Nutritional Rehabilitation Homes: Sustainable Nutritional Education & Treatment

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Nutritional Rehabilitation Homes: Sustainable Nutritional Education & Treatment

Nepal
Organization type: 
nonprofit/ngo/citizen sector
Budget: 
$1 million - $5 million
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

At Nutritional Rehabilitation Homes, severely malnourished children are restored to full health and weight while their mothers are educated in nutrition, child care, and how to share their new knowledge with their neighbors. This pioneering, inexpensive model is decreasing malnutrition throughout Nepal and can be easily applied worldwide.

About Project

Problem: What problem is this project trying to address?

Malnutrition is a severe problem throughout the developing world. It afflicts more than half the children under five years of age in Nepal, and is a leading cause of death in this age group. Most malnourished children fall ill, the reason being that their lack of nutrition compromises their immune systems and leaves them prone to a range of diseases. Most hospitals in developing countries are not equipped to treat malnutrition. Many malnourished children grow up with physical or mental disabilities that limit their potential forever; others do not even survive to adulthood. In many areas, ignorance rather than poverty is the most important cause of malnourishment. The lack of awareness about nutrition in the developing world is not adequately addressed, and nutritional knowledge is the key to ending the global tragedy of malnourishment. Widespread illiteracy and lack of education, particularly among women (who are generally responsible for caring for children), exacerbates the problem.
About You
Organization:
Nepalese Youth Opportunity Foundation (NYOF)
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Section 1: About You
First Name

Gregg

Last Name

Tully

Organization

Nepalese Youth Opportunity Foundation (NYOF)

Country
Section 2: About Your Organization
Organization Name

Nepalese Youth Opportunity Foundation (NYOF)

Organization Phone

1-415-331-8585

Organization Address

3030 Bridgeway, Suite 123, Sausalito, CA 94965 USA

Organization Country
Your idea
Country your work focuses on
Innovation
What makes your idea unique?

The innovative Nutritional Rehabilitation Home (NRH) program uses inexpensive, low-technology methods that can readily be applied to a wide range of cultures and contexts in developing nations. Because the program relies primarily on nutritional education, its impact is not only sustainable, it spreads throughout villages and neighborhoods as parents talk to their relatives and neighbors. The knowledge that people gain at NRHs is also passed on to their families and to future generations. All of the food used at the NRHs is inexpensive and locally available, which facilitates parents implementing what they learn at the NRHs.

This program was created by the Nepalese Youth Opportunity Foundation (NYOF; http://www.NYOF.org ). The government of Nepal deems the project so important that it has agreed to take over the funding of the NRHs. Each facility is built near a major government hospital. The government has an agreement with NYOF which states that these hospitals will manage and assume full financial support for all NRHs after their fifth year of operation. This makes the program financially sustainable. NYOF will continue to operate the flagship facility in Nepal’s main city of Kathmandu, for staff training and nutritional research. The two other NRHs that have been in operation for five years are now successfully managed and funded by local government hospitals.

The Nutritional Rehabilitation Home program can readily be applied to other developing nations. In countries where it is not feasible for the government to fund the NRHs, other agencies can provide funding, such as foreign aid organizations and non-governmental organizations. Furthermore, hospitals may directly assume management and support of the centers. The treatment and prevention of malnutrition is within the mission of most hospitals. As the operating cost of an NRH is a small fraction of the cost of running a major hospital, this will not be a prohibitive expense.

Do you have a patent for this idea?

Impact
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.

Actions

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.

Results

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.

How many people will your project serve annually?

1001‐10,000

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 more than 5 years

In what country?
Is your initiative connected to an established organization?

Yes

If yes, provide organization name.

Nepalese Youth Opportunity Foundation (NYOF)

How long has this organization been operating?

More than 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?

No

Please tell us more about how these partnerships are critical to the success of your innovation.

The Nepalese Youth Opportunity Foundation forms partnerships with Nepal-based non-governmental organizations that implement its programs. Whenever possible, we work with local NGOs that have a deep understanding of the communities that benefit from the programs, including the specific needs and cultural contexts of these communities. In turn, the NGOs are respected by the communities, which is often essential to their success. We ensure that all of our partner organizations are financially responsible and implement funds efficiently. Our staff works closely with these NGOs in all phases of program implementation, frequently traveling to field sites to monitor the programs and provide guidance.

What are the three most important actions needed to grow your initiative or organization?

The Nepalese Youth Opportunity Foundation has been growing consistently since its inception in 1990. Each year, its projects transform the lives of more children than in the year before. NYOF’s Nutritional Rehabilitation Home program has also been growing steadily since it began in 1998. NYOF has created nine NRHs throughout Nepal, and is about to begin construction on a tenth.

The availability of additional funding will enable the NRH program to continue to grow. NYOF provides the operating expenses for NRHs that the organization has not yet turned over to the adjacent hospitals, funds the creation of new facilities, and supports ongoing program monitoring and evaluation.

Second, for this initiative to grow beyond the boundaries of Nepal, NYOF will form partnerships with organizations that have demonstrated success in implementing health care programs in other developing countries. Since the pioneering NRH model is simple, inexpensive, and is not specific to the context of Nepal, it will be readily replicated in other cultures.

A third action needed for the NRH program to expand is public awareness about the project and its widespread success in Nepal. Organizations throughout the world need to be informed about the Nutritional Rehabilitation Home innovation so that they are willing to form partnerships with NYOF to implement it.

The Story
What was the defining moment that led you to this innovation?

The needs of severely malnourished children in Nepal came to the attention of the Nepalese Youth Opportunity Foundation in 1998 when the organization’s founder and president, Olga Murray, visited Kanti Children's Hospital in Kathmandu. She met a five-year-old girl who was hospitalized with a severe lung infection caused by malnourishment. The girl weighed only 25 pounds. She received antibiotics to cure the infection, and when the infection was under control, she was discharged from the hospital even though she had gained only 8 ounces and could not stand or walk. The hospital explained that it needed the bed for acutely ill children. The girl died shortly after she returned to her village.

As NYOF has witnessed, many children who are discharged from hospitals with malnutrition do not survive. If they do, they grow up stunted physically or mentally, since they return to the same deprived environment that brought them to the hospital in the first place.

Tell us about the social innovator behind this idea.

Olga Murray graduated with honors from Columbia University and received her law degree from George Washington University in 1954. Although there were very few women lawyers at that time and most law firms would only hire a female lawyer as a secretary, Olga was offered the first job for which she applied – as a staff attorney to the Chief Justice of California. She worked for the California State Supreme Court until her retirement in 1992. During her time there, Olga helped write important decisions in the areas of children’s issues, the environment, and women’s rights.

Olga Murray first visited Nepal in 1984. After seeing the terribly impoverished condition of children in the villages, she resolved that she would return to help them. She returned the very next year, and upon discovering that children at an orphanage were forced to leave at age 16 with no one to help them, gave five of them scholarships for college. On another trip in Nepal in 1987, Olga broke her ankle. She was treated by a young doctor who had just opened a small hospital that provides free high-quality care to poor, very disabled children. Through this connection, she began giving scholarships to disabled children who had no way of getting to school in their villages and needed to come to Kathmandu for boarding school. As the number of scholarships grew, she decided it was time to start a foundation that would help these kids in an organized way.

In 1990, Olga founded the Nepalese Youth Opportunity Foundation (NYOF) to provide the most impoverished children in Nepal with what should be every child’s birthright – education, housing, medical care, and loving support. NYOF leverages donations from developed countries to maximize the aid for these children. Olga Murray still leads NYOF, spending most of each year in Nepal overseeing the organization’s projects, and the remainder at her home in Sausalito, California, raising funds for NYOF’s programs. The scope of her outreach and the number of children she helps have increased dramatically every year.

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