Prevention & Management of Malnutrition
Project to improve pregnancy outcomes and reduce infant mortality.
Click here to access the SMDT report.
Nutri-Garden Polyhouse Project
This is a project to improve food production in rural areas. Here are several reports giving details
Nutrigardens Project Interim Report
Here is a YouTube video featuring Dr. Narendra Shah. Click here for a good illustration of the Polyhouse project.
Spoken Tutorials
TFP has funded and will fund additional Spoken Tutorials than can be used in various health settings.
Click here to see the proposal
History of TFP Project in India
TFP began their India program with Dr. Narendra Shah, Professor at CTARA (Center for Technology Alternatives for Rural Areas) at IIT Bombay and Dr. Mamta Manglani, head of Department of Pediatrics at Sion Municipal hospital in Mumbai. There was a critical need to bring awareness of RUTF to India. In 2009 Parliament banned the import and use of RUTF until the product was locally produced and tested with Indian children. An expert panel was set up to review existing data and make recommendations on including RUTF in the treatment protocol of SAM children in India.
Dr. Manglani was willing to try this new product with her SAM children if TFP would help them produce the product on site in Dharavi, Mumbai. We agreed to provide technical expertise and funding for pilot production and testing of the product in a clinical trial. Dr. Shah and his team at CTARA provided on-site technical support.
Small scale production of RUTF, renamed Medical Nutrition Therapy (MNT) began in April 2011. A peanut butter grinder and micro-nutrients were supplied from the US. Other equipment and ingredients were purchased locally and the clinical trial followed. The MNT formula was tested against the protocol in use with SAM children at Sion. In 2012 as production demands increased, Hexagon Nutrition, a private nutraceutical company in Mumbai began supplying micro-nutrients. By 2013 we had sufficient data to share at a Regional conference in Nepal. By early 2014, Dr. Manglani decided that based on the data, she was ready to treat all SAM children at Sion with MNT. Its caloric density was one of the main reasons the MNT was more effective. SAM children were simply unable to consume equivalent nutrients with the traditional diet.
In early 2014 Tata Trust approached TFP interested in sponsoring a larger scale validation of MNT with up to 10,000 children with local production of RUTF. TFP was asked to provide technical guidance to Scale-up the production of MNT. Several manufacturers were contacted but Hexagon Nutrition stepped forward and established a larger production plant at their manufacturing facility in Nashik, Maharashtra. By September 2014, Tata Trust began a large scale study in the District of Nandurbar, Maharashtra, with the help of UNICEF and the local ICDS (Integrated Child Development Services), a Government funded organization with reach across India. Hexagon provided MNT product. The state of Maharashtra was fully engaged with our partners Sion Hospital and IIT Bombay during this time.
By early 2014 the expert panel set up by the Government recommended that MNT could be included in the protocol for the treatment of SAM children in India. The policy became official when the new protocol was published in the Journal of Pediatrics in India. Other manufacturers entered the market. A 100% export oriented factory was set up by Compact near New Delhi. Other NGO’s started doing large and small scale studies in various states such as Gujarat, Rajasthan, Madhya Pradesh and Jharkhand.
We at Toddler Food Partners have been in the middle of all these activities. Until 2014 we provided funds to Sion Hospital and IIT Bombay. Today, UNICEF Mumbai is funding Sion Hospital’s NRRC (Nutrition Research and Rehabilitation Center) at Dharavi where SAM children are treated with MNT. A local NGO, Fight Hunger Foundation (FHF) has provided Sion with technical personnel to support MNT production. Hexagon Nutrition also provided them with CSR funds.
We expect the use of MNT and RUSF (Ready to Use Supplemental Food for treating Moderately Acute Malnourished [MAM] children) will increase dramatically in the next few years.
India has over 6 million SAM/MAM children. While we have come a long way much remains to be done. We at Toddler Food Partners believe that we can accelerate the treatment and prevention of acute malnutrition in India by remaining engaged.
Our long term goal is to reduce the incidence of Acute Malnutrition (SAM/MAM) in India to levels seen in developed countries. There will be two components to our program in the future.
- Treatment of SAM/MAM children who are already acutely malnourished
- Education and Prevention related interventions so that no child becomes acutely malnourished
Last year we embarked on one aspect of prevention by initiating a project on the nutrition status of adolescent girls. We hope to identify and recommend appropriate interventions to policy makers and grant makers to break the cycle of acute malnutrition by preventing low birth weight; a leading cause of acute malnutrition in India.
We will work with our current partners and identify new partners to continue this journey. Click here or select About>Our Partners from the main menu to learn more about our partners in India.
Haiti
Currently, the largest project TFP supports operates in Haiti, which in 2008 produced over 100,000 pounds of RUTF – locally known as Medika Mamba – to feed more than 4000 children through over 20 clinics. This partnership is with Meds and Food for Kids (MFK) founded by Dr. Pat Wolff, a pediatrician from St. Louis.
MFK currently operates a manufacturing facility in Cap Haitien for Medika Mamba in a rented two-story house. The peanut roasting takes place in an outbuilding and then must be carried to the second floor for grinding and mixing with other ingredients. In 2009, approximately 139,000 pounds of Medika Mamba were produced.
MFK has recently launched a campaign to fund the building of a new factory in Cap Haitien with a 2011 completion target. This factory will have an estimated capability of producing nearly 800,000 pounds of Medika Mamba annually and will be distributed throughout Haiti to provide food for 32,000 malnourished children. Toddler Food Partners is currently working with MFK and partner, Compatible Technology International (CTI), to evaluate, select, produce and install production equipment for the new factory.
See how MFK is addressing the need for Medika Mamba:
http://www.youtube.com/watch?v=WCKOmhZHuL4
Village Scale Manufacturing
Toddler Food Partners has teamed up with NGOs in India to help develop a village-scale manufacturing facility to be installed in India. The pilot project is targeted for installation in mid 2010. The facility will be able to manufacture moderate quantities of RUTF suitable for treating malnourished children at the village level. Production is expected to be approximately 57,000 pounds annually.
TFP’s focus is on the manufacturing process and equipment. TFP is looking for cost effective off-the-shelf equipment to make RUTF.
Standard RUTF is made from peanuts, milk powder, vegetable oil, sugar and a vitamin/mineral supplement. The manufacturing process is as follows:
- Shell, roast and grind the peanuts
- Weigh ingredients
- Combine ingredients in a mixer
- Pass mixture through the grinder
- Package the final product
Peanuts will be roasted in large woks over propane burners. The roasted peanuts will be ground in motorized grinders. Off-the-shelf food scales will be used to weigh the ingredients. The ingredients will be mixed in hand turned stainless steel mixers. Hand-cranked fillers will be used to dispense the product into containers for distribution.
Peru
Toddler Food Partners established a partnership with a church in Western Minnesota. The church, in turn, has a long established sister parish relationship with a parish in Quillo, Peru.
TFP supplied a motorized grinder to the group in Minnesota. On one of their trips to Quillo, they hand carried the grinder, motor and stand to set up in the field. The parish has encouraged local farmers to plant and harvest peanuts to supply some of the raw material for making RUTF locally. Several hundred malnourished children have been brought back to health through this locally administered program.
The facility in Quillo has gained much publicity in other parts of the country. We are anticipating providing more equipment in the future.