Essential Nutrition Actions

The Challenge

  • Young children aged 2 or less and pregnant and lactating women are the most likely to suffer from the devastating effects of malnutrition, which often lead to death, and, for children, reduced physical and cognitive abilities, depriving them of the chance to reach their full potential as human beings.
  • Simple nutrition actions can help developing countries reduce maternal and child under-nutrition and the associated mortality and morbidity.

HKI Solution

Helen Keller International implements the Essential Nutrition Actions (ENA) framework to deliver an integrated package of cost-effective nutrition actions that are proven to reduce maternal and child under-nutrition and associated mortality and morbidity. A key strategy of the ENA framework is to build a broad coalition of advocates to promote messages and services for the following seven essential nutrition and child health interventions to achieve lasting public health impact and further our goal of preventing malnutrition:

  1. Optimal breastfeeding of infants during the first 6 months of life: entails the initiation of breastfeeding within one hour of birth and exclusive breastfeeding of the child for the first 6 months of its life. (To learn more about optimal breastfeeding, see Infant and Young Child Feeding).
  2. Optimal complementary feeding from 6 months of age with continued breastfeeding to 24 months and beyond: entails improving the nutrient content of traditional baby foods as well as enhancing the quality of the local diet through the introduction of point-of-use products, including micronutrient powders such as Sprinkles or lipid-based nutrient supplements. (For more information about point-of-use supplements, see Food Fortification).
  3. Nutritional care of sick and malnourished children: includes “kangaroo mother” care for infants who have a low birth weight; increased feeding during or after an infant’s illness; treatment of diarrhea in young children with oral rehydration solution as well as Zinc and Vitamin A Supplementation; and integration, where appropriate, of community-based therapeutic care for treatment of moderate and severe acute malnutrition in infants (for more information, see Managing Acute Malnutrition).
  4. Improved nutrition for pregnant and lactating women: includes dietary changes to ensure increased caloric and protein intake, iron absorption and intake of other micronutrients; rest during pregnancy; and iron-folic acid supplementation.
  5. Control of vitamin A deficiency: includes breastfeeding; vitamin a supplementation for children 6-59 months of age and post-partum women; dietary diversification; and promotion of the consumption of fortified foods (to learn more about HKI’s efforts to combat vitamin A deficiency, see Vitamin A Supplementation).
  6. Integrated control of anemia in pregnant women and children: includes improved iron nutrition and supplementation for pregnant women; intermittent preventive treatment for malaria during pregnancy; promotion of insecticide-treated bed nets; de-worming for women during pregnancy and for children starting at 12 months of age; and delayed cord clamping.
  7. Promoting the use of iodized salt.

To achieve high coverage levels, the Essential Nutrition Actions framework emphasizes:

  • reaching children and women through existing programs in multiple sectors such as health, agriculture and education;
  • disseminating messages through multiple channels, including interpersonal counseling, women’s and community group discussions, educational talks at heath centers, community events and mass media, especially radio; and
  • using the techniques of behavior change communications which move beyond message dissemination to supporting individuals and communities in making the transition to healthier practices.

Helen Keller International also builds on and strengthens the capabilities of existing health staff and selected community members:

  • We introduce short, skills-based training programs to teach health personnel and selected community members the importance of the seven elements.
  • The programs also demonstrate techniques for determining behavior change goals with pregnant women as well as with mothers of young children and their families.
  • These actions are promoted at health facilities, in local communities and through other relevant programs such as our Homestead Food Production program and village gardens, Community-based Treatment of Acute Malnutrition, and through primary education and microcredit programs.
  • The ENA framework also addresses HIV/AIDs by preventing mother-to -child transmission of HIV through optimal infant feeding and supporting nutritional care of people living with HIV/ AIDS. (For more information, please see Nutritional Support to People Living with HIV/AIDS.)