13/06/2017
Rambha Joshi, holds her son Parbati while her other son Rukhi sits beside her in front of their house in Oligaun, Achham, Nepal. Mother of Parbati, didn't take her to the hospital despite the fact that FCHV urged her to do so. Villagers to reach the hospital need to walk eight kilometres in one direction. Some mothers do not take their children to the hospital for further examination because they will loose a day of work which would affect their income. Mrs. Joshi is a mother of three children. Her husband is a migrant worker in India. While she works as a daily labor Joshi is left to be taken care off by other siblings.
The MUAC measurement indicated that Parbati reached critical stage of malnutrition. Female Community Health Volunteer (FCHV) referred the child to the hospital for further examination and inclusion in CMAM programme. FCHV are deployed by UNICEF and Government of Nepal backed programme as a part of Community Management of Acute Malnutrition (CMAM) in five districts of Nepal.
Forty-one percent of Nepalese children suffer from chronic malnutrition. Causes of chronic malnutrition in Nepal include poor feeding and care practices so as insufficient nutrient intake. Malnutrition increases the risk of mortality in the early stages of infancy and childhood, impairs cognitive function of those who survive.
Nepal is among the poorest and least developed countries in the world, with about one-quarter of its population living below the poverty line. Agriculture is the mainstay of the economy, providing a livelihood for three-fourths of the population and accounting for a little over one-third of GDP. Industrial activity mainly involves the processing of agricultural products, including pulses, jute, sugarcane, to***co, and grain. Additional challenges to Nepal's growth include its landlocked geographic location, civil strife and labor unrest, and its susceptibility to natural disaster.
The Government of Nepal (GoN), Ministry of Health and Population (MoHP), and UNICEF have been piloting the Community-based Management of Acute Malnutrition (CMAM) program since 2008; it currently operates in five districts. The Nepal CMAM programme aims to improve access to treatment for acute malnutrition among children 6-59 months of age, to promote integration of the CMAM programme in regular health services, and to create effective treatment capacity of the health system. The programme expanded to the Integrated Management of Acute Malnutrition including infants under six months of age (IMAMI) in six new districts. Other ongoing nutrition programmes include Infant and Young Child Feeding (IYCF), micronutrient supplementation to children and women, food fortification, and food distribution in food insecure areas.
photo © Agron Dragaj 2013
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