And HIAM-Healths contribution to

help alleviate the problem

July 2011
 What is malnutrition?
There are two basic types of malnutrition.

The first and most important is protein-energy

malnutrition - the lack of enough protein (from meat
and other sources) and food that provides energy.

The second type of malnutrition, also very important,

is micro-nutrient (vitamin and mineral) deficiency.
 Children suffer the most
Under-nutrition magnifies the effect of every disease,
including measles and malaria. The estimated
proportions of deaths in which under-nutrition is an
underlying cause are roughly similar for diarrhoea
(61%), malaria (57%), pneumonia (52%), and measles
(45%). http://www.worldhunger.org/articles/Learn/child_hunger_facts.htm
 The reasons why malnutrition
happens in Timor Leste
Lack of education
Poor water supply
Lack of nutrients
Poor hygiene and sanitation
Lack of knowledge about garden
Poor access to post clinic
The effect on a malnourished child
In many cases, the plight of malnourished children
began even before their birth - with a malnourished
mother. Under-nutrition among pregnant women in
developing countries leads to 1 out of 6 infants born
with low birth weight. This is not only a risk factor for
neonatal deaths, but also causes:
learning disabilities,
mental retardation,
poor health, and
premature death.
DEATHS ATTRIBUTABLE TO UNDER NUTRITION

www.thequiet world.com
 Malnutrition in Timor-Leste
25 February 2011 - For the past eight years, the same
three have topped a UN ranking of the countries with
the highest percentage of chronically malnourished
children:

Afghanistan (59 percent),

Yemen (58 percent),
Timor-Leste (54 percent)
International Womans Development Agency
UNICEF
A survey in Timor-Leste revealed that
42.6% of under-five children were found to be underweight.
46.7% of children were found to be too short or stunted
12% of under-five children are wasted, meaning they are too light for
their height. Wasting is generally an indicator of recent, acute food
insecurity or illness.
Records of nearly 2,500 hospital births in Dili found 17% to be low birth
weight.
The survey found 21% of women to be shorter than 145cm and therefore
considered to be at significant risk.
28% of women had a Body Mass Index (BMI) lower than 18.5%, which is
underweight, 7% had BMIs under 16 indicating severe under-
nutrition. Only 4% of women were found to be overweight.
Exclusive breastfeeding was only just above 60% at birth and by five
months; only about 20% of infants were still exclusive breastfeeding.
National Nutrition Strategy, July 2004 MOH Timor-Leste) Health Sector Strategic Plan 2008-2012 MOH Timor-Leste
Effect of malnutrition on children in Timor

National Nutrition Strategy Ministry Of Health, Timor-Leste

The HIAM-Health program

To provide holistic care to entire families with an emphasis on

prevention and management of malnutrition through
educational workshop programs.

The VISION of HIAM-Health is to give the people of Timor-Leste

the knowledge and skills to work together in reducing infant and
maternal mortality and the current unacceptable health and
social conditions.
 Live-in facility
HIAM-Health now provides a comprehensive facility to
accommodate and feed children and their parents.
They receive three nutritious meals and two snacks every
day.
Plus workshops and information on: breast-feeding,
balanced nutrition, good hygiene and sanitation, care of
their children and
How to develop a home kitchen garden to grow their
own healthy fruit, herbs and vegetables.
 Atauro Island Project
In partnership with the Ministry of Health and support from
the World Food Program
Supplementary feeding and monitoring of infants (without
criteria) 6 24 months
Supplementary feeding and monitoring of malnourished
children between 2 and 5 years with a MUAC <12.5.
Supplementary feeding/monitoring malnourished pregnant
and lactating women.
Health promotion and education.
 Family Garden
HIAMs newest project is to fund and educate three trial
family gardens.
The basic concept is to provide the basics and training
needed for family groups to grow their own healthy herbs
and vegetables.
The aim is to supplement the families diet with
nutritious, home-grown food and, hopefully, provide
additional income from the sale of excess produce to
fund the next years seeds, gardening tools, etc.
Training for women from rural areas.
 Monitoring and Evaluation
After the families leave their care, the staff at HIAM carry
out a home visit to review, Monitor and Evaluate the
health and wellbeing of the child and their circumstances.

Their vital signs are checked and recorded.

 GRAFICO PASIENTE KADA SEXO HUSI FULAN MAR C0
2010 -JUN 2011 IHA HIAM -HEALTH

78
78

76

74

71
72

70

68

Feto
66 Mane
GRAFICO PASIENTE KADA FULAN IHA TINAN
2010

13 23
MARCO
43 24 APRIL
MAIO
JUNHO
12
JULHO
AUGOSTO
24 SETEMBRO
43 OUTOBRU
16 17 NOVEMBRO
8 DECEMBRO
REFERAL PASIENTE HUSI SENTRO SAUDE FULAN
MARCO, 2010 JUN, 2011
 EVALUASAUN BA FAMILIA IMPLEMENTASAUN TOOS UMA HUN

16 16
16 15

14

12

10

6 5
4
4

2 1

0
No interest No land No tools No water Not needed Yes
MALNUTRISAUN+TUBERCULOSE HUSI FULAN MARCO 2010-JUN
2011 IHA HIAM-HEALTH

21

No
Yes

122
MONITORING AND EVALUATION PROGRAMS
ACTIVIDADE KONA BA EDUCASAUN SAUDE

ACTIVIDADE THERAPI HALIMAR BA LABARIK

DEMONSTRASAUN TEIN
REHABILITASAUN
 The future.?
Cooperation is essential
The Departments of Education, Health and
Agriculture need to work together to create policies to
prevent malnutrition in the future.