Initiative to End Malnutrition: A local, effective, and affordable model in the Rukungiri District of Uganda

Background: Malnutrition affects 25% of the world's children, contributing to more than half the annual 11 million deaths of children under 5. A staggering 30-40% of children under 5 in Rukungiri District of Uganda suffer from acute or chronic malnutrition, yet this crisis remains unaddressed. Purpose: Through education, empowerment of local health workers and the community, create a reproducible, affordable, and sustainable model to identify and systematically treat malnutrition within a rural Ugandan District. Methods: 28 specialized hospital staff, including physicians, pediatric nurses and emergency care providers, were trained in a locally-tailored malnutrition treatment protocol, making Nyakibale District Hospital a referral center for severely malnourished children. A financial analysis was conducted using local products to create a low-cost, sustainable program. An executive committee of local staff was created to manage the program and conduct monthly assessments of intervention-related outcomes. 28 community health providers at 3 health centers were certified in identification of pediatric malnutrition and indications for referral. Nutritional education training was integrated into routine outpatient care. Groundwork for further community health involvement and in identification of barriers to proper nutrition have been established. Results: 1 to 2 severely malnourished children are admitted daily. A financially sound, sustainable, potentially reproducible model to identify and systematically treat malnutrition through education and empowerment of local medical staff and community is underway, with long-term feasibility and intervention-related outcomes to be determined. Conclusions: We present a methodology and model for implementation of an effective, locally-managed, sustainable and affordable program to address a malnutrition crisis.