Nirmal Choradia, Kruti Gandhi, Khushboo Jhala, Jennifer Jones, Katie Smyrski

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DEtermination to reach a goal…

to DEEPEN the lives of others

With one DEvelopment in mind…

DE

Development and Education

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Development and Education for Evolving Processes in Energy and Nutrition

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Development and Education for Evolving Processes in Education and Nutrition

2 Components:

1.) Developing a local sustainable form of nutritional self-sustenance for SAM individuals

2.) Educating the community about how to live healthy, nutritional lifestyles

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1.) There are two corresponding phases in the first developmental component:

Identifying cases of Sever Acute Malnutrition in children and providing an instant source of nutrition through RUTFs

Equipping the community to begin a local RUTFs production facility with primitive tools

2.) There are 3 main topics addressed in the second educational component:

Home gardening Hygiene and sanitation Maternal and child health

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A pilot study carried out in the zone of Bale in the region of Oromiya based in the city of Robe but directed towards a nearby village

Why we chose Bale: Based on agriculture and already

implemented irrigation systems, it is compliant with the infrastructure needed to carry out our plan making it feasible to build upon 2

High prevalence of SAM cases 2

o Upon evaluation of this pilot study, we hope to expand this to villages throughout the region

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•Lack of education is a serious predicament resulting in malnourishment because many are illiterate and unknowledgeable about nutrition, family planning, breast-feeding and parenting

•Stat: In a specific study done on elementary school education, incorporation of a nutritional education system decreased the malnourishment rate from 36% to 29%6

•Feasibility

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• RUTF – Ready to Use Therapeutic Foods

•Stat: A six-week treatment of RUTF is generally enough to carry a child back to healthy development.  A study has shown that 95% of malnourished children on this type of treatment recover in 6 to 8 weeks.  One study has shown that RUTF is an improvement to milk based formulas9

•Malawi, Bangladesh7

 

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Project Coordinators will first teach the local head community members the background of SAM and how to identify cases.

Once trained, community members will collect baseline data on SAM cases and post-intervention data on SAM cases

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The Project Coordinators will then begin to teach them the background and process of making RUTFs using local, sustainable materials

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WHO: a very low weight for height (below -3z scores of

the median WHO growth standards), by visible severe wasting, or by the presence of nutritional edema5

Target Audience: Children under age 5 showing these symptoms

Tape measure and scale provided by the program 

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What the program provides:A production facilityContainers and churnersoil pressCMV (vitamin) tabletsBee harvesting facilityGoatsSeedsSolvatten*don’t be alarmed, yes, we did think about

the cost-analysis. (shown later).

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Common Formulation10

Milk PowderSugarVegetable OilVitamin/MineralsPeanut Butter

New Formulation10

Goat MilkHoneySafflower OilVitamins/MineralsPeanut Butter

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Solar-powered water filtration

Up to 10 gallons of purified water every 4 hours

Cheap - $35 per system

Lasts for up to 5 years11

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What is provided by NGO partnerships:

MERLIN: Project Coordinators Language, established with Ethiopian

governmentHeifer: goatsPeace Corps: Bee harvesting techniquesNutriset: Vitamin and mineral supplementsHelen Keller Institute: SeedsThe Hunger Project: health and nutrition

basis for women

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Cultural issues:Bale is a predominantly Muslim and Christian

regionWe did not find any religious or ethical

conflicts with the process of this programThe food could be incorporated with local tribe

food such as porridge to alleviate possible bad taste8

Legal/ethical issues:By working through the already established

NGOs, legal issues of imposing on territory without permission would be circumvented

All the patents on RUTF production have either been nullified or expired

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To prevent excessive unsanitary practices within the RUTF production process, a separate facility aside from the actual village residences will be built

Some individuals have disliked the taste of the nutritional paste. A common practice to circumvent this problem is mixing it with a local food –porridge, which has shown to work

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It is a sustainable program in which even after the 1 million dollars is gone, the program can still retain its infrastructure and process within the villageRegeneration of food – fuels the internal

economy

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STRENGTHS WEAKNESSES

•Cost-effective compared to in-patient treatment •Time constraint (wait for crops to grow)

•Community involvement: self-efficacy •Cultural values: women tend to be shy

•High rate of women’s participation during program formulation

•Technology (Oil Press) very laborious to operate, design not appropriate for women

•Multi-dimensional approach

SWOT AnalysisD.E.E.P.E.N.

(Development & Education for Evolving Processes in Energy & Nutrition)

OPPORTUNITIES THREATS

•Improve delivery turnaround (nutrition) •Limited funds

•Conduct a baseline study •Non-compliance

•Ministry of Agriculture, Food, and Fisheries gender focal point to provide support

•Program affected by displacement of people/livestock due to droughts/floods

•Educational advancements •Program affected by HIV/AIDS/diseases

•Job opportunities

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Home Base Cost:2 Project Managers – $80,000Electronics and Office Space – $9,000Transportation – $19,000

Cost Per Village:RUTF Starter Ingredients – $4140Clean water – $2,100Production facility – $16,000Other – $2,000

Total: $132,240 for 1 village

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Home Base Cost:2 Project Managers – $80,000 per yearElectronics and Office Space – $7,000Transportation – $4,000

Cost for VillageCMV - $150

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I am powerful

resilient

I am determined

I am Imaginative

Beautiful

ambitious

I am.

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1.Photo http://images.google.com/imgres?imgurl=http://www.runforwater.ca/images/media/Ethiopia_children2_Mark_Chow.jpg&imgrefurl=http://www.runforwater.ca/Media/PhotoDownloads.html&usg=__bd-zzHbp7UDFg4v4S7M_-WC7zGk=&h=2056&w=3090&sz=2905&hl=en&start=18&um=1&itbs=1&tbnid=VtucGRIsvilnxM:&tbnh=100&tbnw=150&prev=/images%3Fq%3DEthiopia%2Bchildren%26um%3D1%26hl%3Den%26rlz%3D1C1CHNG_enUS351US351%26gbv%3D2%26tbs%3Disch:1

2. Bale informationhttp://www.ocha-eth.org/Reports/downloadable/GoroBaleSNNPRFinalConcernFeb06.pdf

3. Photo 2http://andybraner.typepad.com/.a/6a00e54ed0df52883301157249b4b9970b-800wi

4. Photo 3http://www.runfororomia.com/images/oromia2.gif

5. Case definition of SAMhttp://whqlibdoc.who.int/hq/1999/a57361.pdf

6. Nutritional fact education workshttp://www.jstor.org/stable/994185?seq=7

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7. BangladeshHossain et. Al. Experience in Managing Severe Malnutrition in a Government Tertiary Treatment Facility in Bangladesh. J Health Pop Nature. Feb 2009. 8. Porridgehttp://www.compactforlife.com/bp-100-rutf-how-to-use/ 9. RUTF workshttp://www.worlded.org/WEIInternet/gwe/index.cfm  10. RUTF formulationhttp://fex.ennonline.net/102/4-3-2.aspx 11. Waterhttp://www.solvation.se/

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NCHS/WHO normalized reference values for weight-for-height and weight-for-length

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• Vitamin A Supplementation program- design, implement and monitor programs that deliver vitamin A to young children and to new mothers. Also promote consumption of Vitamin A enriched foods.

• Homestead Food Production- increasing local food production systems by creating gardens and poultry and livestock farms. Provides support as well as start-up supplies.

• Food Fortification and Biofortification- developing packets to distrubute to families to add supplements to foods being prepared in the home. Also working on fortifying the plants that are being grown.

• Managing Acute Malnutrition- uses existing community structures and trains community to identify cases of SAM. Uses inpatient for severe cases, and outpatient such as RUTFs.

• Essential Nutrition Actions- breastfeeding promotion, prenatal nutrition, iodine use, edema control, etc.

• http://www.hki.org/reducing-malnutrition/

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• Nutrition Surveillance and Data Collection

• Pilot program initiated in two villages in Sudan in 1992. Aimed at training local community members how to do nutrition surveillance and socioeconomic analysis of women and children. Taught individuals how to collect basic anthropometrics, food consumption data, market conditions, and changes in family norms. Collected data every three months.

• Results of this Pilot Program: Had succeeding in their main objectives. Showed that community-based nutrition surveillance was cost effective. Involving the community ensured sustainability.

• We should implement a training program similar to this one in Sudan. Train local people to do the data collection. Had outside data analyst to help with nutrition surveillance and analysis. This will help us monitor and evaluate the effectiveness of our program.

• http://www.emro.who.int/Publications/EMHJ/0202/07.htm

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Merlin: international organization that focuses on improving health care systems in impoverished nations. Partnered with the Ethiopian Government to help improve the nutrition of the country. Includes water collection and sanitation, nutritional education and health promotion. Merlin established a nutrition program in the Bale region in Oromiya to

combat the problem of severe malnutrition. http://www.merlin.org.uk/Where-we-work/Ethiopia.aspx

Heifer International: helps fight world hunger through community involvement. Provides livestock to families that can not regularly afford such luxuries. Offices in the near-by countries of Rwanda and Tanzania http://www.heifer.org

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Peace Corps: developed to help lesser developed countries educate their people. Volunteers are trained with a specific skill, then go into a country and teach their skill to the local people. Past project in Malawi included teaching local how to properly harvest

beehive for the production of honey Peace Corps currently have a HIV/AIDS education projects located in

Ethiopia http://www.peacecorps.gov/index.cfm?

shell=learn.whatvol.env.sampleprojects

Nutriset: focus is on providing developing countries with vitamins and nutrients that they lack Collaborates with such organizations at PlumpyField and Edesia Provides vitamins and minerals to help establish RUTF production

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