163 posts categorized "Maternal and Child Nutrition"
“I fall, I stand still… I trudge on. I gain a little… I get more eager and climb higher and begin to see the widening horizon. Every struggle is a victory.” – Helen Keller
Today is March 31, the official end to National Women’s History Month. Like so many other months that have been assigned an issue of national or international importance, this month was dedicated in the late 1970s, around International Women’s Day, for the purpose of celebrating the achievements and contributions women have made to society, science, government, and our world at large.
The trouble with these months is that, well, they end. Once they’re over, we’re on to the next month or issue, and have forgotten all of the great things we learned, celebrated, and promised to do in the month prior.
At Bread for the World, we like to look at these important months as a time not only to celebrate, but to reflect on what has been done among specific communities of people to end hunger, and what more there is to accomplish. While these designated months (African-American History Month, Older Americans Month, Hispanic Heritage Month) serve as official rallying cries, we must pursue relevant issues and challenges throughout the year if we are to effect lasting change.
While Women’s History Month ends today, poverty, malnutrition, and hunger among women and children around the world continues. There’s still work to do.
With this in mind, Bread for the World has just completed two new “Hunger by the Numbers’ analyses on women and children.
The international analysis takes a look at the important role women play in development and ending hunger worldwide, particularly with regards to nutrition in the first 1,000 days from a woman’s pregnancy to her child’s second birthday. The domestic analysis highlights some key issues brought to light in the 2014 Hunger Report, Ending Hunger in America. From wages to childcare, this document evaluates some of the main factors that contribute to the hardships of workers in the United States.
We hope these analyses will not only provide valuable information, but that they will encourage us to keep working to end hunger among women and children all year long.
Kristen Youngblood Archer is Bread for the World's media relations manager.
Photo: A mother and daughter in Nicaragua shell peas from their garden. (Margaret W. Nea)
Children at the Nutrition Rehabilitation Home in Dhangadhi, Nepal, receive their 4 a.m. milk feeding on Monday, April 30, 2102. This Nutrition Rehabilitation Home in Dhangadhi, Nepal, in the western part of the country, is run by RUWDUC (Rural Women's Development Unity Corporation), a Nepali NGO. The Dhangadhi facility serves up to 10 malnourished children at a time for up to 60 days; mothers stay with their child. All services are free. (Laura Elizabeth Pohl/Bread for the World)
By Beth Ann Saracco
Thanks to a growing body of research, and the advocacy efforts of Bread for the World members and others throughout the world, Congress is beginning to recognize the importance of global maternal and child nutrition. Our legislators are paying particular attention to nutrition during the critical 1,000-day window from the start of a woman’s pregnancy through her child’s second birthday.
Last year, funding for global nutrition efforts were increased to $115 million, up from the previous year’s funding level of $95 million. That’s nearly a 22 percent increase in funding. Congress is starting to get it. And for good reason— every $1 invested in nutrition generates as much as $138 in better health and increased productivity.
And today, in the House of Representatives, the Foreign Affairs Subcommittee on Africa, Global Health, Global Human Rights, and International Organizations is holding a hearing, “The First One Thousand Days: Development Aid Programs to Bolster Health and Nutrition.” The subcommittee’s chairman, Rep. Chris Smith (R-NJ-4), and ranking member, Karen Bass (D-CA-37), are holding this hearing to learn more about the health and nutritional needs of women and children during the 1,000-day period. The hearing will also address the role of faith-based organizations in partnering with governments and other non-governmental organizations to promote the 1,000 Days movement, and adequate maternal and child nutrition.
Be sure to tune into the hearing at 3 p.m. ET, on Tuesday, March25, to hear testimony from witnesses who have seen firsthand the importance of maternal and child health and nutrition during the first 1,000 Days. Tweet at Rep. Chris Smith (@RepChrisSmith) and Ranking Member Bass (@RepKarenBass), and thank them for their interest in this important issue and for holding this hearing.
To learn more about the growing 1,000 Days movement, and to become part of the momentum, download Bread for the World's 1,000 Days toolkit. You can also visit Bread for the World’s 1,000 Days Movement page and “like” the Women of Faith for the 1,000 Days Movement Facebook page to receive the latest updates.
Beth Ann Saracco is an international policy analyst at Bread for the World.
Around the world, more than 400 million children live in extreme poverty and many suffer from malnutrition and illness. In countries hit hardest by the HIV/AIDS epidemic, this combination can be fatal. (Mariella Furrer/Elizabeth Glaser Pediatric AIDS Foundation)
This article originally appeared on the Elizabeth Glaser Pediatric AIDS Foundation blog.
By Chelsea Bailey
Around the world, more than 400 million children are living in extreme poverty. Subsisting on less than U.S. $1.25 a day, these children are often plagued by malnutrition and illness. In countries hit hardest by the HIV/AIDS epidemic, that combination can be fatal.
HIV has often been referred to as the “wasting disease,” because, if left untreated, the virus wreaks havoc on the immune system, leaving the person emaciated and making exposure to even the most common infections deadly. Similarly, prolonged hunger and malnutrition deprive the body of essential nutrients that support the immune system, making it that much more difficult for the body to properly defend itself against infections.
When given the choice between being able to afford food or antiretroviral medications (ARVs), many choose to have food in their stomach. Nutritionists at the World Food Programme (WFP) have dubbed this cycle the “HIV- Hunger Trap.”
But it is possible to break the cycle. In Lesotho, many children suffer the dual challenge of living with HIV and coping with hunger. Recognizing this, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) integrates nutrition programs into all maternal, neonatal, and child health services in EGPAF-supported hospitals and health centers.
These “Nutrition Corners” are designed to improve the growth, development, and overall health of HIV-positive and HIV-exposed children.
Undernourished children do not receive enough food to lead healthy and active lives, if this condition progresses it can lead to malnutrition, a physical state that makes it difficult for the body to resist disease.
Mothers and caregivers enrolled in Nutrition Corners can attend cooking demonstrations to learn about healthy eating and food preparation using locally available fare, such as sorghum porridge, beans, peas, vegetables, and fruits. Nutrition Corners also help EGPAF identify HIV-exposed children who are still breastfeeding and HIV-positive children who are younger than 2, so they can receive optimal support for HIV prevention, care, and treatment.
Monthly growth monitoring sessions identify undernourished children with low weight-for-age and weight-for-height. Mothers, caregivers, and children with unknown HIV statuses receive HIV counseling and testing services.
Caregivers and parents whose children do not nutritionally improve in three consecutive visits are given one-on-one counseling—while the parents and caregivers who have seen improvements are invited to talk to the entire group about their positive experiences.
The Nutrition Corners are part of the larger effort by EGPAF and the Partnership for HIV-Free Survival (PHFS) program to reduce malnutrition in Lesotho, especially among HIV-positive women and HIV-positive children. PHFS is funded by the U.S. Agency for International Development (USAID) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). [Editor's note: Bread for the World advocated, and continues to advocate for PEPFAR and also supported the PEPFAR Stewardship and Oversight Act of 2013. which extended important provisions and reporting requirements that will help strengthen the program.]
We will not be able to see the end of pediatric HIV/AIDS without strong and sustainable health systems. Integrating nutrition programs into maternal, neonatal, and child health services brings us one step closer to ensuring a viable and efficient health system that not only eliminates pediatric AIDS, but also improves the overall health of women, children, and their families.
Chelsea Bailey is media relations coordinator at Elizabeth Glaser Pediatric AIDS Foundation.
A mother and child share a meal in rural Guatemala. (Joseph Molieri/Bread for the World)
By Amanda Bornfree
Where there is hunger and poverty, mothers and children are almost always disproportionately affected. The 1,000 days from pregnancy through a child’s second birthday are the most crucial for a child’s development, but many women around the world don’t have access to proper nutrition for themselves or their children. The United States plays a crucial role in the fight to eradicate maternal and child malnutrition, and our nation's continued commitment is key to ending this global scourge.
In June, Reps. Mario Diaz-Balart (R-Fla.) and Debbie Wasserman Shultz (D-Fla.) introduced House Resolution 254, which recognizes the importance of U.S. leadership in addressing global maternal and child nutrition. Though the resolution is still active, it’s in need of more support. So far, there are 53 co-sponsors, but only six are Republicans. In order for this resolution to pass, we must make sure the resolution remains bipartisan. This means, we need YOUR help!
We’d like to encourage you—especially if you live in a Republican district—to reach out to your representative and ask her or him to co-sponsor H. Res. 254. This resolution will bolster and strengthen our government's efforts to make sure children everywhere have the nutrition they need to grow and thrive. Please use letters and/or phone calls to reach out to your representatives and ask them to support this important resolution. Share the news with your family and friends that live in Republican districts, too— they may also want to urge their representative to support the fight against global maternal and child malnutrition. Submitting letters to the editor of your local paper will also help get the word out to your community.
As always, we encourage you to check out the resources we have on our webpage that may assist you during this process. And please contact Rev. Nancy Neal, Bread's associate for denominational women's organization relations, Beth Ann Saracco, Bread international policy analyst, or your regional Bread organizer for additional information or assistance. We’d also like to know what you hear back from your representatives —please keep us posted!
Thank you for being a supporter of the 1,000 Days movement!
Amanda Bornfree is a consultant in the church relations department at Bread for the World.
To learn more about WIC , and to watch more informative videos, visit the WIC at 40 website.
Parenthood is wonderful and rewarding, but raising thriving, healthy kids is a big job. Since 1974, WIC has been vital in helping parents give their children a healthy start—this year marks the program's 40th year of strengthening families.
When Chicago resident and WIC advocate Amanda Bornfree lost her health insurance shortly after learning that she was expecting her first child, WIC was a lifeline for her and her family. Her story about how WIC helped her included in the new Circle of Protection "Facts and Faces" project. She says that the program fed her determination to succeed:
When I looked around the WIC clinic, I saw that I was among a community of women that cared for each other. Different generations, complexions, languages, and experiences—all of us present to keep ourselves and our families healthy. We all believed in that, whether we were there to help or to receive help. We all believed that everyone has the right to live a healthy life, and that a healthy life begins during the period from the start of a woman’s pregnancy until her child’s second birthday—the crucial 1,000 days.
WIC, which is funded through the U.S. Department of Agriculture, helped nearly 9 million moms and kids (under age 5) get the nutrition they needed last year. But WIC does more than just provide food vouchers for low-income mothers and their children—the program also provides information on healthy eating, breastfeeding support, and referrals to health care. Families with incomes up to 185 percent of the federal poverty level ($40,409 for a family of four in 2010) can participate.
Bread for the World has campaigned to fully fund and support WIC because we know WIC is a critical tool in the mission to end hunger. Sequestration, the automatic cuts enacted as part of the Budget Control Act of 2011, will continue to erode the effectiveness of the program. The recently-passed 2014 appropriations bill mitigates some of those cuts, and includes $6.7 billion for WIC, which will cover current and projected needs for low-income mothers and children. Bread for the World will monitor future spending bills, and continue to advocate for WIC to receive adequate funding—while pushing Congress to replace sequestration with a balanced approach.
The program's 40th anniversary offers an opportunity to celebrate the dedication of WIC staff, the health of thriving WIC children and their families, and also the efforts of faithful advocates who continue to urge Congress to fully fund this investment in the future of our nation.
During the upheavals over the budget in recent years, Bread for the World and our partners have been successful in maintaining funding for U.S. programs that help hungry and poor people around the world. We have driven a major U.S. initiative focused specifically on hunger, and we have helped to improve the quality of U.S. foreign assistance. Bread will continue to advocate for the protection of programs that provide lifesaving food aid, help thousands of farmers learn increase their yields and incomes, and educate children.
Aid Remains Strong in Tough Budget Climate
During the George W. Bush and early Obama years, U.S. funding for programs that help reduce poverty around the world tripled to $22 billion annually, in part because of the persistent advocacy of Bread for the World members.
This poverty-focused development assistance (PFDA), which accounts for less than one percent of the federal budget, along with increased aid from industrialized nations, has supported rapid economic progress in poor countries.
Despite huge budget pressures, we have managed to protect foreign assistance programs that help poor people.
There was a tragic surge in hunger in 2008, driven by the global financial crisis and soaring prices for rice, wheat, and corn. The incoming Obama administration responded, leading the world in increasing investment in agriculture and nutrition in the most-affected countries. Bread for the World and our members rallied around this initiative, called Feed the Future.
In 2011, more than 4.3 million farmers around the world benefitted from U.S. agricultural development assistance through projects like Feed the Future.
In 2008, major research findings gave the world new knowledge about how to tackle the scourge of child malnutrition. One conclusion was that nutrition assistance should target the 1,000 days from the start of a woman’s pregnancy through her child’s second birthday. Bread for the World Institute played a leadership role in urging U.S. and international officials to incorporate this new knowledge into the global food security program. Secretary of State Hillary Clinton launched the 1,000 Days initiative, and Bread for the World organized a network of U.S. women across Christian denominations — Women of Faith for the 1,000 Days Movement — to support this effort.
Bread for the World Institute convened international meetings on nutrition during Bread’s 2011 and 2013 National Gatherings. At this year's meeting, Dr. Rajiv Shah, administrator of the U.S. Agency for International Development (USAID), told Bread advocates, "You form one of the greatest movements alive today—the fight to make hunger, malnutrition, and extreme poverty permanently a thing of the past."
This year, world leaders committed $4.15 billion over three years to scale up direct nutrition interventions and an additional $19 billion for nutrition-sensitive programs in agriculture and other sectors. Shah is leading a review of nutrition-related programs in the U.S. government in order to use available dollars most effectively.
The number of hungry people in the world has dropped below the pre-2008 level and is continuing to decline—partly because of U.S. leadership in promoting agriculture and nutrition among the poorest countries of the world.
When President Bush decided to increase assistance to poor countries, he set up new institutions within the U.S. governmen t— the Millennium Challenge Corporation and the President’s Emergency Fund for AIDS Relief (PEPFAR). Bread for the World helped secure congressional support, and both of these institutions have been effective.
Still, the entire U.S. foreign assistance system was badly in need of reform. In response to this, Bread helped set up the Modernizing Foreign Assistance Network (MFAN), a foreign assistance reform coalition that has been supported by both the Hewlett and Gates foundations.
In 2009, Bread for the World's Offering of Letters campaign was a push for foreign assistance reform. When the legislation Bread supported passed the Senate Foreign Relations Committee, the Obama administration announced it would work on the issue.
The administration has since improved coordination among the government agencies that work in developing countries, and President Obama issued a directive that established international development policies and priorities for the entire government.
USAID has set up an excellent system of evaluation, and information on the aid projects of U.S. agencies is now available to the public at www.foreignassistance.gov.
"Those of us who push for more dollars for programs of assistance need to work just as hard to make sure those dollars are used well," says Bread for the World President David Beckmann. "Bread for the World's members have been willing to study up on these issues and push for both funding and effectiveness."
Heatherlyn performing at Bread for the World's 2013 National Gathering (Eric Bond).
By Sara Doughton
"I think all of us are artists on some level, because I believe we’re created in the image of the Creator, to co-create this world, each with a different gift that we’re given and unique ways that God wants to manifest love, healing, wholeness, and reconciliation in the world," says singer/songwriter Heatherlyn.
For Heatherlyn, music is more than a job—it’s her calling. It's her way of responding to God’s call to do justice and love mercy in the world. Through "storydwelling" she seeks to honor and amplify individuals and communities relegated to the margins of society.
"We all have a voice, we all have a story, we all have a perspective," she says. "None of us will begin to see the ‘big picture’ without the perspective of others coming from various vantages of personality, geography, economy. Some voices have been marginalized, silenced and dishonored. This is a disgrace to the human race."
When asked to contribute an original song for the Songs for 1,000 Days CD project, a collaboration between Bread for the World Institute and Women of Faith for 1,000 Days, Heatherlyn readily agreed. However, at the time she didn’t immediately notice the connection between her own experiences and the issue of maternal and child nutrition.
"I had a difficult childhood," she says. "I was raised by a single mom, and we were on WIC for awhile. I know there were times in my life when I wasn’t exactly hungry, but our resources were limited…the subsidized, highly processed, non-nutritive foods were a huge part of my younger years. And my mom and I both have suffered a lot of health issues in our lives because of that."
While watching A Place at the Table during the 2013 National Gathering, Heatherlyn heard stories of mothers and children struggling to feed themselves, and increasingly saw how hunger, food insecurity, economic systems, and poverty intersect. She also recognized the importance of multiple levels of support and interventions for her family.
"One of the reasons we weren’t hungry [in terms of lack of food] is because of community," Heatherlyn says. "Our faith community surrounded us. At the same time, it’s significant to note that there were government programs that we needed for awhile, but my mother didn’t seek to stay on them indefinitely. People have that sort of bias about low-income people… I was very aware of socioeconomic prejudice. But it was a both-and for us. We needed [the financial support], and we needed community. And we needed things to get better."
Community continues to play an important role in Heatherlyn’s creative vocation. She looks forward to the unfolding of her story as an artist in connection with Bread for the World.
"I felt like all the people from Bread were incredible, really sincerely warm and an embracing presence," she says. "I felt like I was a part of Bread right away…it seems like the relationship is continuing and growing, and I’m really excited.”
+Sara Doughton, a former intern in Bread for the World's church relations department, is a student at Yale Divinity School.
The anti-hunger community has long known that poverty and obesity go hand in hand. One in eight preschoolers in the United States is obese, and the percentages are higher in black and Hispanic populations. This week, the Centers for Disease Control (CDC) reported modest declines in the obesity rates of low-income preschoolers in 19 states – proof that advocating for better nutrition is bearing fruit. It’s a good start, but the gains could be derailed if current proposals in Congress to take an axe to nutrition programs are passed into law.
The CDC collected data on low-income preschoolers ages 2 to 4; many of the children were enrolled in WIC. In a briefing on the report, CDC director Tom Friedan said that the federal program has improved nutritional standards. The report recommends helping low-income families get affordable and nutritious foods through federal programs like WIC.
However, WIC is one of the programs that has been subject to automatic cuts under sequestration. This past year, WIC has been able to maintain its caseloads with reserve and contingency funds mitigating cuts that could have affected as many as 600,000 women, infants, and children. But back-up funds won’t be available next year. If Congress does not act and replace the sequester with a balanced approach that includes revenue, the program will not have the ability to serve all the mothers and children who need it. More disturbing, appropriations bills in the House would shift cuts affecting defense spending onto programs like WIC and SNAP, reversing positive trends toward reducing both hunger and obesity.
In 2010, Bread for the World and our partners urged Congress to improve nutritional quality in the Healthy, Hunger-Free Kids Act and make it possible to reach more low-income children with nutritious food. In the past two years, Bread for the World members have successfully advocated to create a circle of protection, mitigating cuts to programs like SNAP, WIC, and tax-credits such as the EITC, all of which help hard working low-income families stave off hunger and buy nutritious food.
More progress is needed and more progress is possible. Both quantity and quality of food make a big difference in the health of children. In communities that are considered food deserts, distance to a supermarket may be an insurmountable obstacle to healthy eating. Low-income households with limited resources often need to stretch their food budgets and opt for cheaper, low-density, calorie-rich processed foods in lieu of more expensive fruits and vegetables. Nutrition assistance programs like SNAP and WIC provide these families with healthier options.
Taking into account health, education, and economic productivity, a group of Brandies University economists calculated the cost of poverty in 2011 to be a staggering $167.5 billion. Poverty, complex as it is, affects everyone. Investing in programs now will mean a lot less expense down the road, helping ensure a labor force that is healthy and productive.
Programs like SNAP and WIC help stave off both hunger and obesity, but both programs continue to be at risk of grave cuts. August recess presents an opportunity to get in front of your senators and representative and help influence the decisions they make when they return to Washington in September. Set up in-district meetings with your members of Congress, attend any town hall meetings that they hold, and write letters to the editor about protecting and strengthening SNAP and replacing the sequester with a balanced approach.
What members of Congress hear over the next few weeks will determine the decisions they make this fall.
(Left to right) Amanda Wojcinski, Wynn Horton, Moeun Sun, Aminata Kanu, Rebecca Land, and Robert Mauger, students at Houghton College in upstate New York, navigate Capitol Hill during Lobby Day on June 11, 2013. The students met with their senators and representative and urged them to preserve funding for food assistance in the farm bill. (Eric Bond)
Recently, Rev. Noel Castellanos prayed, “God, when you grip our
hearts we are turned toward our brothers and sisters on the margins of
Rev. Castellanos, chief executive officer of the Christian Community Development Association, offered this invocation as we and our colleagues in the Evangelical Immigration Table gathered for a vigil at the Capitol just before the Senate began voting on the comprehensive immigration bill.
Thanks be to God, our prayers—and your advocacy—worked. The Senate passed its version of the comprehensive immigration reform bill on June 28 with a vote of 68-32. Now we turn to the House of Representatives to see what action it will take. We anticipate a more partisan approach in the House. So we pray that God will grip the hearts of our representatives and bring both parties together to pass immigration reform legislation that will benefit struggling families in our nation.
House Farm Bill Fails
We have another major reason to be thankful to God and to you for your faithful advocacy. On June 21, the House version of the farm bill was voted down, 234-195. Had it become law, it would have meant a $20 billion cut to the Supplemental Nutrition Assistance Program (SNAP, formerly food stamps). More than 47 million Americans depend on this vital food assistance program.
When the current farm bill was authorized in 2008, we won the largest increase ever for food assistance. Since then, the nutrition portion of the farm bill has been targeted for cuts. We are thankful that God has gripped the hearts of our representatives, until now, and stayed those cuts.
As you read this, Congress is be preparing to recess for the summer. This means that your members of Congress will be back in your district. I encourage you to visit or call them, referring to their voting record on amendments to the new farm bill and other food and nutrition bills (see Bread for the World's 2013 Midyear Congressional Scorecard). If they voted in favor of hungry people, thank them. If they did not, still thank them for being your public servants, but express disappointment for the way they voted and remind them that you are counting on them to vote on behalf of hungry and poor people.
International Coalition Pledges to Fund Maternal and Child Nutrition
We are also thankful that God has gripped the hearts of President
Barack Obama and other world leaders to increase investments in maternal
and child nutrition in developing countries hardest hit by
malnutrition. Since we started our work on this issue four years ago,
much progress has been made. Last month, at a high-level event in
London, world leaders pledged $21.9 billion for maternal and child
nutrition programs between now and 2020. The United States pledged $10
billion through fiscal year 2014 toward eliminating malnutrition in the
1,000 days between pregnancy and age 2—and it promised to continue
funding nutrition programs at this level beyond 2014.
On June 10, during Bread for the World’s 2013 National Gathering in Washington, D.C., Bread for the World Institute and Concern Worldwide hosted an international meeting to mark the progress that has been made over the last 1,000 days and to recognize the important role that civil society has played in building the political will to scale up nutrition. The event marked the official launch of the Civil Society Network of the Scaling Up Nutrition (SUN) Movement, which will help coordinate the efforts of the 40 SUN countries.
Dr. Rajiv Shah, administrator of the U.S. Agency for International Development, recognized the role that activists— like the Women of Faith for the 1,000 Days Movement— have played in elevating the voices of poor and hungry people as policy makers set priorities. In addition, Bread for the World and partners hosted a congressional briefing on maternal and child nutrition to raise awareness on Capitol Hill about the critical role of U.S. leadership.
After the briefing, Reps. Debbie Wasserman Schultz (D-Fla.) and Mario Diaz-Balart (R-Fla.) introduced a bipartisan resolution to draw attention to the scourge of malnutrition during the critical 1,000-day window.
This will be a busy autumn and winter for Bread, with important advocacy work around sequestration and other budget issues. We will also be finalizing our plans for the next three years—the first triennial plan within the framework of our long-term vision to end hunger. We will be planning our campaigns for 2014 and launching the 2014 Hunger Report, Ending Hunger in America.
As we enjoy the summer, I give thanks to God for your faithful support and for gripping all our hearts to advocate with those whom Jesus calls “the least among us.”
[This piece originally appeared in Bread for the World’s July-August newsletter.]
Efforts to reduce malnutrition in Rwanda help to thwart the rise of HIV and AIDS, saving the lives of countless infants and young children. (Photo: Bill McCarthy for EGPAF)
By Lior MillerFor the past 10 years, Rwanda has made significant achievements in scaling up its health system to address the HIV/AIDS epidemic and maternal and child mortality. As the Rwanda Country Officer for the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), I have witnessed many of these transformations firsthand. While Rwanda is often cited as a success story for infectious diseases – deaths from tuberculosis, malaria, and HIV/AIDS dropped by 80 percent in the past decade – not enough people know about the remarkable improvements in reducing the country’s high malnutrition rate.
Malnutrition is a state resulting from too little food, inadequate nutrient intake, and frequent infections or disease. It can manifest in a number of ways, but the most common is stunting, which affects 165 million children under the age of ive worldwide. In 2005, more than half of Rwanda’s under-five population was stunted. Just five years later, the stunting rate had dropped to 44 percent. This number is still high, but due to concerted efforts by the national government and its partners, progress is expected to continue.
The first 1,000 days of a child’s development – from pregnancy to 2 years of age – are a critical period for health and survival. Adequate maternal and child nutrition during this period is crucial for both cognitive and physical development. Stunting, in particular, affects brain development and is associated with lower cognitive abilities, poor school performance, and lower earnings throughout the lifetime.
In response to the country’s high malnutrition rate, the Rwandan Ministry of Health developed the National Multi-sectoral Strategy to Eliminate Malnutrition in Rwanda. One of the key strategies outlined was the scale-up of community-based interventions to prevent and manage malnutrition in children under five years of age and in pregnant and lactating mothers. In this intervention, community health workers use behavior change communication to teach women about optimal feeding practices through a package that EGPAF and PATH harmonized with Rwanda’s national plan. The health workers counsel mothers, fathers, and other caregivers to promote social and behavior changes, including improved maternal diet, early initiation of breastfeeding, exclusive breastfeeding for six months, safe water and hygiene, how to care for a sick child, and growing kitchen gardens and learning small animal husbandry for diet diversity.
Counselors also discuss nutrition in the context of HIV, since malnutrition threatens the health of HIV-positive mothers and their children. Malnutrition weakens the immune system and causes faster disease progression. Inadequate food intake can affect adherence to antiretroviral medication and drug effectiveness. Because HIV progresses faster in children than it does in adults, the risks posed by malnutrition make them even more vulnerable to mortality. Moreover, because HIV-positive pregnant women are less likely to gain adequate weight than non-infected women, counseling on maternal nutrition during pregnancy enables them to give birth to normal weight babies, increasing their chances of survival.
Malnutrition has more detrimental effects than hungry bellies, and efforts to reduce stunting rates also improve maternal and child survival, decrease HIV-related mortalities, and increase economic productivity. Rwanda’s success in reducing malnutrition, and eventually eliminating it altogether, is due to a number of factors, including a strong health system with universal health coverage, integrated health services, and an emphasis on vulnerable populations. In addition, the importance of the government’s political and financial commitment cannot be underestimated. With more families being reached at the community level through the concerted efforts of the Government of Rwanda, EGPAF, and other partners, I have no doubt we can achieve the elimination of malnutrition and new HIV infections in children in Rwanda.
To learn more about the Elizabeth Glaser Pediatric AIDS Foundation's work in Rwanda, click here.
Lior Miller is Country Officer for Rwanda for the Elizabeth Glaser Pediatric AIDS Foundation, based in Los Angeles, CA.
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