Replicating and expanding a proven program model into Peru, BRA commits to providing children's multivitamins and deworming medications to 2,000 children (ages 5 and under), vitamin A supplements and prenatal vitamins to 450 pregnant and nursing women living in 19 highly impoverished and vulnerable urban communities in the Metropolitan Area of Lima. BRA has four years of experience implementing similar programs in the Dominican Republic and Haiti, improving the health of more than 75,000 children and pregnant women in those countries.
BRA will distribute vitamin and deworming medication on a quarterly basis for two years at select schools, medical clinics, and community centers. These location have been selected based on the needs of the populations they serve (children and women), and their ability to deliver vitamins and deworming medication to target populations. Parents, doctors, nurses, community health promoters (CHPs), and schoolteachers will be trained to administer daily doses of multivitamins and Vitamin A to combat malnutrition. They will distribute doses of deworming medicines to the children twice a year, as directed by the product donor, Vitamin Angels. The same procedure will be taught for pregnant women.
BRA will work with field technicians, local partner organizations and Peru's Ministry of Health to develop, execute, monitor and report on the program.
BRA will reinforce program efforts through educational and healthcare activities to ensure that recipients take the vitamins and anti-worm medicines appropriately, are oriented on their benefits and receive basic health services. CHP will lead these activities, participating in distributions and educating beneficiaries about health crisis issues and prevention techniques, including hygiene, water and sanitation, best prenatal care, water-borne diseases, sexually-transmitted infections and HIV/AIDS, etc. During the program, annual physical checkups of the children, pregnant women and nursing women, will be conducted to measure the overall improvement in their health and wellness.
Step 1: Quarterly Distribution of Supplements and Medication
BRA will conduct in-school, clinic, and home quarterly distributions of daily doses of vitamin A supplements, children's multivitamins, and twice-a-year doses of deworming medication to 2,000 children (ages 5 and under). BRA will also provide vitamin A supplements and prenatal vitamins to 450 pregnant and nursing women living in highly impoverished, vulnerable rural and urban communities in Peru (in January 2014, April 2014, July 2014, October 2014, January 2015, April 2015, July 2015, October 2015), with 4 distributions per year, for the two year course of the program.
Step 2: Quarterly Program Evaluations
BRA will conduct quarterly evaluations, detailing program achievements, challenges, beneficiary success stories (including before and after photos), and lessons learned from the experience. A mid-term and final report will be produced and presented to CGI in January 2015 and January 2016, respectively.
Step 3: Medical Evaluations
During the two-year program, BRA will conduct one (1) pre-vitamin-distribution and (1) post-vitamin-distribution medical evaluations of 45 beneficiaries (30 children and 15 pregnant/nursing women) to measure the physical effects and health benefits of vitamin and deworming consumption. For these evaluations, BRA will use this sample population of a minimum of 30 children and 15 pregnant and nursing women to demonstrate results from the start to the end of the program.
Micronutrients are essential for good health; when lacking in proper amounts, serious health complications result. The insufficient consumption of micronutrients (i.e. iron, iodine, and vitamin A) affects the health and survival of more than 2 billion people worldwide (WHO, 2006). Children are particularly affected by this issue and it is estimated that more than 1/3 of deaths in children five and under are attributable to under nutrition (WHO, 2006).
Poor maternal nutrition during pregnancy increases infant and maternal mortality rates. At the same time, poor nutritional intake during nursing severely affects the health of infants making children more susceptible to illness and stunted development. For example, an iron deficiency results in anemia, an iodine deficiency during pregnancy can result in miscarriage, stillbirth, and mental retardation, and a vitamin A deficiency can cause blindness in children and night blindness in pregnant women. Adequate nutrition is necessary in early childhood development to ensure healthy growth, proper organ formation and function, strong immune system, and cognitive development. Malnutrition is a critical issue in Peru, where 34.8% of Peruvians live below the poverty line (WHO, 2010).
High poverty rates, food insecurity and lack of resources to acquire adequately nutritious food affect nutrition and overall health for the country. Vitamin A deficiency ranges between 8.7% and 15.7%, 42.7% of Peruvian women of childbearing age (ages 15-44) suffer from anemia and 18.1% of all Peruvian children five and under are stunted. In addition, Peru's maternal mortality rate is 98 deaths for every 100,000 births. While their body's demand for nutrients increase dramatically during stages of these particular stages of growth and development, '
pregnant and lactating women, infants and young children are in the most nutritionally-vulnerable stages of the life cycle'(Lartey, 2008). Nutrition intervention is fundamental to improve overall health of Peruvian women and children.