What impact have you had?
The Nutritional Rehabilitation Homes literally save the lives of emaciated youth and prevent mental or physical disabilities resulting from stunted growth in many others, enabling them to excel in school and attain their full potentials.
Since the Nutritional Rehabilitation Home program began in 1998, the Nepalese Youth Opportunity Foundation has constructed nine NRHs throughout Nepal, and more will be built soon. The government of Nepal strongly endorses the program and actively encourages NYOF to build NRHs throughout Nepal. More than 4,000 extremely malnourished children have been treated at these facilities. The nine existing NRHs have a total capacity of 111 beds, and every year more than 1,000 malnourished children are restored to health while their parents are trained in nutrition and child care. Through follow-up visits with every child discharged from an NRH, field workers have found that 93% of the children retain their health and weight. Of the other 7%, poverty is the most common cause of their poor nutrition, and various illnesses account for the remainder. An indication of the success of the education component of the program is that ignorance about nutrition is not found to be a cause of relapses into malnutrition.
As the NRH program continues to expand, its impact on the health of the people of Nepal becomes more extensive. The nutritional knowledge becomes embedded in the culture and spreads through villages and entire regions, increasing the impact of the program far beyond the children who are treated at NRHs. The program is engendering a nationwide sustainable decrease in malnutrition.
Furthermore, this pioneering model can produce a lasting change throughout the developing world in malnutrition and nutritional knowledge, thereby reducing the fatalities and disabilities caused by malnourishment.
The Nutritional Rehabilitation Homes accept children suffering from severe malnutrition along with a caregiver (who, in Nepal, is almost always their mother). The mother and child live at the NRH for an average of five weeks, during which time the children are restored to full health while their mothers are trained in a wide range of topics including the preparation of nourishing meals, hygiene, and family planning. The mothers are also taught to pass this knowledge on to their relatives and neighbors when they return to their villages. Treatment is always free of cost to the child’s family.
The education for the caregivers is the key to ensure that the children remain healthy; without this component of the program, far more of the youth treated at the center would relapse into malnutrition. Furthermore, this training causes the effects of the program to spread far beyond the children who are treated at the NRH. The mothers become able to provide better care and nutrition for all of their children, and they enthusiastically teach what they have learned to others in their communities.
The most immediate results of the program are that the children treated at the NRHs maintain their weight and health. Beyond that, the children’s mothers are better able to feed and care for their other children, and they teach their relatives and neighbors what they learned at the NRHs. This expands the impact of the program throughout villages and neighborhoods. On a larger scale, the NRH program is engendering an improvement in nutritional knowledge and a decrease in malnutrition rates throughout Nepal. When other organizations implement this model in other countries, the results of the program will occur worldwide.
What will it take for your project to be successful over the next three years? Please address each year separately, if possible.
The continued success of the Nutritional Rehabilitation Home program depends on the availability of funding to construct new NRHs and operate existing facilities. The NRHs that NYOF has built are already fully funded for the five years that NYOF will operate them. (After the fifth year, the government of Nepal will provide all financial support.) Within three years, NYOF hopes to have acquired adequate funds to construct five more NRHs, so there will be one in each of Nepal’s 14 administrative zones.
Within the next three years, NYOF hopes to form partnerships with other organizations that will bring this sustainable, inexpensive innovation to other developing countries. To fully implement the NRH model, those organizations will approach governments, foreign aid organizations, hospitals, and/or other agencies to form agreements that the agencies will assume financial support for the NRHs after they are demonstrated to be successful. Due to the abundance of foreign financial aid for the health sector, it should not be problematic to obtain support for a program that has proven effectiveness in reducing malnutrition.
The success of the program is evaluated by NRH field workers, who follow up with each child who has been discharged from an NRH by visiting them at home at least three times. These visits occur approximately one, three, and six months after discharge. During each field visit, the outreach worker weighs and photographs the child and records data about their condition and appearance. They interview family members about the health and nutrition of everyone in the household, to determine if the mother is applying what she learned at the center. They also serve as an advisor, answering questions about subjects ranging from hand washing to breast feeding.
Furthermore, the outreach worker interviews the mother about her efforts to disseminate nutritional information to other women in her household and in her community, and talks to neighbors to confirm that knowledge is being shared. If necessary, the worker provides further training or builds the woman’s confidence about teaching others.
What would prevent your project from being a success?
The political situation in Nepal is more stable than it has been in over a decade. However, there remains a possibility that the country may descend into political turmoil or insurgency, which could make it challenging to implement projects in rural areas of Nepal. There are similar issues in some other countries where instability impedes the activities of NGOs.
In NYOF’s Nutritional Rehabilitation Home model, hospitals and/or government agencies assume management and support for each NRH after it is demonstrated to be successful, thereby making the program financially sustainable. Specifically how this happens will differ in different countries. If there are areas where no agency can be found to take over the NRHs, then the NGOs that establish the NRHs in those areas may need to continue to support them indefinitely. This affects the financial sustainability of the program, but it does not alter its effectiveness in decreasing malnutrition.