Sight and Life Magazine published an article last month which takes a look at Vitamin Angels’ own multiple micronutrient and deworming project in Honduras. The project is part of our Thrive to Five multivitamin program, implemented with field partner Cristo Salva and supported by Sight and Life. Designed as part of a larger Honduran Ministry of Health (MOH) rural health program, the project was the first stage of a two-stage effort to alleviate malnutrition in the region.

For many Honduran children, like others in developing countries, malnutrition is a severe threat to survival and development.  In 2006, WHO reported that 29.9% of children under five in Honduras were stunted. The same year the Honduras Demographic and Health Survey (DHS) reported that one out of four Honduran children is chronically undernourished. The MOH and DHS indicated that the highest prevalence of stunting and overweight children occurred in the rural western region, with chronic malnutrition reaching 88 percent in some rural communities. Parasitic infection is also a major contributor to malnutrition in the region as parasites rob the body and prevent absorption of essential nutrients.

The Honduras Children’s Micronutrient and Deworming Project was a 3 year “campaign-style intervention [that] sought to provide essential multiple micronutrient supplements to children 2-14 years in selected schools in the northwest region of Honduras.” Beginning in July of 2006, children were given a daily supplement for an average of 180 days per year (the number of school days in the academic year) as well as 400 mg of deworming, anti-parasitic drug Albendazole twice a year. Previously the MOH had worked to provide nutritional supplements and anti-paraistics to at-risk children, but coverage rates had been inconsistent due to limited funds.

At the request of the Honduran government, Vitamin Angels and Cristo Salva targeted 55,000 children at 88 schools in four districts of northwest Honduras – Macuelizo, Azacualpa, Nueva Frontera, and Quimistan.  Teachers delivered nutritional supplements each school day and Albendazole once every six months to eligible children. Additional supplements were provided to the parents of school-going children in order to reach preschool-aged children, and eligible out-of-school children were reached by local intermediaries. Through the school system, adults were educated on the “preparation and use of local foods rich in vitamin A as well as gardening, sanitation, and basic hygiene.“  

Over the course of the three year project (July 2006 – June 2009), nearly 100% of school-going children (26,034 children) at the 88 selected schools were reached annually with nutritional supplements and deworming tablets. Approximately 75% of preschool aged children age 2-5 (approx. 29,000 children) were reached with the same regimen.

Observational and anecdotal accounts from parents and teachers collected by the MOH and Cristo Salva indicate that the children have shown improvements in health, growth, and attentiveness in class. It was also concluded that the “distribution mechanism and effective monitoring served the project well.” Cristo Salva program director and staff visited the distribution locations regularly, and those schools found not to be fulfilling their obligation were given feedback which resulted in improvement.

Although the Honduras Micronutrient and Deworming Project shows success, concern is present for the length of time it will take for longer term interventions to take hold. This project was the first stage of a two-stage strategy, meant to move from “immediate interventions to abate the nutritional crisis, to a longer term set of policies and programs to alleviate the underlying causes of malnutrition.” Second phase policies and programs include supporting “nutrient-rich gardening among communities and schools, ongoing education on available red, green and orange leafy fruits and vegetables that supply vitamin A and other essential nutrients, and education on hygiene sanitation, water, and nutrition in schools.” 

While there has been both short term and long term success in achieving nutritional objectives in schools in the district of Azacualpa, overall the cost of alleviating malnutrition through longer term means is proving to be greater than anticipated. The MOH believes that “supplementation and deworming efforts will need to be in place for several more years until its longer term interventions take hold.” Vitamin Angels intends to continue to support this project as a part of our larger Thrive to Five program.

Read the article>>