Urgent Need

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Kazakhstan

SPOON is working in close collaboration with the Kazakh Academy of Nutrition in Kazakhstan to develop improved nutrition policies and practices for thousands of young children in the country’s Baby Houses (orphanages for children ages 0-5). This program represents the first time ever, worldwide, the unique nutritional needs of young orphans have been studied and addressed through the development of new, highly customized nutrition and feeding practices.

Key Objectives

Map of Kazakhstan
  1. Identify the most pressing forms of under-nutrition faced by young orphaned children
  2. Design and evaluate a new menu and nutritional practices to prevent the under-nutrition identified
  3. Leverage the results of the program to change nutrition policy in Baby Houses nationwide, and to influence orphan nutrition policies and procedures around the globe

Project Components

  1. Conduct a comprehensive feeding, nutritional, and developmental assessment of approximately 200 orphaned children ages 0-3 living in 8 representative Baby Houses around the country. Completed in 2010.
  2. Implementation of new and improved menu developed specifically for Baby House children, as well as vtamin and mineral supplementation. Commenced Summer 2010.
  3. Evaluation of impact of dietary changes and supplementation through repeat assessment post-intervention
  4. Utilize results to assist the Kazakh Academy of Nutrition in developing new nutrition practices and policies throughout all of Kazakhstan’s Baby Houses.
  5. Distribution of vitamin and mineral supplementations to 8 participating Baby Houses throughout course of the program.
  6. Train country health officials and Baby House staff on the new diet preparation and administration, rationale behind the new nutrition policy, and critical best feeding and nutrition practices for Baby Houses.
  7. Catalyze improvements in nutrition practice for the millions of children living in orphanages globally through broad dissemination of program results and the replication of the change model developed through this program.

Methodology for Establishing Proven Nutrition Intervention

Phase 1 consisted of collecting and analyzing information on the nutritional and developmental status of all children ages 6-36 months living in the pilot baby houses. The assessment included blood tests for various vitamins/mineral levels, head/weight/height measurements, a standardized assessment of motor and cognitive function, as well as detailed observation of baby house menus, food prep, and feeding processes.

During Phase 2, a customized nutrition intervention, consisting of an improved menu, fortified formulas and vitamin/mineral supplements, was given to a randomly selected subset of children in the participating baby houses.

Phase 3 of the project consisted of a re-assessment of the developmental and nutritional status of all of the children who participated in the project, and included blood tests, head/weight/height measurements, and a standardized assessment of motor and cognitive function.

Progress Assessment

SPOON Foundation has made the following progress toward achieving each of our key objectives:

  1. The project has received the full support, including some financial assistance, from the Ministry of Health of Kazakhstan. International experts from the U.S. and Kazakhstan have jointly designed and carried out an assessment and intervention protocol that meets the highest ethical and scientific standards.
  2. SPOON Foundation's highly regarded, well-published expert team (see below), has worked intimately with public health and medical professionals in Kazakhstan to complete a nutrition intervention that can be sustained, and easily replicated in other orphanages.
  3. Initial analysis confirmed that Kazakhstani orphans are deficient in key micro and macro nutrients. Analysis is currently underway to uncover specific nutrient deficiencies in more detail.
  4. Nutritional intervention with an improved menu and multi-vitamins has been completed. [All children in the program are continuing to receive multi-vitamins.]
  5. Analysis of results from the pre- and post-intervention assessments are is currently being led by SPOON’s expert team Using assessment data and outcomes from the intervention, SPOON Foundation and project partners will recommend policies and procedures to leverage systemic change.
  6. SPOON Foundation has received generous grants from the Nestle Eurasia and Ferrosan Companies, including in-kind donations of nutritional products for use in the nutritional intervention, The Margaret A. Cargill Foundation, the International Foundation, Chevron, General Mills and KazComm.

Next Steps

SPOON is planning a dissemination and training conference for spring of 2012, to share results with key government officials and other leaders in children's services and to train providers in best feeding and nutrition practices for children in institutional care.

SPOON will continue its work in Kazakhstan, with a focus on advocacy for nation-wide adoption of a new nutrition protocol in the country’s Baby Houses and other institutions. In addition, SPOON remains committed to ongoing monitoring and on-site support to ensure that the new feeding and nutrition practices continue to bring positive results for orphaned children in Kazakhstan.

Why Kazakhstan?

Kazkahstan is known to have some of the world’s best orphanges and Baby House, yet it became clear to SPOON’s co-founders upon the adoption of their children from Kazkahstan in 2006, that the orphans of this country are not spared the high risk for malnutrition that plagues many of the world’s orphans. A 2007 survey of 300 Kazakhstan adoptive parents showed that] while there is variance across regions, despite the best of intentions, many of Kazakhstan's baby houses are not meeting the exceptional nutrition and feeding needs of these children, which may result in debilitating health problems, stunted physical and cognitive growth, and even easliy preventable causes of death.

A 2005 Unicef-led study demonstrated that Kazakhstani children as a whole are at significant risk for malnutrition. Nearly half of all women of childbearing age are anemic, placing their newborn children at risk. As many as 50% of Kazakhstani children have some level of iron-deficiency anemia. Fifty-seven percent of children under age five are moderately-severely deficient in Vitamin A, a likely indication of other additional micronutrient deficiencies. Kazakhstani children are additionally at risk for vitamin D deficiency due to the country's position north of the equator and a common early diet of unfortified formula or milk product.

According to data released in January 2008 from the Ministry of Health, nearly 40% of children in the Baby Houses demonstrate delays in physical development; more than 25% children suffer from some level of anemia; and 16% have other nutrition disorders and/or rickets.

As orphans are amongst the most vulnerable of a country's population, it can be expected that nutrition deficiencies are magnified in orphanages. Kazakhstan is home to more than 48,000 institutionalized orphans. There are few national or international resources being channeled to this population, nor are there existing programs that focus on orphan nutrition. SPOON Foundation is the first known organization worldwide to collect data specifically on orphan micro- and macronutrient levels and to implement a systemic intervention aimed at reducing the prevalence and significance of key nutrient deficiencies in orphans.

In addition to the personal connection and underserved need that drew SPOON Foundation to Kazakhstan, it was a logical place to pilot the Orphan Nutrition Project for practical purposes as well. The country's political stability, sophisticated laboratory resources, and overall investment in orphan care have qualified it as a prime location to pilot this type of project.

Experience and Capabilities

SPOON’s work in Kazakhstan is accomplished by the SPOON Foundation staff (US) and SPOON Foundation Central Asia staff, with guidance from a team of highly recognized national and international leaders in children's nutrition and public health, including: the SPOON Foundation Medical Advisory Board, the SPOON Foundation International Advisory Board, and our project partners in Kazakhstan: