March 2018—In Afghanistan, 41 percent of children under age 5 are stunted. Acute malnutrition may lead to stunting, and the period around 6 months of age—when children transition from breastfeeding to solid foods—is a particularly vulnerable time.

To reduce stunting rates and address child malnutrition, USAID’s Initiative for Hygiene, Sanitation and Nutrition project has been working with the Ministry of Public Health to conduct community-based growth monitoring and nutrition counseling.

In Kart-e-Sulh village of Hazrat-e-Sultan district, Samangan province, Fatima Sanawbar is a busy mother of six children. When community health workers diagnosed her son with moderate acute malnutrition, she was referred to intensive nutrition counseling for 10 days. The counseling also included other health-related topics, including hygiene.

Before attending the counseling sessions, Sanawbar was not aware of the importance of serving a diverse selection of foods to her family. “When I attended the sessions, I realized that I should cook and feed my family with all types of foods available in our village,” she said. “I also learned that I should have a proper feeding schedule for my children. Above all, I learned that hygiene is directly linked to the health of my family members, and if we keep our environment clean and wash our hands properly after using the toilet and before cooking the meal and feeding the children, then we would be able to fight against several diseases that affect the growth and health of our children and families.”

Since 2016, more than 44,000 people (approximately 20,800 females and 23,400 males) have received the community-based nutrition services, which have also benefited 6,800 children under age 2.

The Initiative for Hygiene, Sanitation and Nutrition project is designed to improve the nutritional status of women of reproductive age and children under 5, focusing on the first 1,000 days of life from conception to 24 months of age. The program, which runs from 2016 to 2021, aims to decrease stunting by at least 5 percent over five years and to reduce anemia among women of reproductive age by at least 10 percent by further institutionalizing nutrition programs; increasing optimal nutrition and hygiene practices at community and household levels; and increasing nutrition, hygiene and sanitation services in 25 provinces throughout Afghanistan.

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