Group 5


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Group 5

  1. 1. Nirmal Choradia, Kruti Gandhi, Khushboo Jhala, Jennifer Jones, Katie Smyrski 1
  2. 2. DEtermination to reach a goal… Development and Education With one DEvelopment in mind… to DE DEEPEN the lives of others 2
  3. 3. Development and Education for Evolving Processes in Energy and Nutrition 3
  4. 4. 4
  5. 5.  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 5
  6. 6. 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 tools2.) There are 3 main topics addressed in the second educational component:  Home gardening  Hygiene and sanitation  Maternal and child health 6
  7. 7. A pilot study carried out in the zone ofBale in the region of Oromiya based inthe city of Robe but directed towards anearby villageWhy 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 2o Upon evaluation of this pilot study, we hope to expand this to villages throughout the region 7
  8. 8. •Lack of education is a seriouspredicament resulting inmalnourishment because many areilliterate and unknowledgeable aboutnutrition, family planning, breast-feeding and parenting•Stat:In a specific study done onelementary school education,incorporation of a nutritionaleducation system decreased themalnourishment rate from 36% to29%6•Feasibility 8
  9. 9. •RUTF – Ready to Use TherapeuticFoods•Stat: A six-week treatment ofRUTF is generally enough to carrya child back to healthydevelopment. A study has shownthat 95% of malnourished childrenon this type of treatment recoverin 6 to 8 weeks. One study hasshown that RUTF is animprovement to milk basedformulas9•Malawi, Bangladesh7 9
  10. 10.  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 10
  11. 11. The ProjectCoordinators willthen begin to teachthem the backgroundand process ofmaking RUTFs usinglocal, sustainablematerials 11
  12. 12.  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 12
  13. 13.  What the program provides:  A production facility  Containers and churners  oil press  CMV (vitamin) tablets  Bee harvesting facility  Goats  Seeds  Solvatten *don’t be alarmed, yes, we did think about the cost-analysis. (shown later). 13
  14. 14. Common New Formulation10 Formulation10 Goat MilkMilk Powder HoneySugar Safflower OilVegetable Oil Vitamins/MineralsVitamin/Minerals Peanut ButterPeanut Butter 14
  15. 15.  Solar-powered water filtration Up to 10 gallons of purified water every 4 hours Cheap - $35 per system Lasts for up to 5 years11 15
  16. 16.  What is provided by NGO partnerships:  MERLIN: Project Coordinators  Language, established with Ethiopian government  Heifer: goats  Peace Corps: Bee harvesting techniques  Nutriset: Vitamin and mineral supplements  Helen Keller Institute: Seeds  The Hunger Project: health and nutrition basis for women 16
  17. 17.  Cultural issues:  Bale is a predominantly Muslim and Christian region  We did not find any religious or ethical conflicts with the process of this program  The 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 17
  18. 18.  Toprevent 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 18
  19. 19.  Itis a sustainable program in which even after the 1 million dollars is gone, the program can still retain its infrastructure and process within the village  Regeneration of food – fuels the internal economy 19
  20. 20. SWOT Analysis D.E.E.P.E.N.(Development & Education for Evolving Processes in Energy & Nutrition) STRENGTHS WEAKNESSES•Cost-effective compared to in-patient •Time constraint (wait for crops to grow)treatment•Community involvement: self-efficacy •Cultural values: women tend to be shy•High rate of women’s participation during •Technology (Oil Press) very laborious toprogram formulation operate, design not appropriate for women•Multi-dimensional approach OPPORTUNITIES THREATS•Improve delivery turnaround (nutrition) •Limited funds•Conduct a baseline study •Non-compliance•Ministry of Agriculture, Food, and Fisheries •Program affected by displacement ofgender focal point to provide support people/livestock due to droughts/floods•Educational advancements •Program affected by HIV/AIDS/diseases•Job opportunities 20
  21. 21.  Home Base Cost:  2 Project Managers – $80,000  Electronics and Office Space – $9,000  Transportation – $19,000 Cost Per Village:  RUTF Starter Ingredients – $4140  Clean water – $2,100  Production facility – $16,000  Other – $2,000 Total: $132,240 for 1 village 21
  22. 22.  Home Base Cost:  2 Project Managers – $80,000 per year  Electronics and Office Space – $7,000  Transportation – $4,000 Cost for Village  CMV - $150 22
  23. 23. I am ambitious powerful I am determined I am. BeautifulresilientI am Imaginative 23
  24. 24. 1.Photo Bale information Photo 2 Photo 3 Case definition of SAM Nutritional fact education works 24
  25. 25. 7. BangladeshHossain et. Al. Experience in Managing Severe Malnutrition in aGovernment Tertiary Treatment Facility in Bangladesh. J Health PopNature. Feb 2009.8. Porridge RUTF works RUTF formulation Water 25
  26. 26. 26
  27. 27. NCHS/WHO normalized reference values for weight-for-height and weight-for-length 27
  28. 28. • 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.• 28
  29. 29. • 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.• 29
  30. 30.  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.  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  30
  31. 31.  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  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 31