Hearth nutrition model : applications in Haiti, Vietnam, and Bangladesh

The model has evolved from earlier community-based approaches to alleviating childhood malnutrition. The focus is on energizing volunteer mothers to rehabilitate malnourished children using local, affordable, nutritious positive-deviant foods for two weeks in the context of a growth monitoring and counseling program. The visible change in the children is a powerful motivator for mothers to continue good feeding practices acquired through adult learning practices (self-discovery, learning by doing) in the Hearth feeding sessions. Hearth programs are meant to be supported by other programs such as deworming, growth monitoring, income generation, and micronutrient supplementation. Findings from recent technical evaluation reports indicate that Hearth can make a significant contribution to the reduction of malnutrition. Results in Haiti indicate that while the short-term rehabilitation of severely and moderately malnourished children under 5 years of age is highly motivating to mothers, the most important long-term impact of the program appears to be the prevention of nutritional deterioration in mildly malnourished children. The results in Vietnam show that the program has improved weight-for age in participating children under 3 years of age by 0.36 Z-scores on average, and eradicated 82% of all severe and very severe malnutrition in the same group. The solution is rapid, significant, and sustainable. Further studies are needed to ascertain whether the program can be replicated in less organized and literate settings. Three-month data from Bangladesh show that the program may have helped to reduce overall malnutrition in the project area from 37.6% to 33.4%. (Author abstract)