Nutritional Support for HIV-exposed infants and children
Our idea will prevent HIV transmission and malnutrition in HIV-exposed children by providing families with formula alternatives to breast milk. Because of their continued vulnerability to malnutrition, we will provide fortified sosoma as babies wean from formula and until they are two years of age.
About You
Section 1: About You
First Name
Wendy
Last Name
Leonard
Organization
The Ihangane Project
Country
Rwanda
Section 2: About Your Organization
Organization Name
The Ihangane Project
Organization Website
Organization Phone
831-688-2030
Organization Address
206 Santa Clara Avenue Aptos CA 95003
Is your organization a
Non‐profit/NGO/citizen sector organization
Organization Country
United States
Your idea
Name Your Project
Nutritional Support for HIV-exposed infants and children
Country your work focuses on
Rwanda
Describe Your Idea
Our idea will prevent HIV transmission and malnutrition in HIV-exposed children by providing families with formula alternatives to breast milk. Because of their continued vulnerability to malnutrition, we will provide fortified sosoma as babies wean from formula and until they are two years of age.
Website URL
Innovation
What makes your idea unique?
The key to sustainability is often a combination of community engagement, utilization of existing infrastructure and financial security. Our idea is unique because these important features are woven into the fiber of the project. We have been consulting with Partners in Health, Project Healthy Children and Treatment & Research AIDS Center (TRAC) in Rwanda to design a program that provides the successful results of model hospitals such as PIH’s Rwinkwavu Hospital in a way that is sustainable and realistic given the financial constraints of many rural Rwandan hospitals. To address sustainability, we will help community nutrition workers develop a means of locally producing fortified sosoma to provide income for themselves and to provide low cost nutritional supplements for their community.
The medical staff at Ruli District Hospital initially noted that many poor families are not able to follow the recommendation of abrupt breastfeeding cessation for HIV-exposed infants at 6 months of age due to lack of access to formula alternatives. Our project has been implemented within the existing infrastructure of Ruli Health Center’s Prevention of Mother to Child Transmission (PMTCT) program. The women whose families will benefit from this program are involved in the development process, and their needs and cultural beliefs will be incorporated into the final product. Sustainability is addressed through a series of income-generating opportunities that directly support the nutrition program and the communities it targets. Our goal is to create a program that is sustainable despite the financial limitations of typical rural communities in Rwanda.
Do you have a patent for this idea?
Impact
This Entry is about (Issues)
What impact have you had?
Our unique approach of engaging the target community in the development process has earned The Ihangane Project the respect and trust of the medical staff and patients alike. The staff of the PMTCT program at Ruli Health Center have been successful at educating all HIV+ women on the importance of abrupt breastfeeding cessation when their infants are six months of age. The women involved in our pilot project are receiving education regarding the safe preparation of formula so that they are prepared when their child is six months of age. The foundation of this project is in place, and will be initiated when the first child in our group is six months old.
Problem
In Developing Countries, the World Health Organization recommends that HIV-infected mothers should breast feed their newborn babies for the first 6 months of life. Although HIV is transmitted through breast milk, these newborns are at high risk of mortality due to severe malnutrition and diarrhea if they are formula-fed. The WHO recommends that these women discontinue breastfeeding abruptly at 6 months of age to minimize HIV transmission. Unfortunately, this is very difficult for poor families who do not have any other means of feeding their child. This program will provide formula to HIV-exposed infants from 6 months to 12 months of life. It will include education regarding the safe preparation and storage of formula, as well as education regarding avoidance of mixed breast and formula feeding. Once this project has been implemented and risks for diarrhea in the local community have been identified and addressed, it will be extended to include all HIV-exposed infants beginning at the time of birth. This is to address the 7% risk of HIV transmission that exists for those infants who breast feed from zero to 6 months of age.
Actions
We will begin a pilot project with 7 women who participated in our first project interviews. These women are currently pregnant or have 1-2 month old infants, and will eventually be trained as peer educators. Our idea is to provide them with formula alternatives when their children are 6 months of age. The program will extend until the child is two years of age, and will eventually include newborns. Although our initial project will include water purification through boiling, we will eventually introduce an environmentally appropriate alternative for clean water that minimizes the use of fuel or wood. Once the child is 9 months of age, we will provide fortified sosoma as a nutritional supplement as he or she is gradually weaned from formula. We will continue to provide sosoma until the child is 2 years of age. Each family would also receive a household nutrition consultation that would include evaluation for malnutrition risk factors and education regarding kitchen gardens.
Results
Because of the extensive evaluation of malnutrition that is routinely performed in Ruli, we will be able to clearly identify and follow indicators of success. We will evaluate for the incidence of acute and chronic malnutrition in HIV-exposed children, the incidence of new HIV diagnoses amongst HIV-exposed infants, and the incidence of diarrhea. The new sosoma factory will serve the entire community rather than focus solely on our HIV-exposed target population. We will evaluate for the cost-effectiveness of local production, the number of families served, and the overall impact on malnutrition in this community.
What will it take for your project to be successful over the next three years? Please address each year separately, if possible.
For the next year, The Ihangane Project and the PMTCT program at Ruli Health Center will work intensively with the women in our pilot project to help them be successful and to learn how to improve upon our initial project. This will include assessments to improve our ability to minimize the incidence of morbidity such as diarrhea with formula feeding. During the same year, we will work with Community Nutrition Workers to develop a fortified sosoma production venture that will provide income generation and sustainable access to fortified sosoma. In the second year of the program, we will open the program to all HIV-exposed children from the time of birth.To improve our likelihood of success, we hope to work with government agencies and other NGOs such as Partners in Health to negotiate with East African suppliers of baby formula to obtain formula at bulk prices. By the third year of existence, we anticipate that our program will extend to all HIV-exposed children and will be self-sustaining. Throughout this project, we hope to incorporate household nutritional assessments and recommendations to help families improve their ability to provide ongoing nutritious food to themselves and their children.
What would prevent your project from being a success?
Currently, baby formula is so cost-prohibitive that it is not even carried in any Ruli stores. This project is dependent upon our ability to create sustainability through income-generating ventures and negotiations of bulk pricing. We are confident that we will be successful in developing income-generating businesses that will support the nutrition program. We are also hopeful that our program will become a model for other communities in Rwanda. This will provide incentive for all parties to work together to negotiate lower prices for formula with the companies who produce and distribute this product. We hope to engage these companies in finding solutions to the current cost barriers we face.
How many people will your project serve annually?
More than 10,000
What is the average monthly household income in your target community, in US Dollars?
Less than $50
Does your project seek to have an impact on public policy?
Yes
Sustainability
What stage is your project in?
Operating for less than a year
In what country?
Rwanda
Is your initiative connected to an established organization?
Yes
If yes, provide organization name.
The Ihangane Project
How long has this organization been operating?
1‐5 years
Does your organization have a Board of Directors or an Advisory Board?
Yes
Does your organization have any non-monetary partnerships with NGOs?
Yes
Does your organization have any non-monetary partnerships with businesses?
No
Does your organization have any non-monetary partnerships with government?
Yes
Please tell us more about how these partnerships are critical to the success of your innovation.
The Ihangane Project strongly supports collaboration, and believes in the importance of utilizing systems that have already been proven effective. We have traveled to Rwinkwavu Hospital to meet with Partners In Health's medical director in Rwanda to discuss their current nutrition policies for HIV-exposed infants. They have gratiously provided us with all of their policies, protocols, and educational information for providing formula alternatives to HIV+ mothers. Because they have several years of experience, PIH has kindly offered advice and support as this project progresses. We are also collaborating with Catapult Design, an engineering firm focused on appropriate technology solutions for developing communities, to consider improved options for clean water needed to mix formula. The executive director of Project Healthy Children has provided invaluable information regarding the general nutrition policies and protocols of the Ministry of Health in Rwanda. She has also been working on simple systems of local sosoma production that includes fortification. We are hoping to develop an income-generating sosoma production business that incorporates her advice and recommendations.
What are the three most important actions needed to grow your initiative or organization?
1. Fundraising for the successful implementation and completion of our pilot project.
2. Establishment of a fortified sosoma production factory.
3. Negotiation of prices for formula
The Story
What was the defining moment that led you to this innovation?
Dr. Ngirabega initially sent us a proposal to provide formula and sosoma to all HIV-exposed children in the Ruli District Hospital catchment area. The proposal was extremely expensive, and we were not sure how to ensure sustainability. While in Ruli and interviewing each HIV+ woman about their interest in providing formula alternatives to their children, I realized the incredible determination of each woman to do whatever it takes to keep their child healthy. At that moment, I realized that we must find a way to make this program work. As a team, The Ihangane Project and Dr. Ngirabega have been working to find creative ways to ensure the sustainability of this important project.
Tell us about the social innovator behind this idea.
Dr Ngirabega is passionate about addressing malnutrition in his community. Not only is he the Medical Director of Ruli District Hospital, but he has a Masters in Public Health and is currently working on his PhD in nutrition. He has written a research paper that evaluates the appropriate measurements of nutritional status in rural Rwanda, as well as another paper that identifies the underlying risk factors of chronic malnutrition and undernutrition in his community.
Dr. Leonard was the first physician to volunteer for the Clinton HIV/AIDS Initiative's clinical mentoring program in Rwanda. Since 2006, she has continued to work as an educator and consultant to the health care providers in Ruli, Rwanda. In the United States, she is dedicated to providing quality HIV care to those living with HIV in her local community. Inspired by the dedication of the Ruli community to find solutions to their local dilemmas, she founded The Ihangane Project in 2008. She is joined by a committed group of volunteers in the United States who are passionate about supporting innovative proposals that are developed at a grassroots level.
How did you first hear about Changemakers?
Friend or family member
If through another, please provide the name of the organization or company
 | 123 weeks agoWendy Leonard said: One of our priorities in this project is to create a program that can be financially sustainable and can support the local economy. We ... about this Competition Entry. - read more > |
| 129 weeks agoWendy Leonard said: The Ihangane Project has forged a formal collaboration with Amy Lockwood of Project Healthy Children and Paul Clyde,PhD of the Stephen ... about this Competition Entry. - read more > |
| 134 weeks agoWendy Leonard said: Dear Naveen, Thank you for your comments! The question of sustainability is always the question on my mind. We are confident that local ... about this Competition Entry. - read more > |
| 134 weeks agoNaveen Shakir said: This is a great initiative! We’re interested in learning more about your plans for financial sustainability. Specifically, what are the ... about this Competition Entry. - read more > |
| 134 weeks agoWendy Leonard updated this Competition Entry. |
| 135 weeks agoWendy Leonard said: Thank you for these ideas. Your thoughts are quite helpful for framing a discussion with the companies regarding formula. It's also true ... about this Competition Entry. - read more > |
| 135 weeks agoWendy Leonard said: Dear Rubina, Thank you for your comments and feedback. We love Partners in Health's model, and they have been very generous in offering ... about this Competition Entry. - read more > |
| 135 weeks agoRubina Khan said: Congratulations! I like your innovative idea for addressing the nutritional support for this vulnerable population, and focusing on ... about this Competition Entry. - read more > |
| 135 weeks agoMoises Herszenhorn said: I can see it is hard approaching these companies. The important issue here is creating a process that is easy to be implemented for them ... about this Competition Entry. - read more > |
| 135 weeks agoWendy Leonard said: Dear Moises, Thank you so much for your comments! I appreciate your suggestions. We are constantly looking for ways to create ... about this Competition Entry. - read more > |
