Nepal

The Problem

  • Malnutrition, one of the key contributors to mortality, is a serious public health problem throughout Nepal.
  • The 2006 Demographic and Health Survey estimates that 49% of children under 5 years of age in Nepal are stunted due to chronic malnutrition. The situation is particularly critical in the Far Western Region of the country, where 52% of children are stunted.
  • Anemia prevalence is extremely high, over 50%, among both women of reproductive age and young children. 
  • The most recent Nepal Blindness Survey found that 2.4% of all blindness in the country was caused by trachoma.

What HKI Is Doing

Since 1989, Helen Keller International has worked in Nepal with national partners. Current programs include:

  • Vitamin A Supplementation Read more
  • Action Against Malnutrition through Agriculture Read more
  • School Health/Trachoma Control Read more

Vitamin A Supplementation
Nepal’s national vitamin A supplementation(VAS) campaign is a public health success story thanks to the partnership that includes Helen Keller International, the Government of Nepal, UNICEF, the Nepali Technical Assistance Group (NTAG), and other NGOs. HKI works in Kathmandu, Kirtipur, Lalitpur, Madyapur, and Bhaktapur to sustain vitamin A distribution coverage for 90% of children 6-59 months.  Last year, nearly 98,000 children were reached with sight-and life-saving vitamin A.

HKI works closely with NTAG to develop innovative public outreach strategies to improve vitamin A supplementation efforts. Radio announcements, posters, presentations to mothers' groups and other efforts spread the word to adults about the dangers of vitamin A deficiency; in some areas, magic shows are put on to convey the importance of healthy eating to children.

While vitamin A supplementation has achieved 80-98% coverage in most areas of Kathmandu, there are some areas where it is notably lower. Helen Keller International has begun to look closely at the reasons for these discrepancies. The growing slum areas pose a serious problem; without access to clean water, toilets and appropriate services, the health and nutrition of children and families are at risk. HKI is gathering data to assess not only vitamin A coverage, but the overall nutritional status in these under-served areas. 

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Action Against Malnutrition through Agriculture (AAMA)
HKI’s signature Homestead Food Production(HFP) programs have been improving household food security and diversification for over 10 years in Nepal.  HKI’s four-year AAMA program, which began in October 2008, expands on the Homestead Food Production model to deliver a package of Essential Nutrition Actions (ENA)to the most vulnerable communities and populations in Nepal. The model will combine food security, behavior change communication and high impact maternal and child interventions to improve maternal and child nutrition and health. AAMA means mother in Nepalese.  

AAMA provides integrated training in HFP and ENA to volunteers across the terai district of Kailali and the hill district of Baitadi in the Far West Region of Nepal with a combined population of 860,000. The limited availability of food, especially in variety and with high nutrient content, and high poverty rates contribute to the higher rates of stunting, underweight and anemia in the Far West Region.  

The program develops village model farms that in turn support almost 11,000 home gardens through their associated Mothers Groups. Key ENA messages are also conveyed  to these mothers and their wider communities. Helen Keller International is building on Nepal’s highly successful Female Community Health Volunteer program to expand nutritional skills and introduce incentives to sustain the motivation of these community-based agents. 

Over the four years, HKI expects to reach a total target population of 206,156 women of reproductive age and 41,414 children under two with Essential Nutrition Action (ENA) behavior change communications, while Homestead Food Production will benefit an estimated 40% of the population of Baitadi and 15% in Kailali.  The interventions addressed include infant and young child feeding, vitamin A supplementation, control of diarrheal diseases, and maternal and neonatal care. The project is designed to be adapted and taken to scale in other areas. 

The AAMA project has begun to expand beyond Kailali and Baitadi districts including: an extension of the program to Bajura and Kanchanpur districts, the implementation of a study on the added value of micronutrient powder, and a governance component that works in all 9 districts of the Far Western Region. 

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School Health Project (SHP)
The SHP project in Nepal is mainly focused on trachoma elimination. The program will promote increased face-washing among school children, and improved environmental cleanliness and proper sanitation on school grounds (through better pit latrine construction and the provison of clean water). The overall aim of the program is to reduce the prevalence of trachoma in the project area. Specific objectives include:

  • Change knowledge, attitudes and behaviors of school children and parents/mothers about trachoma through health education, mothers' groups, and the use of behavior change communication materials.
  • Enhance schoolteachers' knowledge of trachoma and personal hygiene, and include trachoma education into school curriculum.
  • Develop and increase the habits of face-washing and cleanliness among school children, and teach them the importance of latrine use.

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