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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Last week our blog passed 10,000 views! We began writing in October 2009, the time when we applied to join the Peace Corps. Thanks to all of you who read and comment on our entries. We enjoy keeping folks back home informed of our work and play here.
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