An Outsized Problem With a Small-Sized Solution

Posted by Jessica Hartl
October 16, 2014
U.S.-Produced Ready-to-Use Therapeutic Food Is Given To Child

In the lush countryside of Burundi, you wouldn’t expect there to be chronically high rates of malnutrition. But hidden behind the walls of a family’s house, poor feeding practices, compounded by large families with kids close in age, means malnutrition lurks. According to a 2013 IFPRI study, more than 73 percent of the population in Burundi is undernourished, and 58 percent of the population is stunted. These figures are staggering, given the population of Burundi is only 10 million.

That’s where USAID and partner UNICEF come in. Burundi is one of the first countries where U.S.-produced Ready-to-Use Therapeutic Food, or RUTF, is being used to treat acute malnutrition.

Why do these small packets make such a difference? Previously, kids with severe acute malnutrition (SAM) had to be treated at the hospital. This meant families’ staying weeks and weeks as the child recuperated. Now, with the advent of products like RUTF, children without any other health symptoms can be treated at home. Imagine you’re a small kid who is sick – which would you prefer? Being at a hospital for weeks at a time, or in the comfort of your own home? It’s a no brainer.

A new food assistance product for the Agency’s Office of Food for Peace, this product is a game changer for tackling severe acute malnutrition. Previously the Agency did not have capacity to purchase this product in the United States for food assistance programs because U.S. suppliers were not producing it. This meant only doing small scale interventions with locally purchased ready-to-use foods, or not being able to treat severe acute malnutrition at all through food assistance.

Starting in 2012, this changed. Currently USAID plans to meet at least 10 percent of UNICEF’s global need for RUTF, and has already provided this specialized product in 14 countries since 2012. In Burundi, RUTF is helping treat 16,500 severely acutely malnourished kids under 5 in nine provinces.

UNICEF staff are working tirelessly to ensure that the Ministry of Health of Burundi is able to treat severe acute malnutrition, and help mothers learn to treat it themselves at home. In villages across Burundi, every week women bring their children to the local health clinic for nutrition training, and to get their kids’ health assessed. In exchange, they receive a week’s supply of RUTF for their kids identified as severely acutely malnourished.

Elias Ndikumana, a father of three, has two children enrolled in treatment for severe acute malnutrition. Twins Alain Don Divin Igiraneza and Alain Bon Idée Ahishakiye, both 1.5 years old, were brought into the health center in Muyange colline, in Makamba Province,  when they started to show some of the telltale signs of being malnourished.

“The children were so weak when I brought them to the clinic. I was so worried about them,” said Ndikumana. For the last six weeks, they’ve been eating RUTF. “Now they’ve been eating the paste, they are livelier and getting healthier. I am so relieved.”

UNICEF and USAID are not stopping there. We are working to build the capacity of the Ministry of Health nutrition office to do outpatient care at the health center level and inpatient treatment of SAM at the hospital level. A first step is helping the government manage the supply chain for RUTF. With funding from both PEPFAR (the U.S. President’s Emergency Plan for AIDS Relief) and Food for Peace, warehouses to store the RUTF have been equipped to improve storage space and stock management.

Health workers, nurses and doctors, including those still in medical schools, are also being trained to recognize the signs of acute malnutrition and how to treat it so the problem can be tackled early on, and not once a child gets to a critical stage. It is hoped in the long run that the Ministry of Health will be able to tackle this persistent problem without outside assistance.

About the Author: Jessica Hartl serves as lead Information Officer for the Office of Food for Peace. Follow Food for Peace on Twitter at @USAIDFFP.

Editor's Note: This entry also appears on the USAID Impact Blog.


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Ek c.
October 17, 2014
Thanks guys 4 yo help
Vincent S.
October 17, 2014
I have been an adviser to the White House in the past and I recommend the U.S. to double the budget of USAID. One good way to have less enemies in the world is to make more friends, and for this USAID may help a lot.


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