A nurse at Binkolo Health Centre distributes high-protein mix to families with undernourished children. Sierra Leone has one of the world's highest rates of child malnutrition, even though most households grow food. Higher prices in 2007 and 2008 made it more difficult for mothers to feed their families, according the nurses at the centre. Many subsistence farmers sell more of what they grow than they eat. They use the cash for food, school fees, medicine and other needs.