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Project Description

SPOON Foundation is spearheading an international collaboration to identify and prevent nutritional deficiencies of young institutionalized orphans ages 0-3.

The project is being piloted in eight Baby Houses throughout the country of Kazakhstan, in a region that is underserved by the international aid community, despite the demonstrated nutritional risks. Collaborating partners include the state-run Kazakh Academy of Nutrition and a local NGO, the "Kazakh Children's Nutrition Foundation." The project has the full support of the National Government of the Republic of Kazakhstan at its highest level.

The Orphan Nutrition Project will be the first time ever - worldwide - that the nutrition of orphaned children will be closely examined to create a model for improving orphan health and development through nutrition. Results of the project will be widely shared through publications and conferences, in order to catalyze change in children's nutrition policy throughout the region and beyond.

The project will include:

1. Conducting a comprehensive feeding, nutritional, and developmental assessment of approximately 200 young orphans.

2. Evaluating the impact of dietary changes and vitamin and mineral supplements on the health and well-being of young orphans.

3. Identifying results that will inform and improve nutrition policies and procedures throughout Kazakhstan, and eventually beyond.

4. Developing a model that can be effectively replicated in neighboring countries and beyond.

5. Gaining insight into the nutritional risks of institutionalized orphans that will inform nutrition guidelines for adopted children in the U.S.

The first phase of work consists 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 includes 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 the second phase of the project, a customized nutrition intervention, consisting of fortified formulas and vitamin/mineral supplements, will be given to a randomly selected subset of children in the participating baby houses.

Using assessment data and outcomes from the intervention, SPOON Foundation and project partners will recommend policies and procedures to leverage systemic change. Ultimately, the impact of this project extends well beyond the hundreds of orphans helped in the pilot. In demonstrating the nutritional needs of orphans, as well as the effectiveness of nutritional supplementation on orphan health, the Orphan Vitamin Project has the potential to advance nutritional policies and procedures impacting Kazakhstan's 48,000 institutionalized orphans. Moreover, by developing a solid protocol for researching and implementing vitamin therapy in orphanages, SPOON Foundation will establish a model that can be replicated in institutions housing vulnerable children worldwide.

Key Objectives

1. Identify the most pressing nutritional deficiencies impeding the health and development of young orphans.
2. Design and implement a sustainable and replicable nutritional intervention to prevent common deficiencies that impede orphan health and development.
3. Leverage the results of the assessment and intervention to influence global orphan nutrition policies and procedures.

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Why Kazakhstan?

While in Kazakhstan adopting their children in 2006, SPOON Foundation's founders experienced the institutions housing their kids as greatly under-resourced. A recent survey of 300 Kazakhstan adoptive parents showed that while there is variance across regions, many of the Kazakhstan's baby houses are struggling to meet the needs of the children they shelter. Yet there are very few, if any, national or international resources being channeled to this vulnerable group, and none that focus on orphan nutrition.

A 2005 Unicef-led study demonstrated that Kazakhstani children 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. Critical nutrient deficiencies in early life put children at risk for brain mal-development, other significant developmental and growth delays, and a host of medical conditions. In the majority of cases, anemia, rickets, and other micronutrient deficiencies are easily prevented and treated with a basic vitamin/mineral supplement.

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 vitamin 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 the SPOON Foundation to Kazakhstan, it is 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 qualify it as a prime location to pilot this type of project.

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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 an assessment 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 lay the foundation for a nutrition intervention that can be sustained, and easily replicated in other orphanages.
3. 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, and The Margaret A. Cargill Foundation.

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The Uniqueness of Our Program

While other organizations provide relief to orphans, SPOON Foundation's unique focus on nutrition through needs assessment and intervention is exceptional. This approach allows for great impact on orphan health and development, with minimal cost. As a small, grassroots organization, we rely on partnerships with researchers, clinicians, and policy leaders in target countries to create systemic change. Ultimately, this difference will be proven by our abilty to engage local government to utilize the findings for optimizing nutrition policies and procedures in orphanages and other children's institutions.

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