Haiti’s malnutrition rates are among the world’s highest.  One-third of Haitian children under age five are severely malnourished and 40% suffer from anemia. Because 56% of Haitians live on less than US$1 per day, malnutrition and starvation are widespread.  Pregnancy through the first two years of life – the first 1,000 days – are recognized as the “window of opportunity” to prevent early childhood stunting and anemia and promote long term health and development.

In 2009, with the support of M.A.C AIDS, GHESKIO implemented and evaluated a new intervention targeting non-breastfed HIV-exposed children from 6 to 11 months of age.  The strategy was delivered through a group-based approach called the “Caregivers Club” in which HIV-infected mothers with children of the same age came together monthly to receive health and nutrition education from a GHESKIO nurse-counselor and to provide one another with social support.   Infants were also given a daily nutritional supplement called manba fotifye – a locally-produced specially-fortified peanut butter that provided children with supplementary energy, vitamins and minerals.   At age 12 months, stunting prevalencewas 55% lower and wasting 70% lower in intervention participants compared to infants seen at GHESKIO in the previous year.

Caregiver’s Clubs

GHESKIO serves over 300 HIV-positive pregnant women a year.  To enhance the care and support given to these patients, the nutrition program organizes Caregiver’s Clubs.  As part of the clubs, women meet monthly to receive one-on-one medical care from GHESKIO pediatricians and nurses.  The mothers are grouped by their babies’ ages so that clinicians are able to address the health issues that mothers will observe at each stage of their babies’ growth.  Most importantly, the Caregiver’s Clubs act as a supportive environment where women can share experiences and gain helpful advice from one another.  Particularly for HIV-positive women whose families do not know their status, the Caregiver’s Clubs provide a safe space to foster a sense of community.

A Growing Program

As one of many initiatives GHESKIO is undertaking to bridge the gap between clinical care and community development, the nutrition program is gaining its own newly constructed Maternal and Child Health and Nutrition Center supported by the M.A.C AIDS Fund.  The center will provide a welcoming space for the Caregiver’s Clubs to meet.  It will also house a Pediatric Clinic, Ob/GYN Clinic, Adolescent Clinic, Pharmacy-Phlebotomy, Community Nutrition, and Clinic Nutrition to provide a comprehensive range of healthcare services for women and children.  The nutrition program has grown from a focus on newborn nutrition to include HIV-affected children from birth to 2 years old.  Most recently the program expanded to include a community outreach aspect for those affected by the earthquake.