Recent estimates suggest that maternal and child undernutrition is the underlying cause of 3.5 million deaths. Undernutrition is not merely a result of too little food; rather, it is a consequence of myriad factors, including poverty, repeated illnesses, inadequate access to health services, insufficient macro and micronutrient intake, unsafe water, and lack of access to improved sanitation. Cost-effective and proven interventions, when appropriately tailored and applied during the Window of Opportunity, “The First 1,000 Days” from conception to age two, can break the vicious cycle of undernutrition. PSI seeks to launch and scale up evidence based nutrition interventions including iron folic acid and multivitamin tablets for women of reproductive age, the promotion of exclusive breastfeeding, home fortification with micronutrient powder, and large scale food fortification. PSI reaches women and children with these lifesaving interventions through community health workers, private sector providers as well as public health facilities.

Maternal, Infant and Young Child Nutrition

Through targeted maternal, infant and young child nutrition (MIYCN) interventions that engage pregnant and lactating mothers, PSI has a positive health impact on both mother and child before, during, and after birth. At the root of undernutrition in most developing countries is poor maternal nutrition, which leads to low birth weight babies. Subsequent poor infant and young child feeding practices such as sub-optimal exclusive breastfeeding during the first six months of life leaves infants vulnerable to an array of infections during a time of critical immune system development.

To address this problem, PSI promotes exclusive breastfeeding during the first six months of a baby’s life. In order to make messages culturally sensitive and ensure mothers understand the importance of breastfeeding, PSI uses different approaches to reach mothers. PSI also reaches mothers with messages about the importance of appropriate and timely complementary feeding for children after six months. In addition, PSI promotes iron folic acid and multivitamin supplements for pregnant women and women of reproductive age.

Community Management of Acute Malnutrition

Each year, severe acute malnutrition (SAM) affects more than 20 million children under five and results in more than one million under five deaths. Currently SAM interventions are mainly targeted in emergency contexts where the need is heightened. However, children under five living in non-emergency contexts also suffer from severe acute malnutrition. These children typically go unnoticed by governments and donors alike. PSI hopes to integrate the treatment of SAM using the community-based management of severe acute malnutrition (CMAM) approach into integrated case management programs. Given PSI’s vast network of community health workers and social franchises, outreach and care can be provided on an outpatient basis through early identification of children with acute malnutrition.

Home and Industry Level Fortification with Micronutrient Powders

More than two billion people globally are estimated to be deficient in key vitamins and minerals, including iron, vitamin A, iodine, zinc and folic acid. Micronutrient deficiencies, which can cause an irreversible reduction in cognitive ability, most severely affect children aged 6-23 months. Most caregivers are unaware of appropriate complementary feeding practices and similarly lack access to diversified foods, thus making children vulnerable to macro and micro nutrient deficiencies. Additionally, repeated infections exhaust young children’s bodies of essential vitamins and nutrients.

Part of PSI’s Maternal, Infant and Young Child Nutrition (MIYCN) strategy, focused on preventing malnutrition by targeting the first 1,000 days of life, includes the promotion of home fortification with micronutrient powder (MNP). Packed with essential micronutrients, MNP is added to a child’s homemade family food in order to prevent and treat iron deficiency anemia. The same powder can also be used more regularly and longer term for children aged 6 to 23 months to ensure they receive critical micronutrients. By making home fortification supplements available, PSI ensures that mothers and caregivers are able to enhance the nutritional value of homemade family foods. Since 2006, PSI has distributed MNP in Pakistan, Haiti, and Botswana.

In addition to home fortification, PSI supports large scale, national efforts to fortify foods such as flour, oil, salt, and sugar in Kenya and Mozambique. In Kenya, PSI utilizes forty years of social marketing experience to address the promotion, demand creation, and branding for fortified food products by promoting an “umbrella logo” that is recognized by caregivers nationwide. Similarly, PSI is supporting efforts to increase awareness and demand for iodized salt in Ethiopia and Mozambique.