Standing in a classroom named after Alberto Joaquim Chipande, the first Defense Minister of Mozambique, is 17-year-old Marciela Mateus, leader of an adolescent girls’ club in her community in Nampula, Mozambique. She is surrounded by twenty-five teenage girls of various ages and backgrounds— gathered here with a common objective— to learn how to transform their lives through proper nutrition.
As the largest, most densely populated and one of the most agriculturally important of Mozambique’s 11 provinces, the nutritional status of young women in Nampula is critical to the future of the southern African country.
But given the impacts of natural disasters, COVID-19 and other health threats, as well as the ongoing reality of armed conflict, the rate of multidimensional child poverty in Nampula is at 58.9%, with 46.7% of the population suffering from malnutrition.
Gender inequalities in access to nutritious foods, lack of nutritional knowledge, high rates of teenage pregnancy and limited access to proper hygiene and sanitation have had profound impacts on nutritional outcomes among local teenage girls.
Heroína | Heroína não chora | Heroína | Heroína não chora…
Under the leadership of Marciela, the girls clap and sing the lyrics of “Heroine don’t cry.” This is the typical introduction to Jogo das Heroínas — the Heroine Games— a social and behavioral change initiative designed and implemented by a consortium of Mozambique-based NGOs (ADPP, h2n, Global Alliance for Improved Nutrition, VIAMO and UNILURIO) to help influence food choices and improve the nutritional status of adolescent girls in the area.
At the fore is ADPP, a Mozambican organization involved in community-led development initiatives— among them, a program called Transform Nutrition which seeks to improve the nutritional status of target populations in Nampula through nutritional behavior change.
“The Heroine Games is an intervention in which the girls receive challenges and activities to do during a 16-week period,” explains Lúcia Amaral Santomeio, Senior Program Assistant with the Behavior Change Unit at the Mozambique office of Swiss NGO, Global Alliance for Improved Nutrition (GAIN), one of the implementing partners. “These challenges might be, for example, related to eating fruit or dark green vegetables or beans. With each week, the difficulty of the challenge increases.”
Many of the topics are taught using colorful cards which generate enthusiasm around nutrition, particularly among girls who are less literate.
It is Sunday and while still early in the afternoon, most of the girls have already completed their domestic and religious obligations for the day. They are using the little available time before the school week begins to make a change in their own lives and in their communities.
Each week, Marciela arises from her little twin bed and checks in on her seven-year-old sister lying beside her. She says her morning prayers and walks past the little library that her parents have created for her in the corner of the house. After completing her various academic and domestic obligations, she wastes no time making her way to that week’s Heroine Games location.
“So who remembers what we talked about last time?” Marciela asks, after she has taken attendance and led the group in song.
She eyes the group for hands…
“Who remembers the definition of anemia? What happens when someone has anemia?”
Upon listening to the contributions of some animated volunteers, Marciela reminds the girls that anemia develops when the blood produces a lower-than-normal amount of healthy red blood cells, stressing that iron deficiency anemia is caused by a lack of iron, often due to blood loss or pregnancy, which can be corrected by eating iron-rich foods.
For some of these girls, access to this information could mean the difference between life and death.
More than half the girls between the ages of 12 and 17 in Mozambique suffer from anemia, and iron deficiency anemia is one of the leading causes of morbidity and mortality among girls between the ages of 10 and 19 in northern Mozambique. Knowledge of iron-rich food intake practices has proven to be highly successful in creating nutritional behavior change, and improved health outcomes.
“Nuts and seeds… beans… dark leafy green vegetables…”
The girls begin to take turns naming iron-rich foods.
As the leader of the group, Marciela has changed her own eating habits significantly since she began participating in the initiative.
“Before the Jogo das Heroínas, the only foods I ate were rice, beans and cooked bananas,” she says. “My mother kept trying to make other foods for me, but I wouldn’t eat anything else. Now I understand that she was right. I must diversify my food.”
Today, a typical meal for Marciela includes a wider variety of foods such as pasta, rice, fish, meat, xima (maize porridge), karakata (cassava porridge), matapa (a stew made of peanuts, moringa leaves, cassava leaves and seasonal vegetables) or a variety of seasonal fruits and vegetables.
Marciela is also influencing her siblings and other members of her community, who are not participants in the Heroine Games, to eat better.
“I would like to be a teacher someday, like my parents,” she says. “They are my role models. I’ve been watching what they do and I’m very motivated because I see that they are changing people’s minds. I know that I can do it not only in school, but I want to be where I can help people to learn and to change the way they think.”
Fernando Pedroza Moussa, Coordinator of the Transform Nutrition program for the district of Memba for the United States Agency for International Development (USAID) the funders of the project, says that Marciela’s success story is one of many in Nampula.
“We know about girls who didn’t like to eat vegetables before, but when they joined the Heroine Games, they started to like eating vegetables and include them in their daily meals,” he says.
“Girls are learning how to eat better, so that they can avoid the chronic malnutrition that we have identified in our communities. They are also gaining enough knowledge to be able to pass it on to others and influence behavior change in the community. This initiative has also helped to improve their self-esteem.”
Heroine Games has also created cohesiveness among its young participants and has helped to create a culture of equality by integrating girls from various backgrounds, allowing them to come together based on shared experiences rather than socio-economic means. Marciela has become a big proponent of this change and is a passionate advocate for inclusion.
“The thing that children here in my community struggle with is inequality. People here who have money, who are richer than others, they tell their children not to play with the poorest ones. This frustrates me a lot. And because of that, these children, the poorest ones, they feel alone, and they feel that they don’t belong. Everyone is welcome to participate in Jogo das Heroínas.”
Small and slight, Marciela’s fine stature belies her mighty spirit. Unafraid to challenge the status quo, she is committed to helping as many girls as she can.
“In our group we talk about our dreams. I like that it is very motivational,” says Marciela of her experience with Jogo das Heroínas. “It is not just a place where you are there to learn about food but also to share experiences. It teaches me good things and that is what I like the most.”
In Mozambique, adolescent girls and women are disproportionately impacted by conflict, gender-based violence, child marriage and pregnancy, malnutrition and disease, poverty, and social and economic shocks. The nutrition status of adolescent girls and women continues to face ongoing threats due to local and global crises.
And with one of the highest incidences of child marriage in the world and the highest adolescent fertility rate among the countries of the Southern African Development Community, without intervention, there is increased potential for perpetuated cycles of undernourishment.
According to a GAIN study, the disproportionate impact of malnutrition on girls and young women “has intergenerational consequences via malnourishment carried later into pregnancy, childbirth, breastfeeding, and beyond.”
With the unique issues faced by Mozambican women and girls, the need for nutrition interventions targeted specifically at female adolescents is critical and has the potential to be highly transformative at a national level. In this light, Heroine Games is not only a safeguard for the health of its young beneficiaries but also for their families, their communities and for future generations.
“I believe that it is important for girls and women to learn about nutrition,” says Marciela. “At least here in Mozambique, we are the ones who cook at home and since I’m a child now, I think if I have my own family one day, I can teach my children how to eat properly and ensure that my family is healthy…
For me, I know this is how I am making a change.”