<figure><img width="1600" height="1200" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221129151140/638619ea9c7e80680e0ccccfjpeg.jpg" alt=""/><figcaption>Young children suffering from undernutrition have poorer school achievement, diminished cognitive and language ability, and more behavioural problems. Adults who were malnourished in childhood have less economic productivity and increased incidence of health problems.</figcaption></figure>Malnutrition has long been identified as a major barrier to development in Nepal, and other low-income countries. The solution seems obvious: ensure that children eat enough of a balanced diet so they get the needed proteins, vitamins and minerals.Two recent projects set out to do just that. The first provided animal source foods (meat, fish, eggs and dairy), vegetables and a diverse diet to children in low-income farming households in Nepal’s Banke district. The second helped women in Bajura to grow vegetables in kitchen gardens. Both succeeded, but would have done even better if the beneficiary families did not face so many other obstacles.In Bajura, researchers found that ‘structural barriers’ prevented some women participants, all of who were pregnant or had children two years old or younger, from committing fully to the garden.‘Participants demonstrated high levels of knowledge about the program’s nutrition messages and expressed interest in and motivation to engage in the program,’ wrote the study’s authors. ‘However, access to water, land, and time determined the extent to which their full participation in the program was feasible.’<a href="https://www.nepalitimes.com/banner/nearly-half-of-nepali-children-still-malnourished/">Nearly half of Nepali children still malnourished</a>, Sonia Awale <img width="1600" height="1200" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221129151140/638619ef9c7e80680e0cccd0jpeg.jpg" alt="">That finding was not surprising, says Pooja Pandey Rana, deputy chief of party for the Suaahara nutrition program, the operational arm of Nepal’s multi-sector nutrition plan. Based at Helen Keller International, which carried out the garden project, Rana was a co-author of the study, ‘Navigating structural barriers to the implementation of agriculture-nutrition programs in Nepal’ published in the journal <a href="https://link.springer.com/article/10.1007/s12571-020-01031-0" data-saferedirecturl="https://www.google.com/url?q=https://link.springer.com/article/10.1007/s12571-020-01031-0&amp;source=gmail&amp;ust=1589177540738000&amp;usg=AFQjCNFVbcRmzXA6g1wjMOG3fB0pgUvJzQ">Food Security</a> in April 2020.<a href="https://www.nepalitimes.com/latest/covid-19-affecting-food-security-in-nepal-wfp/">COVID-19 affecting food security in Nepal: WFP</a>, Nepali Times“We have made massive progress on stunting, on the nutrition indicators. But on the underlying barriers, access to food, to all these resources, I think we can do a lot more and not one project can do everything,” said Rana in a telephone interview. “It also raises the question of what the broader interventions we can do in a nutrition program, and are donors ready to support them. They have their own targets, their own agenda and theory of change.”The study notes that difficulties accessing water were raised in nearly every conversation researchers had with participants and staff and in focus group discussions with female community health volunteers. In some cases, the barrier was the time required to fetch water, in others it was a ban on Dalit villagers using taps or scarcity of water overall.The research suggested solutions to overcome such barriers, at least in the short term. For water, that included ‘micro-irrigation’ equipment (sprinklers and hoses). ‘Enabling households to access such equipment, possibly by subsidising it or through community sharing schemes, could ease access to water and substantially reduce the work burden associated with kitchen garden cultivation for many participants,’ the report said.<a href="http://nepalitimes.com/article/nation/child-undernourishment-a-major-risk-after-the-earthquake,2379" target="blank" rel="noopener noreferrer">You eat what you sow</a>, Sahina ShresthaRana says that phase two of the project has incorporated some such ideas. These include training women farmers on wastewater management and forming village farmer networks so women growers can better negotiate with traders.Overall, she is optimistic, partly because of interest from local governments: “Most of the municipal leaders we’ve interacted with want to do really good, impactful work. But they need support on strategic things, for example who to contact for poultry vaccination. They need these sorts of networks and connections and capacity-building.” <img width="1600" height="1200" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221129151140/638619f29c7e80680e0cccd1jpeg.jpg" alt="">In Banke, researchers found that over four years the contribution of diet to developmental status were striking. ‘Even small changes in dietary intake were associated with impressive improvements in child developmental performance,’ wrote the authors in the journal <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.12964" data-saferedirecturl="https://www.google.com/url?q=https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.12964&amp;source=gmail&amp;ust=1589177540739000&amp;usg=AFQjCNHBxK1QHeXh453q39WMO2zTUc8MEg">Maternal &amp; Child Nutrition</a> in January.   But that impact was tempered by household wealth, mother’s education and ‘home environmental quality’ including such things as availability of toys, dolls, and books, interactive activities such as mothers and children reading together, telling stories, and playing, and how often the child was left alone or under the supervision of another child.‘Limited resource environments present many potential hazards to growing children, including poor nutrition, lack of medical care, increased exposure to infections, physical and emotional neglect,stress, and lack of stimulation for cognitive development ... lower educational levels of the parents (particularly the mother) are one of many additional risk factors in impoverished households.’<a href="http://nepalitimes.com/article/nation/the-face-of-hunger-debt-malnutrition,3604" target="blank" rel="noopener noreferrer">The face of hunger</a>, Om Astha Rai‘We found that child developmental scores were significantly associated with household wealth, maternal education, and the home environmental quality’, the authors concluded.Those findings echo the analysis in <a href="https://www.nepalitimes.com/opinion/newborn-deaths-and-a-vision-for-a-post-pandemic-nepal/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/newborn-deaths-and-a-vision-for-a-post-pandemic-nepal/&amp;source=gmail&amp;ust=1589177540739000&amp;usg=AFQjCNFcHt-4ZzGFqJg6SysOZykYQjFvvg">another recent study</a>, which concluded that Nepal’s poorest families are 50 years behind its richest households in terms of newborn health. Key risk factors for neonatal mortality were a mother’s lack of a tetanus vaccination, her education status, giving birth before the age of 20, household air pollution, poverty, and having no toilet at home.Rana says she sees hope in the next generation of women, who are different than their mothers: “Almost 70% of them have access to cell phones in Bajura. How do we use that technology to empower them? They want to do more, study more … The progress we’ve made is tremendous in terms of nutrition indicators but adolescence and youth is a missed opportunity — we need to do more.”Read also:<a href="https://archive.nepalitimes.com/article/nation/malnutrition-stunting-wasting,3603">Thought for food</a>, Marty Logan<a href="https://www.nepalitimes.com/banner/junk-food-is-making-nepali-children-shorter/">Junk food is making Nepali children shorter</a>, Marty Logan

original

674x448

610x380

500x500

400x266

400x240

400x203

301x200

1250x600

1084x550

Food for thought for Nepal’s nutrition planners

<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110714114/636902cc9c7e80680e037c85jpeg.jpg" alt="" width="640" height="480"/>The 15-year-old boy weighs 54kg, much more than an average Nepali his age. He is malnourished.His breakfast and lunch consist of biscuits, instant noodles and other packaged foods. His uncle buys him <a href="http://archive.nepalitimes.com/article/nation/diabetes-in-south-asia,3018" target="_blank" rel="noopener">fizzy, sugary drinks</a>. The boy does not like home-cooked meals, and when he does they are oily and deep-fried.Read also: <a href="https://www.nepalitimes.com/here-now/nepalis-binge-on-junk-foods-the-west-rejected/" target="_blank" rel="noopener">Nepalis binge on junk foods the West rejected...</a>, Duksangh SherpaWhen he came to me, the boy was already suffering from a sore back, he could not run, and found it difficult to climb the stairs to the third floor.There is a strong chance he will suffer from diabetes and hypertension by the time he is 25. His grandmother is worried about his addiction to sugar-sweetened sodas and packaged foods.While in the US, 15 years ago, I saw many obese adolescents, and remember thinking we had the opposite problem in <a href="http://archive.nepalitimes.com/article/nation/malnutrition-stunting-wasting,3603" target="_blank" rel="noopener">Nepal: under-nourishment</a> and stunting. Not any more, however, because urban Nepal is now seeing an American-style epidemic of malnutrition.It used to be rare to see an overweight child in Nepal’s schools, but today it is a common sight. In a recent informal survey of a school in Sindhupalchok, I found students mostly bring money from home to buy packaged food for lunch. Teachers themselves consumed junk foods for snacks, and had no idea about the lack of nutritional value. They purchased the packets out of convenience.The mothers of the students told me they always believed instant noodles were nutritious. They liked the fact that it was cheap, didn’t need to be cooked, and their children loved it. They were aghast when I showed them pictures of children gaunt with malnourishment. Some mothers asked: if junk food was so bad , then why were there so many celebrity-endorsed TV advertisements? If the government does not care about your health, we have to think of it ourselves, I answered.A three-year-old in Far Western Nepal was dying from malnutrition: not because she had nothing to eat, but because she had been eating the wrong food. Her mother took the child to a health centre, where she admitted her daughter only ate instant noodles and cheese balls. The girl was referred to the Nutrition Rehabilitation Center in Nepalganj, and was nursed back to health.I have an acquaintance who works in one of the instant noodle factories in Nepal, and he says he wouldn’t touch the stuff - he knew what went into it. “I would never eat it, and never give it to my children,” he told me.The junk food industry is all about creating demand through marketing and branding. It equates packaged foods with modernity, affluence, and a trendy lifestyle. What it is really all about is putting them in non-biodegradable single-use plastic into our landfill sites, and robbing our people of their health. Junk food is another symptom showing we are becoming a throw-away society, and if we are not careful we will throw away our children’s futures.Aruna Uprety is a public health specialist and co-author of the book 'Khana Khanu Bhayo'?Read also: <a href="https://www.nepalitimes.com/?p=10606&amp;preview=true" target="_blank" rel="noopener">Could Nepali cuisine go global?</a> Thomas Heaton<a href="http://archive.nepalitimes.com/news.php?id=2409#.W2L-r9UzbIU" target="_blank" rel="noopener">Junk food epidemic</a>, Aruna Uprety<a href="http://archive.nepalitimes.com/regular-columns/GUEST-COLUMN/promoting-nutritious-local-food-for-post-quake-children,524" target="_blank" rel="noopener">Local is best</a>, Aruna Uprety

Living to eat

mainNavigation

footerNavigation

opinionSubnav