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 Health  Nepal Project #2055

Rescue Children Suffering From Severe Malnutrition

by Nepal Youth Foundation (NYF)
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Rescue Children Suffering From Severe Malnutrition
Rescue Children Suffering From Severe Malnutrition
Rescue Children Suffering From Severe Malnutrition
Rescue Children Suffering From Severe Malnutrition
Rescue Children Suffering From Severe Malnutrition
Rescue Children Suffering From Severe Malnutrition
Rescue Children Suffering From Severe Malnutrition
Rescue Children Suffering From Severe Malnutrition
Rescue Children Suffering From Severe Malnutrition
Rescue Children Suffering From Severe Malnutrition
Rescue Children Suffering From Severe Malnutrition
Rescue Children Suffering From Severe Malnutrition
Rescue Children Suffering From Severe Malnutrition
Rescue Children Suffering From Severe Malnutrition
Rescue Children Suffering From Severe Malnutrition
Rescue Children Suffering From Severe Malnutrition
Rescue Children Suffering From Severe Malnutrition
Nutritional education for mothers and children
Nutritional education for mothers and children

In Nepal, around half the children under five are malnourished. Malnutrition is a leading cause of death in young children.

NYF's Nutritional Rehabilitation Homes (NRHs) are small home-like hospitals throughout Nepal that use an innovative method to restore severely malnourished children to good health while educating their mothers in nutrition and child care. When mother and child return home, the mother shares her new knowledge with her family and neighbors, multiplying the impact.

NYF opened the first Nutritional Rehabilitation Home in 1998. Since then, the program has treated 8,443 severely malnourished children and educated 7,528 of their parents and guardians. In 2011-2012 alone, the NRHs rescued 1374 children and trained 1249 caretakers.

NYF’s Solution

In Nepal, the main cause of malnutrition is ignorance, rather than poverty. Severely malnourished children come to NRHs with their caretakers (who, in Nepal, are almost always their mothers). Many of these children are emaciated and lifeless. The NRHs’ nurses, dieticians, and cooks provide medical care and nutritious food to restore the youngsters to full weight and health. More than 80% of the patients are younger than five.

At the same time, the staff trains the youngsters’ guardians about a wide range of topics including preparing nutritious meals using locally available, inexpensive food; sanitation and hygiene; preventive health care; and how to share this knowledge with others. The daily hands-on training sessions and practical demonstrations are very effective with illiterate and uneducated parents.

After an average of five weeks, a happy, healthy child and a newly educated mother return to their home. The mother provides better nutrition for her entire family and tells her relatives and neighbors what she learned at the NRH, extending the effects of the program far beyond the children who are treated at the facilities.

According to a typical case study, “When Lhamu returned to her village, the entire community was in awe over her improvement. Moreover, her mother has now changed her feeding habits and improved her family’s hygiene.”

NRH field staff visit every child at least twice to ensure they are retaining their health and weight. They also provide additional training to the caretakers and refer the children to hospitals or NRHs if they suffer from health problems. In 2011-2012, NRH staff conducted 1,490 follow-up visits and found that the small number of children who were still malnourished were generally suffering from chronic diseases or were from deeply impoverished families.

Expansion of the Program

This program has been extremely successful. At the request of the government of Nepal, NYF has built Nutritional Rehabilitation Homes throughout the country. With the exception of the flagship facility in Kathmandu, each NRH is constructed on or next to the grounds of a large government hospital. Through an agreement with the government, NYF builds the facilities, hires and trains staff, and gradually transfers management and funding of the operation to the government hospital. After five years, the government is fully responsible for the NRH.

NYF has now constructed 12 NRHs, which can treat a total of 143 children at a time. In 2011-2012, the organization transferred two NRHs to the government. NYF’s staff inspected all five NRHs that have crossed the five-year threshold and found that all are adequately funded and effectively managed.

The program continues to expand across the country to rescue children from malnutrition in remote areas. In 2011-2012, NRHs were in all stages of development: a newly built one began operation, NYF completed construction of another, and plans were made to begin one more. NYF also secured funding to construct three more facilities in rural and remote areas of Nepal.

In early 2012, NYF’s flagship NRH moved to a new and much larger facility. In addition to its functions as an NRH, it serves as a nutritional education center for training dieticians and health care professionals.

The NRHs’ pioneering approach has built-in sustainability. The nutritional knowledge imparted on the caretakers stays with them for life and will be handed down for generations. On a larger scale, by transferring management of the NRHs to government hospitals, NYF ensures they will continue to rescue malnourished children for decades to come, and frees NYF’s funding to be used for other projects.

Akha when he first arrived at the NRH...
Akha when he first arrived at the NRH...
...Akha after just a few weeks of treatment
...Akha after just a few weeks of treatment


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Anika after 4 weeks at the NRH
Anika after 4 weeks at the NRH

Within the last half year, 442 malnourished children were admitted to NYF Nutritional Rehabilitation Homes.  While the children's health was being restored through proper nutrition on a diet of locally available foods, 377 caregivers were trained in proper food preparation and child care.

In addition, 745 children who had been treated previously received follow-up visits from our field workers who ensure that the children continue to receive appropriate care. 

And, our Bi-Annual report indicates that all of the NRHs are meeting their target admission, discharge and follow ups schedules.  Plus, due to improved practices and streamlined methods, to restore a child to WHO health standards costs our donors $80 less per child now than last year.

And, now, next Wednesday, March 14 ONLY...

... because we appreciate every dollar you have given to support our program, NYF is thrilled to invite you to participate in GlobalGiving’s Bonus Day event.

Wednesday, March 14, 2012, will match 30% for every dollar you donate!  $50,000 in matching funds are available, but only on March 14.  This 30% matching offer begins right after the stroke of midnight, March 13, and runs only until the $50,000 is claimed. Once the funds are used, no more matching funds will be applied.

Add even greater value to the gifts you give NYF.  Mark your calendars for NEXT Wednesday, March 14, 2012.

And, GlobalGiving will make this 30% match for single contributions up to $1,000!  That’s $1,300 value for a $1,000 donation.

As far as NYF's Nutritional Rehabilitation Homes go, this means that the same $1,000 donation which can normally support the return to health by fewer than four severely malnourished children can, on Wednesday, March 14, 2012 ONLY provide for the full program of revitalized health for five youngsters, including parental education to ensure the entire family's well-being for the same investment.


  • The organization that raises the most funds on Bonus Day will receive an additional $1,000 from GlobalGiving.
  • The organization that has the most unique donors on Bonus Day will receive an additional $1,000 from GlobalGiving.

Thank you again for your support of the Nepal Youth Foundation.  Namaste!


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Jamuna at arrival in Nepalgunj NRH
Jamuna at arrival in Nepalgunj NRH


A case study: Jamuna Budha Magar

Jamuna Budha Magar is almost 12 years old.  Her family lives in the far west part of Nepal in the Rukum district.  She is one of eight children ranging in ages from seven to 14.  Her parents lack formal education and are illiterate. Jamuna, herself, never learned to read or write, and, now, due to serious and unaddressed ailments she cannot speak.  Recently, she lost her sight as a result of a severe E.coli infection.  When Jamuna arrived at the Baluatar Nutritional Rehabilitation Home (NRH) in Kathmandu, her length was 107 cm (3.5 ft) and weight, 9 kg (19.8 lbs).  According to World Health Organization guidelines, this is a score of minus-4 on a weight to height ratio (a comparative scale which normally goes only to minus-3:

Under other circumstances, it is very probable that Jamuna would be dead by the time you read this.

After Jamuna’s admission, NRH nutritionists designed a diet plan to address her nutritional deficiencies. She was fed milk, rice pudding and other foods which her system could assimilate. From the first week, she began to gain weight at a steady rate of almost 1 kg (2.2 lbs) per week. In the initial 29 days of her stay in the NRH, Jamuna has gained 4.4 kg (9.7 lbs). Now, her total body weight is 13.4 kg (29.5 lbs). Despite losing her vision, Jamuna has begun responding and, although she cannot speak, according to the staff at the NRH, she smiles when she is happy. Recently, she was taken for a consultation with the doctors at Tribhuvan University Teaching Hospital. Their recommendation is that Jamuna gain optimum weight before she undergoes surgery to deal with ailments contracted due to severe ongoing malnutrition, including hydrocephalus.

We continue to be deeply grateful for your support of the NRH program and, especially, when we can save a child on the very brink of death as Jamuna was. Please give as generously as you can, so that we can continue to help kids in Nepal grow up to live as fully as possible.

Jamuna after 10 days of NRH Nutritional Care
Jamuna after 10 days of NRH Nutritional Care
Jamuna after 29 days of NRH Nutritional Care
Jamuna after 29 days of NRH Nutritional Care
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Newest NRH in Rajbiraj
Newest NRH in Rajbiraj

Rajbiraj Nutritional Rehabilitation Home

Seven years ago, the Nepal Youth Foundation offered to build a Nutritional Rehabilitation Home (NRH) next to the government's "zonal" hospital in the town of Rajbiraj in southeastern Nepal.  From the first NRH built in Kathmandu in 1998, Nepal's Minister of Health supported the project and urged NYF to expand these facilities around the country.  A goal of 14 NRH's was set, with the intention of establishing an NRH adjacent to each of the country's zonal hospitals.

In 2004, NYF approached the administrator for the Sagarmatha zonal hospital in Rajbiraj. The hospital itself was in desperate need of upkeep and the conditions for the patients were very poor and unsanitary.  One of the most unhealthy aspects of the site was an open pond right on the hospital grounds into which biological waste was dumped. We were certain that the NRH would be a welcome addition as a place to provide long-term care for infants and children suffering malnutrition, a frequent cause of children's hospitalization. However, the administrator refused the offer.

Yet, NYF did not forget their commitment to build an NRH by every hospital. So our staff kept offering. This year, Sagarmatha hospital's new administrator said, "Yes."  In less than half a year, the new NRH was built and opened its doors to children and their caregivers.

And, the most wondrous part of the story is the open waste pit was emptied, disinfected and backfilled and is now the very place on which the NRH stands.  Yes, "out of the mud grows the lotus." 

On behalf of the children we serve, thank you for your support.  For more information please visit our website, Follow this link to watch our new 4 minute video:

Rajeev Thakur at Admission to Rajbiraj NRH
Rajeev Thakur at Admission to Rajbiraj NRH
Rajeev Thakur after 18 days at NRH
Rajeev Thakur after 18 days at NRH


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Nutritional Rehabilitation Homes


In 1998, Nepal Youth foundation (NYF) started piloting Nutrition Rehabilitation Home (NRH) initiative in Kathmandu.  The successful learning encouraged NYF to expand this program to other regional and zonal hospitals.  So far NYF has established 9 NRHs that has been able to support 6724 malnourished children to regain normal health and 5969 parents (caretakers) have been provided with intensive counseling and hands-on training on nutrition, family health and personal hygiene.  NYF has been successfully supporting the Nutritional Rehabilitation Homes (NRH) at nine regional and zonal hospitals outside Kathmandu.


  • To rehabilitate the severely malnourished children 
  • To educate the caretakers on food and nutrition 


-         The NRHs are located in10 districts of the country.  The total capacity of 10 NRHs is 123 beds.  With an average of 35 children staying days and a ninety percent occupancy target, these NRHs have a capacity to serve 1154 malnourished children per year.  

-         NRH Nepalgunj, NRH Biratnagar and NRH-Bhadrapur were taken over by the respective zonal hospitals in June 2009 & 2010.  The government of Nepal, Ministry of Health provided the budget for these NRHs and they are functioning smoothly.  Now NYF is managing 7 NRHs with 86 beds capacity

-         During the nine month period the overall construction work of NRH building in Janakpur was completed.  The inauguration of the building was held in 29th December 2010 and it has started operation.

-         President, Executive Director and Nutrition Coordinator of NYF visited Janakpur for the inauguration.  NRH building was inaugurated jointly by the President of NYF Ms. Olga D. Murray and the Chairperson of Janakpur Zonal Hospital Development Mr. Kunwar Kanta Jha.

-         At the same time they have visited Rajbiraj to observe the progress in construction activities of the new NRH building.

-         The construction of NRH-Rajbiraj on the premises of Sagarmatha Zonal Hospital is going on and it will be completed by the end of April.

-         The process of finalizing the agreement with Dhaulagiri Zonal Hospital, Baglung is already completed and it will be signed in January 2011.

-         During this period Program Director of NYOF visited NRH-Pokhara and provides some instruction to the staffs for the better functioning of the facility.

-         Training sessions were organized at NRH-Kathmandu for the staff of NRH-Janakpur.  The objective of the training was to show the overall management of establishment of satellite NRH and its smooth operation and to strengthen the confidence of the newly appointed staff for the conduction of the project.

-         Ministry of Health, Department of Health Services has declared that every last week of December will be considered as nutrition week.  The government agencies for health services, NGOs and INGOs involving in nutritional activities have been celebrating this occasion by conducting different nutritional events in their respective fields.  All NRHs celebrated it in coordination with the District Public Health Offices demonstrating locally available nutritious food-stuffs and providing education on nutrition.

-         NRH-Kathmandu conducted an outreach Nutrition Awareness Camp in Dukuchhap Village Development Committee of Lalitpur district on October 29th 2010 to cover the children from Danuwar ethnic group. Including NRH team, 7 volunteers from project's abroad were involved in the camp to help the team.  Enrollment of children was very impressive, 332 children attended in the camp and anthropometric measurement were taken.  All the mothers participated in the nutrition education session delivered by the dietitian. The health workers tried to educate the mothers through songs to make the education more impressive.

Regular Activities: 

Admissions, discharges and follow-ups are the regular procedures of all NRHs.  At the time of admission and discharge, anthropometric measurement and photographs of all the children are taken.

During July to December, the following activities were carried out by the seven NRHs.

-         A total of 491 children were provided with nutritional care and 424 caretakers were educated on nutrition.  Among the admitted children 84% belonged to age-group under 5 years.                                                 

-         During the period, 494 children were discharged including 287 male and 207 female.

-         Among the discharged children, 377 were officially discharged, 59 discharged before time due to the Dashain and Tihar festival, 31 referred to hospital, because they were having more complications and needed to be re-hospitalized.

-         During the reported period, 870 follow-ups were recorded from 7 NRHs in which 353 were the first, 291 and 226 were the second and third follow-up, respectively.  During follow-up period, most of the children’s health conditions were found to be satisfactory.  Few children were still malnourished due to poor economic condition while a few were having chronic diseases as well.

-         During this period 4 death cases were recorded from NRH Kathmandu and Surkhet.  It was recorded in the follow-up process.  It was due to other diseases.

-         Counseling services were provided by different NRHs to the guardians whose children are mildly malnourished, and these guardians are not able to stay for the recommended treatment.  They receive counseling services by the staff of NRH.  The nursing staff and manager counsel the guardian especially mothers to feed the appropriate balanced diet to recover the weight that the child has lost.  This activity seemed effective.  After attending in the counseling session, maximum number of guardians reported a good improvement observed in their children.


Case History

Akha Pun a 21 month old boy was referred from a private pediatric hospital - IFCH (International Friendship Children's Hospital) on September 8, 2010 in a severe stage of PEM (Protein Energy Malnutrition).   He got admitted in IFCH for few days and stabilized there.  The causes of admission in the IFCH were vomiting, loose stool, skin infection, fever and lose of weight.


Akha belongs to a middle class family and his parents are well educated.  He was the second child of his parents.  Even having a good surrounding such as economically and socially, Akha's health condition was deteriorating day by day and he had to visit Kathmandu for the treatment.


The main occupation of the family was agriculture though his father was abroad for the livelihood.   His mother Rima is responsible for looking after both of the children.   Akha used to get 2 meals and 3 snacks a day which is enough for a little boy like Akha but the ingredients were not properly mixed while preparing the food.


At arrival, he weighted at 6.5 kg and height was 71 cm and as per WHO guideline he was severely malnourished (<-3 standard deviations).  He looked very sad and pale.  The rehabilitation program was started with formula 75 and he passed through the entire treatment course.  He received Vitamin A single dose, folic acid regularly.  He started to consume 975 kilo calorie per day and finally able to consume 1545 kilo calorie per day.   Mother Rima had the opportunity to participate in the nutrition education session offered by the NRH.  She understood the importance of good nutrition for a child's growth and development.


After 34 days at the NRH, Akha had reached his desired weight and was no longer malnourished.   During his stay at NRH, his weight was dramatically increased and he reached 8 kg at the date of discharge (October 12), which was a 1.5 kg weight gain in 34 days.   His mother, who was caring him in the Centre, also gained 3.7 kg of her weight.   Akha seemed very happy and healthy at the time of discharge.


We thank you for supporting this worthwhile project.


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Organization Information

Nepal Youth Foundation (NYF)

Location: Sausalito, California - USA
Facebook: Facebook Page
Twitter: @nepalyouthfound
Project Leader:
Julie Pofsky
Associate Director of Development
Sausalito, CA United States
$42,139 raised of $50,000 goal
856 donations
$7,861 to go
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