The network includes satellite clinics, rural health posts, and community health workers who function much like nurse practitioners. Babies have their weight and length measured when they come in for check-ups and immunizations. If their growth is not progressing or if they fall below the second standard deviation for age, they are are given supplements. If they are at minus three standard deviations, they are referred to the regional doctors, since they may also have parasites or other illness in addition to not eating enough calories.
Children are supplemented up to the age of two since that is the critical time of development that cannot be corrected by feeding later in life. The cut-off at age two is not a hard end point, and there is some flexibility.
The supplement used is Incaparina and comes dry and packaged in plastic. It looks like corn meal but is mostly soy protein and has vitamin supplements. Each serving (corn and soy flours) of Incaparina contains 379 calories and has 21.75 grams of protein, no sugar, 5.58 grams of fat, 9.9 grams of fiber and zero cholesterol. The brochures describe many ways to prepare it. It keeps for up to four days with refrigeration once it is prepared.
I think the program is a wonderful one and is pretty successful. The weak point may be the number of community health workers who are on the front lines of the campaign. They work extremely hard and are underpaid. I think they need more help. The payoff will be the next generation of youth who will start life without the deficit of malnutrition.
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