For less than $1 a day, we are working to create a model malnutrition program in rural Uganda that will train health workers and improve outcomes for children.

The Initiative to End Child MalnutritionGHI volunteer working in Uganda

The Initiative to End Child Malnutrition (IECM) was established as collaboration between the Division of Global Health and Human Rights (GHHR), the Harvard College Global Hunger Initiative (GHI), and Karoli Lwanga Nyakibale Hospital in Rukungiri District, Uganda.

Our continued mission is to create, within the District of Rukungiri, an affordable and locally sustainable model that utilizes community nutrition awareness and education, addresses barriers to appropriate child nutrition, and identifies and systematically provides high quality care for children suffering from malnutrition both in the district health centers and at the malnutrition referral center of Nyakibale Hospital.

Inpatient Referral Center

In January of 2010, the IECM first implemented an inpatient treatment protocol at Nyakibale Hospital to effectively treat child malnutrition amidst the challenges of a developing world setting. GHHR and GHI volunteers trained staff to diagnose and treat children presenting with severe or moderate malnutrition with complications (ie malaria, pneumonia, etc.). Physicians and nurses implement this treatment protocol on a daily basis. As the regional referral hospital, Nyakibale Hospital provides lifesaving treatment to children from throughout Rukungiri District. Hundreds of children and their families have benefited from this lifesaving program.

Outpatient Therapeutic Care 
“Outreach” is an exciting cornerstone of the IECM program. Five days per week, a hospital vehicle travels to district health centers to provide malnutrition screening and treatment for some of the district’s most remote villages. IECM nurses give health education talks to the crowds of mothers, weigh and measure new children, provide follow-up exams for outpatients, and provide a week’s supply of ready-to-use-therapeutic-food (RUTF) for malnourished patients to gain weight quickly while remaining at home. IECM outpatient treatment overcomes countless barriers to care, enabling hundreds of children to regain their health without being displaced from their communities.Community Education and Training

Education is an essential component to any public health prevention effort. Thus, the IECM provides education for all relevant stakeholders in the Rukungiri community. The IECM has trained physicians, nurses and other health providers to diagnose and treat malnutrition within Nyakibale Hospital. Nursing students receive hands-on and classroom education in the neighboring Karoli Lwanga nursing and midwifery school.

Education is just as important at the village level. The IECM has trained many of the region’s health center workers to identify and refer malnourished children for necessary outpatient or inpatient treatment.  In early 2012, the IECM began training Village Health Team volunteers to provide nutrition education within community households, and refer malnourished children to Outreach locations for care. Nutrition and general health education is provided to mothers of both inpatients and outpatients on a weekly basis. 
Nutrition Demonstration Gardens
The first IECM demonstration garden was planted at Nyakibale Hospital in early 2011.  Since then, the garden has increasingly been utilized as an education tool for the mothers of inpatients. Hospital nursing staff conducts education sessions in the garden to teach about micro-nutrient rich crops and diet diversification. The demonstration garden has since been duplicated at regional health centers, providing both nutritious produce and education for more rural communities. All garden success has been in partnership with the Ugandan National Agricultural Advisory Services (NAADS).

Student Collaboration and MentorshipStudent volunteers from the Harvard College Global Hunger Initiative have been instrumental since the establishment of IECM. Each year, more students travel to Uganda during their summer and January terms to work with Ugandan colleagues and implement innovative approaches to building program sustainability. In addition, student interns from other undergraduate and graduate schools have also volunteered their time and talents to develop the program. Students have maintained program collaboration with Nyakibale Hospital colleagues, the Ministry of Health, NAADS, and many others.