I've spent the last few weeks in front of a computer looking at child growth data. It may sound boring, but actually it has been pretty exciting to have the time to do these interim analyses of our community nutrition programs.
These programs, as many of you who have supported our work over the years know, are comprehensive. They provide medical checkups to young children, in addition to regular treatment for parasites and anemia and the provision of nutritional supplements. Recently, in the last year or so, we've also been working hard to improve our educational support of parents as they learn how best to support their children in the first few critical years of life.
Our primary endpoint is trying to reduce rates of stunting, or chronic malnutrition, in young children. This is the primary form of malnutrition in rural Guatemala, which leads to lifelong disability through short stature and impaired intellectual development.
And the good news is that our programs are working. For example, in one set of community data that I was analyzing last week, the rates of severe stunting have decreased more than 50%. At the same time, the rates of children who are underweight have decreased more than 60%. These sorts of demonstrable improvements in child health give us hope for the future!
A central part of the community-based nutritional education that we are doing this year are classes on nutrition for women with young children. The idea is to provide women with up-to-date nutritional information, and to give them a forum to ask questions, clarify misconceptions, and support each other’s efforts to improve the health of their families.
WK core staff and I have spent much of the last three weeks meeting with community liaisons in the 8 communities in which we will be rolling out these classes. Because stunting (being very short for one’s age) affects as much as 100% of children in some of the communities that we are beginning to work with, many women are very excited to learn more about what they can do to help their children grow to their potential.
Last week, we inaugurated this limb of the nutrition education program with our first class in in one of our partner communities. Twenty-two women, from first-time mothers to seasoned grandmothers, laughed along as our staff led them through an explanation of how microbes cause disease, correct hand washing technique, the best way to store food without refrigeration, and low-cost methods to purify water.
Although there are many organizations in Guatemala that are working on nutrition, one unique aspect of our program is that whenever possible we use the first language of the community in our programming. The women in this community, for example, speak a mixture of Kaqchikel and K’iche. Our staff gave this class in Kaqchikel, and the women participated in either Kaqchikel or K’iche (or both!). Many women emphasized how much they appreciated being able to take part in a class where they could speak comfortably in their own language. Doing these classes in first languages meant that all women–not just the ones that felt the most comfortable speaking Spanish–were able to understand the materials and offer their own questions and ideas to the group.
We are looking forward to being able to bring these women classes in maternal nutrition, breastfeeding, complementary feeding, and nutrient deficiencies in the months to come!
Thanks so much for your ongoing support this year! We greatly appreciate it.
We wish you and yours a pleasant and enjoyable holiday season. If you are still looking for an end of the year giving opportunity, don't forget that it is easy to donate to any of Wuqu' Kawoq's projects through the Global Giving interface here. In addition to regular giving options, the interface also allows you to give holiday gift cards or donate in honor of a loved one, both great options for alternative holiday giving!
As the year draws to a close, I wanted to provide a brief research update from one of the community nutrition projects that you have supported this year. This project has been providing direct nutritional supplementation and medical care for children for 18 months now. In this time, based on new data that we just collected last month, we've seen that the rates of severe stunting have fallen by more than 40%. This reduction in stunting has occurred at the community level, including even the small number of children who haven't been always so regular at taking their supplements or coming to medical checkups. This means that the positive messages about child nutrition and coming together to combat this problem are really having an effect at all levels in the community!
Also, as the year draws to a close, we are just wrapping up analysis of our focused needs assessment survey that we performed over the summer, and to which I've alluded in prior updates. This survey, they results of which I'll share with you when the analysis is complete, are really pointing us towards some new opportunities in 2013, especially focused on improving dietary diversity and support for new mothers. Look for these changes and additions to our programming in coming months!
As always, thanks for your support, and feel free to email me with any questions at email@example.com.
Our child nutrition programs have always had three basic pillars.
(1) The provision of nutritional supplements to children, to help prevent malnutrition and provide as a "safety net" in times of food insecurity.
(2) The provision of excellent medical care, to help identify and treat the diseases--both common and rare-- that contribution to child malnutrition.
(3) Education of caregivers and community leaders about child health and nutrition, to help provide communities with the tools they themselves need to be engaged in protecting the health of their children.
Of these three pillars, by far education is the most challenging. This may sound counter-intuitive at first. However, if you think about all the different barriers that exists to a good educational program--such as low rates of literacy, or the inherent resistance there always is to changing infant rearing practices (which are time-honored and passed down from generation to generation in every culture)--then it is becomes easier to understand why educational programs are numerous but quality educational programs (that produce real change at the community level) are few indeed.
With this mind, I'm happy to report that Wuqu' Kawoq has just finished up the initial stages of a massive program evaluation designed to improve our nutritional education programming. To accomplish this, we assembled a highly skilled team of community health workers, anthropologists, and nutritionists, who spend most of July and August conducting dozens of focus groups and hundreds of interviews with community leaders, parents, and other stakeholders in our communities.
This evaluation was wide-ranging, designed to help us understand better what parents think about the health of their children and the causes of malnutrition. It will also give us deeper inside into dietary diversity, breastfeeding and weaning practices, and competing nutritional messages from other groups (such as companies which market infant foods).
Right now our team is evaluating the immense amount of data that was collected during this evaluation. Within the next month or two, we will have a formal report from the team which will identify the areas where our current nutrition education programming might be deficient or not exactly in line with the needs of our communities and give us recommendations for improvement. We're very excited about this great opportunity we have to continue to improve our programs so that we can better serve the children of Guatemala!
As always, thanks so much for your continued support, and keep in touch! Feel free to drop me an email at any point at firstname.lastname@example.org.
Once again I'm writing to you all to thank you for your ongoing support of our child nutrition and health projects in Guatemala.
I thought I would take this update opportunity to reflect on something that we haven't talked about in a while. Although we talk about the need to fight the overwhelming rates of child malnutrition in Guatemala frequently, what we haven't mentioned is how poor nutrition is just one of the many health challenges that children in Guatemala face. One of these that we face in our work everyday is the lack of primary care (pediatricians). Not having pediatricians means that children do not receive the normal "well child" check ups that we take for granted in the developed world. Consequently, if a child has a serious medical condition, it may not every be picked up, since there is no one around to pick it up!
To give you an idea about how this plays out, our experience has been that about five percent of all the children we see in a new nutrition program will have a serious medical condition. Even though our "in road" to communities is the nutrition programming, we are also committed to providing comprehensive health care, and so we always do our best to help out those children who need more than just nutrition.
One case that we are currently managing is quite typical. This is a 1 year old boy with Down's syndrome who was brought to us for the usual reason - "not growing." However, with just a quick physical examination, it was clear that something more was going on. He had a very loud heart murmur and signs of heart failure. We quickly obtained a heart ultrasound, which confirmed that he did indeed have a heart defect that was going to need surgery. Although he was certainly malnourished, the heart defect was really the major reason that he was 'not growing.'
Fortunately, we have an excellent collaboration with a group of pediatric heart surgeons who can make this happen. Therefore, over the last few months, we have been managing the child's heart failure with medications while he recuperates nutritionally. He should have surgery within the next few weeks and go on to be a much healthier child afterwards!
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