’s workloads
or reduce the burden on women and the availability of
adequate time to utilize nutrition programs. The study is
engaging 200 mothers and fathers of infants and young
children from six villages in Zambia, including those who
participated in the Baby WASH study. The “women’s
workload” study is offering CARE and Cornell the
opportunity to determine how the implementation of
play yards (conducted in the previous study) influences
women’s work loads. It will inform the two institutions’
design of optimal activities that would reduce workload
and stress among women and, as a consequence, allow
women time to invest in good nutrition practices and
have leisure time.
One Health for Babies and Livestock
CONTACT CARE-CORNELL COLLABORATION
Vidhya Sriram
Nina Chaopricha
Senior Partnership Advisor
Program and Collaboration Coordinator
151 Ellis St. NE
200 Rice Hall
Atlanta, GA 30303
Cornell University
USA
Ithaca, NY 14853
T) 404-979-9529
USA
E) [email protected]
T) 607-255-7535
E) [email protected]
The CARE-Cornell Collaboration fosters and integrates cutting-edge research and practices on food and nutrition
security that can advance innovative solutions to real-world problems and catalyze real, long-term change at scale.
www.CARECornellCollaboration.org
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