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Malnutrition

Current portfolio


Project:             Supporting early year’s development: WASH, improved nutrition and hygiene behaviour                                       change for under-5s in rural Malawi.
Partner:             Pump Aid
Total grant:       £268,686
Grant period:    October 2020 - September 2022
Beneficiaries:   21,285 ​
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This project aims to provide under-5s in the Mchinji District of Malawi a chance to reach their full potential by promoting safe environments in which to learn, grow and thrive. Using 15 pre-schools (CBCCs) as an entry point, Pump Aid will engage with local communities to provide sustainable WASH facilities, build capacity to improve feeding, reduce illness and promote stimulating learning environments for young children. Activities will include:

  1. Construction of waterpoints, latrines and handwashing stations in 15 pre-schools.
  2. Operations and maintenance training for members of the pre-school management committees.
  3. Development of income generation plans to cover the cost of maintaining the facilities built as part of this project, but also for resources and improvements to the pre-school.
  4. Training caregivers and frontline health workers on hygiene behaviour and nutrition.
  5. Establishing kitchen gardens at each pre-school and at 6 larger plots. Crops will be used to provide nutritious meals to pre-school students and sold for income generation.
  6. Forming Women’s Task forces who will provide peer-to-peer education on health and nutrition and conduct marketing activities to promote improved water and sanitation technologies.
 
Through this two year project, Pump Aid hope to:

  • Reduce the percentage of Under-5s at the target pre-schools suffering from diarrhoea from 27% to 13%.
  • Improve attendance at the target preschools by 20%.
  • Increase the percentage of target Under-5s washing their hands at critical times from 25% to 75%.
  • Increase the percentage of households in the surrounding communities with access to increased sanitation from 50% to 65%.

Project:             Small Scale Fortification in Tanzania
Partner:             Project Healthy Children - Sanku 
Total grant:       US$767,208                                                                                     
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Grant period:    September 2019 - September 2022
Beneficiaries:   1,300,000
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Beneficiary mills sell fortified flour in pink bags with the official fortification logo. Millers confirm that the eye-catching colour and high quality bags help differentiate their flour from competitors and increases sales
Despite the increasing adoption of large-scale fortification programs throughout the developing world, the majority of individuals living in rural and remote areas do not have access to centrally processed foods. 95% of the Tanzanian population rely on small maize flour mills for 60% of their daily calorie intake. Sanku has developed a one-size-fits-all dosifier machine, currently used to fortify maize with key nutrients in over 200 small-scale Tanzanian flour mills.
 
By bulk buying and then reselling empty flour bags to millers, Sanku is able to generate revenue and thus provide micronutrients to millers for free, thereby offsetting the cost of fortification for millers in a sustainable manner.
 
Through this project, Sanku will expand throughout Northern Tanzania with the aim of:
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  • Providing 200 additional small and medium-scale millers with the necessary tools and training to fortify maize flour.
  • Enabling 1.3 million people to consume fortified maize flour.

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Project:             Canning II - Improving health through WASH, nutrition and healthcare in West Bengal, India  
Partner:
             Terre des hommes                                                                                                
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Total grant:       £313,401
Grant period:    January 2019 - June 2021
Beneficiaries:   46,746 direct beneficiaries

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One of the 250 keyhole gardens that will be constructed as part of this project. Seasonal survey data reveals that keyhole gardens heavily increase the production, diversity and consumption of vegetables. According to Terre des hommes, at baseline, 70% households consumed vegetables that they produced; after two years of keyhole gardening, consumption of vegetables by the households increased to nearly 90%.
34% of rural children under 5 years in West Bengal suffer from stunting, 22% from wasting and 25% of women of reproductive age have a Body Mass Index (BMI) below the recommended cut-off value of 18.5 kg/m2[1]. 
 
For drinking water, the population of the Canning-II Block in the South 24 Parganas district of West Bengal depends on a limited number of shallow tube wells.[2] These tube wells are often poorly located, requiring villagers (mostly women and girls) to walk up to 2 kilometres to reach them. This amounts to an average round trip of 45 - 60 minutes during normal weather conditions. In addition, existing tube wells draw water from the upper aquifer which is generally saline and unfit for consumption. Many of the existing tube wells are constructed without raised platforms to protect them during floods, thus increasing the risk of contamination and often limiting access. Poor access to safe drinking water and sanitation, together with inadequate dietary intake, result in recurrent illnesses, in particular waterborne diseases such as diarrhoea. During the baseline assessment performed at the start of the project, Terre des hommes learned that 27.3% of under 5 children in the target area had suffered from diarrhoea in the previous two week period. 
 
Terre des hommes hope to improve mother and child health in the flood-prone Canning-II Block of West Bengal by enhancing water, sanitation and hygiene (WASH), nutrition and health care practices. Key activities will include (i) supporting the construction of 250 keyhole gardens, (ii) constructing 30 communal tubewells with platforms raised above the maximum flood level and 250 Ecological sanitation toilets; and (iii) improving hygiene and infant feeding practices through Participatory Learning Action
 
Some of the changes that Terre des hommes hope to achieve during the grant period include:
  • Reducing the percentage of U5 children with low weight-for-age from an estimated 35.3% to 24.3%.
  • Reducing the prevalence of diarrhoea among U5 children by 20%.
  • Ensuring that 65% of the population in the target area has access to improved drinking water in all weather conditions (baseline 8.4%)

[1]National Family Health Survey 2015 - 2016
[2]Tdh data collected from Canning II

Completed

Project:             Addressing Children's Needs through Fortified Rice, Gujarat, India
Partner:
             Path
Total grant:       US$ 260,000 (increased to  US$ 355,278)
Grant period:    May 2017 to May 2018 (extension until April 2019)
Beneficiaries:   129,000 school children
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Children enjoying a rice-based meal as part of the government’s mid-day meal scheme. Through this project 129,000 Gujarati school children will be served rice that has been fortified with iron, folic acid, Vitamin A and B complex vitamins. Photograph courtesy of Path
Although Gujarat is one of the richest states in India, according to the National Family Health Survey 2015-2016, more than a third of Gujarati children suffer from chronic malnutrition (39% stunted), and more than one-quarter suffer from acute malnutrition (26% wasted). This project attempted to tackle this issue by serving PATH’s fortified Ultra Rice® in school lunches in Ahmedabad via the government’s midday meal programme.
 
Thanks to this project at least 129,000 children are receiving the benefits of sustained delivery of vital micronutrients such as iron, folic acid, vitamin A, and B complex vitamins.

According to the independent endline evaluation report:

  • the intervention successfully reduced the proportion of anaemic children by 10% from baseline to end-line.
  • the average cognitive score of beneficiary children increased by 20.57% from baseline (49.80%) to end-line (70.37%). A mere 9.31% increase was observed amongst the children in the control district.  
  • children from the intervention district showed a decline in stunting of 3.5 percentage points from the baseline (32.2%) to end-line survey (28.7%). 
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The beneficiary kitchen continues to serve fortified rice, the Government of Gujarat plans to scale up the incorporation of fortified rice in the mid-day meal scheme within Gujarat and the Government of India is exploring its incorporation into other government safety nets.

Project:                Prevention and management of acute malnutrition through an integrated approach of                                           Nutrition and Care Practices in high burden tribal blocks of the Baran District, India
Partner:             Action Against Hunger
Total grant:       £170,779
Grant period:    December 2017 – November 2018
Beneficiaries:   58,922 expected direct beneficiaries (actual 38,538)
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Mother learning how to use a Mid-Upper Arm Circumference (MUAC) tape to track the nutritional status of her child. Through this project, mothers in 110 villages will learn how to use MUAC tapes resulting in early referral and treatment of acute malnutrition. Photograph courtesy of Action Against Hunger.
The Kishanganj and Shahabad blocks of the Baran District, Rajasthan have experienced high rates of severe acute malnutrition-related mortality and morbidity. A survey conducted by Action Against Hunger in the Kishanganj block in June 2014 on children between 6 and 59 months revealed an overall prevalence of global acute malnutrition of 33.7% and severe acute malnutrition of 7.6%.  
 
This project attempted to tackle acute malnutrition by improving knowledge and understanding within the community through an assisting behavioural change strategy and by strengthening the mechanisms for timely identification, treatment and monitoring of children with severe acute malnutrition.
 
Following the start of implementation, Action Against Hunger realised that levels of malnutrition in the target area were significantly lower than expected (e.g. during the project year 1,901 children were treated for severe or moderate acute malnutrition - against an expected caseload of 13,100 children). Action Against Hunger believe that their previous and ongoing work in the target area has contributed to this impressive fall in malnutrition levels. 
 
During this one-year period, Action Against Hunger:
  • Increased the percentage of households with knowledge on nutrition, Infant and Young Child Feeding (IYCF) and Water, Sanitation and Hygiene (WASH) practices for under-five children from 0 to 44% (target 30%).
  • Increased the percentage of government health workers conducting regular screening for severe and moderate acute malnutrition from 10 to 73% (target: 60%).
  • Increased the percentage of government service providers with increased knowledge on nutrition IYCF & WASH practices from 0 to 80% (target: 75%).

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Project:             Improving access to essential vitamins and minerals in foods in Tanzania through
                          national-level capacity building

Partner:
            The Global Alliance for Improved Nutrition (GAIN)
Total grant:       £248,141
Grant period:    August 2016 – January 2018
Beneficiaries:   19 million Tanzanians who eat fortified food

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Inspector using a Bioanalyst icheck to test whether edible oil has been fortified correctly. Icheck tests are quick and inexpensive compared to the laboratory equipment used by government inspectors prior to this project. Through this project, the government food inspection bodies received ichecks with reagents and 41 industry representatives and government inspectors were taught how to use ichecks by a Bioanalyst trainer. Photograph courtesy of GAIN
Tanzania suffers from high rates of micronutrient malnutrition with one third of children deficient in iron and/or vitamin A (as per Micronutrients: Results of the 2010 Tanzania Demographic Health Survey). One of the most cost-effective solutions for improving intakes of essential vitamin and minerals is the fortification of staple foods and condiments. Tanzania has a mandatory wheat and maize flour fortification programme. However, low capacity to produce and monitor these foods is limiting the programme from benefiting vulnerable populations to its full potential. This project aimed to strengthen Tanzania’s food quality monitoring and processing capacity thus improving access to adequately fortified foods.
 
Activities included:

  • Arranging 5 National Food Fortification Alliance meetings, bringing together key stakeholders to discuss progress on fortification projects, regulations and other important issues.
  • Relaunching the fortification Management Information System (MIS) and providing MIS training to government and industry representatives. By the end of the grant period, 16 industries were inputting data into the MIS on a monthly basis, with 8 doing so for at least 6 months.
  • Providing refresher training to 5 food analysts and 20 inspectors to increase their capacity to perform field inspections.
  • Encouraging industries to procure premix from a list of quality assured suppliers. By the end of the grant period, 12 industries were sourcing premix from certified sources.
  • Training government inspectors and representatives of 26 industries on quality assurance procedures for micronutrient fortification resulting in a significant improvement in the quality control and quality assurance systems at inspected factories (as per the Tanzania Food and Drug Authority Second Inspection report).
 
As a result: 

   1.  The Tanzania Food and Drug Authority (TFDA) performed 3 food fortification inspections during the grant period. ​
   
2.  74% of wheat flour samples tested as part of the final inspection complied with food fortification standards (baseline 49%).
   3.  Over 19 million Tanzanians are consuming oil and 18 million wheat fortified in accordance with national fortification standards  
        (baseline: 9.5 million consuming adequately fortified oil and 11.9 million consuming adequately fortified wheat).
James Percy Foundation
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