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16 Dec 19

Tackling Malnutrition in the First 1,000 Days of Life

We are delighted to announce that we have received funding to launch a two-year project working with mothers and children in three areas of Bajura: Rugin, Bichhaya, and Kolti. Bajura has been selected for this project due to high malnutrition rates and a lack of primary healthcare service provision. This risks leaving the area behind in long-term health outcomes. The maternal mortality rate here is 320/100,000 compared to a national figure of 239/100,000.

The project will complement our already existing primary healthcare services in all three areas. The project will focus on three key integrated areas: increasing nutritious foods, nutrition training/interventions, and community advocacy.


First 1,000 Days

The window of the 1,000 days of life (from conception to a child’s 2nd birthday) is widely associated with critical interventions in good nutrition. Evidence suggests that opportunities missed during this stage can be irreversible for a child’s future health. Key preventative measures include exclusive breastfeeding, eating a varied diet rich in nutrients, and supplementation with iron, iodine, and folic acid.

A lack of service provision, support for mothers, and awareness within the wider community of these preventative measures, are causing very high rates of malnutrition in Bajura. PHASE Nepal data shows that 39% of children in Bichhaya and 75% in Rugin are malnourished.

This project will focus on interventions to treat current cases of malnutrition and prevent future malnutrition. This will include training mothers and Female Community Health Volunteers in food fortification, with a method called super flour, using locally available grains and supplementation to create a nutrient-dense porridge, which is highly effective in the treatment of malnutrition. Alongside this, PHASE will provide antenatal and postnatal care, providing practical and emotional support for mothers and advising on supplementation, breastfeeding, and good nutritional practices.


Increasing the profile of good nutrition

Delivering training to health workers, volunteers and the wider community ensures that knowledge stays within the community. Street dramas, workshops, and healthy baby sessions will all focus on maternal and child health, encouraging women and their families to engage with health services throughout pregnancy and early years. Embedding this within the community not only ensures women are aware of the benefits of seeking health advice, but that they also have the wider support of their families and other community members.

As with all PHASE projects, a programme of community advocacy will take place, working with key stakeholders at the community and district levels, to increase understanding and community ‘buy-in’ of nutrition as a key factor in breaking the cycle of poverty.


Improved agriculture to increase food security

A lack of food security and specifically a lack of availability of a range of nutrient-dense foods is a key cause of malnutrition in remote communities. A recent survey found that in Bichhaya, 90% of families produce only enough food for 3-6 months of the year.

One farmer involved in our current UK Aid Direct project in neighboring Mugu said, “I knew how to make super flour for my children, and why it is important, but I just didn’t have the grains to make it.” This highlights our key role in not just treating the symptoms of malnutrition, but also addressing the underlying causes, particularly food security.

To ensure better long-term health, this project will train female farmers in poultry production and mushroom cultivation, to provide high quality, nutrient-rich foods. Agricultural technicians will work closely with each farmer to establish which method best suits their needs. Poultry production is a well tried-and-tested method that enables remote communities to establish micro-hatcheries for food and to supplement income. Poultry and mushrooms provide a good source of protein, and mushrooms, in particular, have a range of important nutritional qualities.

PHASE is currently the only NGO trialing the cultivation mushrooms in the Far West, and results as part of our project in Mugu are proving very promising. Cultivation of mushrooms in this region has the potential to greatly improve the nutritional quality of diets of many thousands of people.

PHASE Worldwide is pleased to be continuing to support integrated solutions to malnutrition, in an area of very high need in the Far West of Nepal. We would like to thank all donors and supporters of our work, which is improving the health and lives of people in remote communities in Nepal.

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