Joint efforts in battling malnutrition

In Nepal’s far-west, a mother breathes with relief after her little girl regains her health following treatment for acute malnutrition, thanks to the dedication of local healthworkers and community volunteers

Niru Bohara
25 July 2022
Dipika and Sita Bist
UNICEF Nepal/2022

Dhangadhi, Nepal: Sita Bist recalls the deep worry that had settled on her when she learned that her newborn baby girl, Dipika, weighed just 1.5 kilograms at birth.

Sita, a local of the Dhangadhi Sub-Metropolitan City in Kailali District in far-western Nepal, had herself not gained much weight during her pregnancy. “My family and I had been worried that this would mean the baby would be underweight too, and when she was born, it was like that fear came true,” she says.

Even as Sita hoped that it was just a matter of time, Dipika –now well over two years of age – was still not putting on weight as expected. Desperate for a solution, the young mother had initially consulted traditional healers or Dhamis in her community. Fortunately, before she could fully give over to their advice or other superstitious beliefs, she came into contact with Ratna, a female community health volunteer.

Sita had met Ratna at one of the local mothers’ group meetings, a regular gathering of women in the area usually guided by female community health volunteers to discuss maternal and child health and nutrition, among other issues. Learning of Sita’s problems, Ratna had offered to conduct a Mid-Upper Arm Circumference (MUAC) test on her child using a MUAC tape.

UNICEF Nepal/2022
Female community health volunteer, Ratna, measures Dipika's arm

When Dipika’s arm was measured, the tape showed that she was at “yellow”, an indication of moderate acute malnutrition. Ratna explained to Sita what this meant and suggested a visit to the nearby outpatient therapeutic care (OTC) center. Sita, however, was reluctant to go.

“I didn’t think it would work,” she says. “And besides, I didn’t want to go anywhere until I had discussed the matter with my husband.”

Sensing the urgency of the situation, Ratna sought the support of the Nutrition Officer, who organized a home visit together with their team. Sita was stubborn in her decision at first, but over several visits during which the team counselled her and her family about the need for immediate treatment, and the probable consequences of delay.

Eventually, understanding dawned on Sita and her husband, especially after a second MUAC test showed that Dipika’s condition had deteriorated to “red” or severe acute malnutrition. The parents agreed to take the child to the Nutrition Rehabilitation Home at the Seti Provincial Hospital in Dhangadhi.

UNICEF Nepal/2022
Dipika results green in MUAC tape measurement

Following treatment – including being fed ready-to-use therapeutic food and put on a balanced diet – Dipika was doing much better. Indeed, within a month of staying at the NRH, Dipika had gained two kilos, and was looking far livelier and healthier than ever: a source of joy and relief for her parents.

“I’m glad we brought her to the facility,” Sita says, after they were discharged. “And I’m grateful to everyone who convinced us that this was the right thing to do.”

 Since 2013, UNICEF, through generous funding from the European Union, has been supporting the Government of Nepal in implementing the Multi-Sector Nutrition Plan, to promote healthy, nutritious, and diversified diets for adolescents, pregnant women, breastfeeding mothers, infants, and young children. This includes supporting the important work of FCHVs, nutrition officers and others mobilized on the ground to identify and treat cases of malnutrition.