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Micronutrient supplementation brings new hope for children in Nepal

By Ashma Shrestha Basnet and Pragya Mathema

PALPA DISTRICT, Nepal, 15 September 2010 – Leela Rana has been volunteering as a Female Community Health Volunteer for the past five years.  In this role she provides counselling and basic health and nutrition services to members of her community.

VIDEO: UNICEF's Ashma Shrestha Basnet reports on efforts to improve infant and young child feeding in Nepal.  Watch in RealPlayer


These days, Ms. Rana is busy disseminating information on Infant and Young Child Feeding (IYCF) practices and distributing Multiple Micronutrient Powder, known locally as ‘Baal Vita,’ to children from the age of six months to two years old.

Tackling malnutrition

In Nepal, about one out of every two children under the age of five suffers from chronic malnutrition, which often results in stunting. Furthermore, a large percentage of children below two years of age suffer from anaemia. In a country with an estimated per capita annual income of only about $400, access to micronutrient-rich foods on a regular basis is a distant reality for most families.

Along with these economic hindrances, lack of proper education on the importance of energy-dense complementary feeding and other care practices – including good hygiene in the community – is contributing to the country’s high levels of under-nutrition.

© UNICEF Nepal/2010/SuShrestha
Leela Rana, a Female Community Health Volunteer, holds her five-month old daughter in Nepal's Palpa district.

“After attending the IYCF and Baal Vita training, I now know that 80 per cent of the brain develops within the first two years of life,” said Ms. Rana. “When I became a mother for the first time, nine years ago, I was not even aware that infants should be exclusively breastfed for six months.”

Ms. Rana recalls feeding only rice and lentils to her daughter for her first year, without realizing how essential diverse and energy-dense food was to her overall development.

“I will now be giving my six-month old daughter the first round of Baal Vita along with high-energy food,” she said. “Although I missed the opportunity for my first child, this time I will ensure that she gets a chance to develop fully, both physically and mentally.”

‘Baal Vita’ fills gaps

Today, Ms. Rana is a strong advocate of proper nutrition and care for children. She has been promoting Baal Vita along with IYCF practices among mothers and care-givers in her community. She organizes mothers’ group meetings every month where she highlights the importance of micronutrient supplements, breastfeeding, improving the quality of complementary feeding, and the importance of hygiene and child stimulation for the holistic development of children.

© UNICEF Nepal/2010/SuShrestha
Leela Rana (left) and a fellow Female Community Health Volunteer talk to a mother's group in Palpa district, Nepal.

“Baal Vita has helped increase the appetite of my granddaughter and she has become much more active now,” said Narayan Devi Gyawali, who has been feeding Baal Vita to her 18-month-old granddaughter for the past month.

In Palpa district, local authorities in the villages and others, such as youth clubs, have been supporting the Female Community Health Volunteers to promote Baal Vita in their communities. In Pipaldanda village, the local governing body distributed a bowl and spoon to every mother with the Baal Vita sachets.

“This small initiative among us will motivate the community to make optimum use of it,” said Bhakta Jung Rana, the Village Secretary.  He pointed out that this was the first time the village had ever provided support to any nutrition programmes.

The project, which is now supported by local communities across Nepal, is a major push to help the country achieve the United Nations Millennium Development Goals targets related to ending poverty and improving child health by the year 2015.

Government scale-up

To improve the national nutrition status, the Government of Nepal, with support from UNICEF, is piloting integrated community promotion of IYCF and Multiple Micronutrient Powder distribution in six districts of Nepal. The project is also being supported by the non-governmental International Zinc Association, the European Commission, USAID, AusAID, the World Bank, the Centres for Disease Control (Atlanta) and UNICEF committees in the United Kingdom and the Netherlands.

© UNICEF Nepal/2010/SuShrestha
A Female Community Health Volunteer counsels a mother on improved child feeding practices in Palpa district, Nepal.

“Based on lessons learned, a national programme will be designed and rolled out in all 75 districts of the nation,” said Director General of the Department of Health Services. Dr. Yashovardhan Pradhan.

Dr. Chet Raj Pant, who heads the social sector in the National Planning Commission, after interacting with mothers in the field, said he was happy to see that mothers have really noticed a difference in their children after giving them Baal Vita. “This, quite simply, will bring a brighter future to Nepal,” he said.



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