Innovating Against Hunger: CHMI Database Explores Nutrition

Every year, poor nutrition contributes to nearly half (45 percent) of the deaths in children under five, which is approximately 3.1 million children each year[i].

The Center for Health Market Innovations contains 45 programs in its database that have identified nutrition as a health focus. Twenty-one of these programs weave nutrition into maternal, newborn, child health programs (MNCH), 11 programs include nutrition in its larger focus of primary care, and 9 programs integrate it with HIV/AIDS. Popular models used by these programs for improving nutrition include training community health workers or the public on healthy nutrition, distribution of nutrition products, and the use of ICT to capture and monitor patients’ nutritional statuses.

Training on nutrition services:

 

According to the database, 10 programs offer counseling to community health workers and 11 offer counseling to community residents on nutrition.

Training for General Public

Busog Kalaaman, Lusog ng Katawan, aims to advance the nutritional status of children under five in Barangay, Philippines. Barangay Nutrition Workers (BNWs) in each health center identify groups for nutrition lessons, and invite nutritionists to conduct education sessions on diet counseling for members of the hypertensive and diabetic communities, as well as breastfeeding for pregnant and lactating women, and nutrition lessons for children in daycare.  The BNWs also provide general lessons on proper nutrition to families.

Training for Community Health Workers

The Initiative to End Child Malnutrition (IECM) aims to reduce child morbidity and mortality in Uganda by training community health workers to identify and refer malnourished children for treatment at the region health center. The IECM also provides nutrition education to physicians and nurses on diagnosis and treatment of malnutrition.  Building on this experience the IECM has developed a national nursing school curriculum on child malnutrition, where nursing students receive hands-on and classroom education in neighboring nursery and midwifery schools. During the summer of 2010 and winter of 2011, volunteer students of the initiative trained 9 community health center staff on child malnutrition topics; and conducted malnutrition education trainings for 80 local Ugandan nursing students.

Mobile clinics as a means to reach vulnerable populations:

 

Indonesia’s Prosmiling Terpadu operates a number of mobile clinics, which deliver nutrition services as part of a larger primary care package, including monitoring the growth and nutritional status of toddlers.  Low-income families in targeted areas are identified by local stakeholders and receive vouchers for free medicines and nutritious foods.

HIV/AIDS Project – Anderson Clinic operates a number of mobile clinics in Uganda that visit villages, government farms, and schools to teach HIV/AIDS patients about suitable diets for a weakened immune system. These clinics also provide patients with a small garden where they can grow healthy fruits and vegetables. The program treats over 30,000 patients a year.

Distributing nutrition products door to door:

 

Two programs in the database are using an avon-like model of door to door sales for nutrition products to improve supply chain distribution. One example is SWAP of Kenya. SWAP’s community health workers sell a number of health and hygiene products such as Sprinkles salt, a blend of micronutrients in powder form that can be sprinkled onto home-cooked foods to fortify them.

M-Health and e-Health enable programs to monitor patients’ nutritional data more efficiently:

 

Six programs use mobile or electronic health technology to capture and monitor patients’ nutritional statuses.  For example, Totohealth, a Kenya-based social enterprise, uses an SMS-based platform to allow parents and caregivers to monitor their child’s physical development. Using TotoHealth’s set of abnormality indicators, the platform has the ability to monitor these indicators against milestones, which helps with the timely detection of abnormal growth in children below 5 years of age or during pregnancy. The platform also provides automated nutritional advice to parents of children under 5, who are then asked to reply to these text messages with any questions they might have for Totohealth’s helpdesk. To ensure that the marginalized are covered, the platform adjusts itself to the local language the parent or guardian understands. 

Questions Left Unanswered:

 

The CHMI team was surprised to find no programs that focused on the emerging epidemic of obesity in low and middle income countries, though this does represent a relatively new problem and the database is not comprehensive.  A second major question the CHMI team wished to explore, but for which little information could be found was what number of people pay out-of-pocket for nutrition services from the private sector. CHMI will continue to track nutrition programs in LMICs with the goal of understanding these and other questions in the nutrition sector.

For more information on CHMI profiled programs that focus on nutrition email Ankita Panda at apanda@r4d.org.

 

[i] “Hunger Statistics – Fighting Hunger Worldwide.” United Nations World Food Programme. 2015. Web.