In Nepal, 36% of children who are under the age of five remain underdeveloped in terms of growth and health despite progress in recent years. Through cooperation with USAID, the Nepalese Government and local private sector groups, Hellen Keller International (HKI) has provided impactful services that have helped rectify the systematic obstacles causing these health issues. Hellen Keller International is a non-profit organization that aims to reduce malnutrition. The Suaahara II project takes a pivotal role in these efforts.
What is the Suaahara II Project?
One of HKI’s most notable services is the Suaahara II project, which started in 2016 and was initially set to end in 2021. However, it will now extend to March 2023 due to COVID-19. Operating in 42 of Nepal’s districts with a $63 million budget, HKI partnered with these six organizations for the project:
- Cooperative for Assistance and Relief Everywhere, Inc. (CARE)
- Family Health International 360 (FHI 360)
- Environmental and Public Health Organization (ENPHO)
- Equal Access Nepal (EAN)
- Nepali Technical Assistance Group (NTAG)
- Vijaya Development Resource Center (VDRC)
Hellen Keller International’s primary role in the Suaahara II project deals with the technical assistance of child and maternal nutrition. This means that its tasks are oriented around building the skills and knowledge of health workers. This includes teaching health workers how to adequately measure and evaluate assessments; additionally, another technical facet relies on promoting governance that invests in nutrition.
A Multi-Sectoral Approach
Kenda Cunningham, a senior technical adviser for Suaahara II who works under HKI, told The Borgen Project that the Suaahara II consortium has taken a “multi-sectoral approach.” She believes in the importance of this as it pushes individuals to “learn and think beyond their sector.” The Suaahara II Project’s demonstrates its integrated strategy in the initiatives below:
- The WASH program focuses on water, sanitation and hygiene through WASHmarts, which are small shops dispersed across districts that sell sanitary products like soap and reusable sanitary pads. Kenda explained how this has helped “bridge a gap” so that poorer households can access hygiene enhancing products. This also allows assistance from private actors, who can expand their markets in rural areas.
- The Homestead Food Production program (HFP) encourages households to grow and produce micronutrient-rich foods through vegetable gardening and raising chickens, for example. As a result, 35 districts have institutionalized HFP groups.
- The Bhancchin Aama Radio Program is a phone-in radio program that runs twice every week. It hosts discussions among marginalized communities and demonstrations for cooking nutritious foods. It has encouraged the Nepalese to socially and behaviorally alter their health habits.
Advancements from Suaahara I
The Suaahara II project’s contribution to improved health and nutrition in Nepal is also illustrated in its progression from the Suaahara I project’s framework. In addition to understanding the changes made in household systems and at a policy level from Suaahara I, Cunningham told The Borgen Project that technological developments have elevated the Suaahara II Project’s impact in Nepal.
Specifically, smartphones expedite the data collection process when studying trends pertaining to the 2 million households across the districts. The development of new apps provided more households with access to smartphones and key information. This therefore allowed officers to transition from pursuing “a mother-child focus to a family focus” in terms of the Suaahara II project’s accommodations and services.
Challenges with Suaahara II
While the Suaahara II Project has led to institutional and social enhancements regarding health and nutrition, some districts had access to the project earlier. This created a dissonance in the rate of health improvements amongst the districts. Cunningham reported that “far western areas are much more remote and therefore disadvantaged and food insecure.”
This inconsistency was largely due to the “Federalism” that took place in Nepal in 2017, which was a decentralization process that created 42 municipalities for 42 districts. Since every municipality has a different political leader, some districts had the advantage of assistance from foreign NGOs while others did not because their leaders rejected involving foreign NGOs. In these cases, as Cunningham explained, it is like “you are creating your own NGOs from the ground up.”
Suaahara II Achievements
These obstacles, however, have not been pertinent enough to counter the consortium’s efforts in fulfilling the Suaahara II project’s objectives. For example, a primary objective for Suaahra II is to increase breastfeeding amongst babies under six months of age. Exclusive breastfeeding of children under six has increased from 62.9% in 2017 to 68.9% in 2019, according to data that Cunningham shared with The Borgen Project.
Expanding children’s access to diverse and nutritious foods is another objective that has been achieved under the Suaahara II project. The dietary diversity among women of reproductive age (WRA) has increased from 35.6% in 2017 to 45.3% in 2019, according to Cunningham. Given the efficient rate of improvement in women and children’s health, governance and equity in only the first two years of the Suaahara II project, it can be inferred that the consortium will continue to progress in achieving its targets among the Nepalese in the three years that remain.
Regarding how HKI has responded to challenges with the Suaahara II project, Cunningham said “[We] don’t use a one size fits all approach.” The advancements in Nepal’s health and nutrition systems can be largely attributed to HKI’s multifaceted and integrated strategy, a model that could yield prosperity in the rest of the developing world.
– Joy Arkeh