Improving Maternal-Child Nutrition in Latin America

Summary

In 2024, Batey Relief Alliance (BRA) committed to improving maternal-child nutrition in the Dominican Republic and Peru through micronutrients supplementation and community WASH education. BRA will distribute a total 1,775,000 doses of vitamin A and deworming medication to 54,000 children and multivitamins to 9,180 pregnant women on a quarterly basis until 2026 at select schools, medical clinics, and community centers in the Dominican Republic’s rural “batey”, communities built around sugarcane plantations, in Monte Plata province and Peru’s province of Cañete. Two hundred women will be trained as community health promoters to reinforce vitamin distribution with educational and health care activities to emphasize their benefits, proper use, and other related topics. Dominican Republic beneficiaries will receive monthly USAID-donated nutritious food products to supplement their dietary regimen. BRA will work with local partner organizations and Ministries of Health to develop, execute, monitor, and report on the programs

Approach

Batey Relief Alliance (BRA) commits to improving maternal-child nutrition in the Dominican Republic (DR) and Peru through targeted efforts to address the micronutrient deficiencies that put women and children’s health at risk. BRA will lead distribution of micronutrients, nutritional supplementation and community WASH education. BRA will distribute a total 1,775,000 doses of vitamin A and deworming medication to 54,000 children and multivitamins to 9180 pregnant women on a quarterly basis for two years at select schools, medical clinics, and community centers in DR’s rural “batey” communities in Monte Plata province and Peru’s province of Cañete.

These locations have been selected based on population needs, and their ability to deliver nutritional products to the target populations. Parents, medical personnel, community health workers (CHWs) , and schoolteachers will be trained to administer daily doses of vitamin A to combat malnutrition as well as deworming medications twice a year. Pregnant women will also receive education in how to use supplements effectively. DR beneficiaries will receive monthly USAID-donated nutritious food products to supplement their dietary regimen. BRA is deeply integrated with the local health systems and all program participants will also have access to primary and pediatric care services in their respective communities.

BRA will work with local partner organizations and Ministries of Health to develop, execute, monitor, and report on the program. They will reinforce program efforts through educational and healthcare activities to ensure that recipients take the medications appropriately, understand their benefits, and receive basic health services. Through this commitment, 200 women will be trained as volunteer CHWs and will lead these activities, participating in distribution and educating beneficiaries about health crisis issues and prevention measures.Through referrals made by CHWs , beneficiaries will also be sent to local clinics for their regular medical checkups and follow-up care, as needed to measure the overall improvement in their health and wellness.

Action Plan

Step 1: Quarterly Distribution of Supplements and Medication in Dominican Republic and Peru
In-school, clinic and home quarterly distributions (8) of daily doses of children’s vitamin A supplements to 54,000 children (6-59 months) Distributions (8) of multivitamins to 9180 pregnant women
Twice-a-year distributions (4) of doses of deworming medications to 54,000 children

Step 2: Quarterly Program Evaluations and Midterm and Final Reports
Evaluations (8) detailing program achievements, challenges, beneficiary success stories (including before and after photos) and lessons learned from the experience
Mid-term and final reports will be produced and presented to CGI

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 1% of the total target populations to measure the physical effects and health benefits of vitamin and deworming consumption, a total of 540 children and 92 pregnant women:
Dominican Republic: 510 children and 90 pregnant women
Peru: 30 children and 2 women

For these initial evaluations, BRA will use half of the two sampled populations to demonstrate results from the start to the end of the program, a total of 270 children and 46 pregnant women:
Dominican Republic: 255 children and 45 pregnant women
Peru: 15 children and 1 woman

Background

Micronutrients are essential for good health. When lacking in proper amounts, serious health complications may result. The insufficient consumption of micronutrients (i.e. iron, iodine, and vitamin A) affect 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 undernutrition (WHO, 2006) . Poor maternal nutrition during pregnancy increases infant and maternal mortality rates. Poor nutritional intake during nursing severely affects the health of infants making children more susceptible to illness and stunted development. For example, iron deficiency results in anemia, iodine deficiency during pregnancy can result in miscarriage, stillbirth, and mental retardation, and 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 adequate 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 under 5 are stunted. Meanwhile in Dominican Republic’s impoverished rural communities like sugarcane plantations “bateyes”, malnutrition disproportionately affects children and women, with the basic nutrition indicators below the national average. In 2013, 2% of children under 5 in the bateyes were diagnosed with acute malnutrition and 3% were overweight. For women from 15 to 49 years old, 46% were affected by being overweight or obese (UNPD 2014, CESDEM 2015, USAID 1999) .

Progress Update

Partnership Opportunities

BRA seeks funding and other financial resources, and local collaborators, best practices information and pro bono media/marketing opportunities. The projects will depend on both in-kind donations (vitamin, food, and anti-worm products) as well as financial (to carry out activities) . The financial resources will help cover the costs of field personnel, international travel for program managers to visit the projects and report to donor/CGI, monitoring and evaluation, administration, field surveys, etc. BRA will offer other organizations best practices information and program experience. Via meetings and workshops, BRA will meet with local partners about its 17-year experience in managing maternal-child nutrition programs; instruct about best practices in areas of health promoter visits to educate communities; share instructional materials produced by VA to reinforce program development; and BRA field studies on beneficiaries to measure program success and challenges.