Mothers and community based organisations tackle childhood nutrition in Nepal

Evidence from countries such as Indonesia and Burkina Faso suggests that community-based organisations (CBOs) can play an important role in helping rural women reduce childhood malnutrition. This could be the key to addressing malnutrition in rural Nepal, where government programmes have so far failed to empower women with the knowledge to reduce high levels of chronic malnutrition in children.

Childhood malnutrition is asevere problem in Nepal. On average, every second child is chronicallymalnourished or stunted. The causes are diverse: poverty, a harsh physicalenvironment, conflict, and overextended national institutions. To date, therehas been little research into the potential of CBOs in Nepal. Researchers fromthe University of Manchester, in the UK, and the International Fund forAgricultural Development, in Italy, consider the strengths, weaknesses, andimpact of CBOs with regard to child malnutrition in Nepal.

The researchers explore therole of programmes designed to support groups of women and mothers in improvingfood and nutrition security in Nepal. They draw upon data gathered from 63 CBOsand 427 households in two districts of Nepal, one in the hill region, the otherin the plains. These CBOs can be divided into three groups: those receivingintensive support from United Nations Children’s Fund (UNICEF) programmes,those receiving moderate support from the Ministry of Local Development, andindependent organisations belonging to mothers’ groups.

Key findings include:

• Autonomous mothers’groups play an important role in improving childhood nutrition, and performbetter than organisations that are being supported or funded by the governmentor donors.
• Not all childrenof households in mothers’ groups, however, are better nourished.
• External supportto train mothers to diagnose types of child malnutrition, learn causes and findlocation specific solutions is essential to reduce the prevalence of stuntedchildren.
• Radio is aneffective instrument for reinforcing training provided by facilitators.
• Healthiermothers, healthier children: children of energy-deficient women are three timesmore likely to have low birth weight than those of women with normal Body MassIndex.
• If policymakersand donors treat malnutrition as a minor issue of ‘home economics’ or relegateit to food and micronutrient supplementation,  it is inevitable that the problem willpersist, with high costs for the country as a whole.

The results support evidencefrom nutrition-focused programmes in India, Tanzania, Thailand and Indonesiathat their success relies on community understanding and knowledge ofmalnutrition, and that the improved status of women generally improves the nutritionalwell-being of their children.

The authors suggest thatpolicymakers and donors design programmes that:

• raise thecapabilities of mother’s groups in leadership and management, and savings andfinancial support through training programmes
• raise maternalnutrition knowledge
• are grounded in abetter awareness of levels of chronic malnutrition, including its causes andsolutions
• use relevant indicators in targeting interventions andfor community monitoring of effectiveness (stunting, underweight and maternalBody Mass Index).