woman measuring baby's arm to check status of malnutrition

2021 Annual Report: Nutrition & Health

Whether through emergency food, clean water, parasite treatment, health screenings or child nutrition program trainings that empower caregivers to properly feed the children in their care, Holt’s nutrition and health services made an incredible impact in the lives of children and families in 2021. But none of this would be possible without the generosity and compassion of Holt donors.

Analyn’s world was small. About four ceiling tiles to be exact. Ceiling tiles that she stared at for hours every day from her crib at an orphanage in the Philippines.

Analyn in her crib.

Analyn has cerebral palsy and first came to the orphanage at 10 months old. Although she received physical therapy, her regular caregivers had little experience working with children with cerebral palsy — especially when it came to feeding her. Thinking it was the easiest way for Analyn to eat, her caregivers fed her while she was lying down. But this caused her to choke and get fluid into her lungs, which can lead to pneumonia. Not to mention the constant choking was scary for Analyn.

Four years ago, Holt’s child nutrition program (CNP) team traveled to the Philippines to train caregivers at Analyn’s care center. Her caregivers learned that upright is the best feeding position for children with cerebral palsy. They learned how to spoon feed her and support her jaw to aid in swallowing. With Holt’s training resources, the orphanage nurse and cook also created a high-protein, high-calorie diet for Analyn with modified food textures to meet her needs.

smiling child with face hidden by heart graphic holding Holt sponsorship booklet
Analyn holds a bookmark with her picture on it that her sponsor sent her as a special gift.

Through these huge changes in diet and feeding, Analyn’s world began to change. Instead of lying down all day, she began to spend more of her day upright, engaging with the world around her.

When Holt’s nutrition team visited Analyn’s orphanage again two years later, they were astounded by the change they saw in Analyn. “We saw a happy girl who played with her friends, enjoyed her caregivers’ attention, and could actively participate in her meals,” says Emily DeLacey, Holt’s director of nutrition and health services. “Additionally, we [could] see that she is now on a stable growth trajectory and is no longer at risk of malnutrition. This is what Holt’s child nutrition program is all about.”

Holt’s Child Nutrition Program

Started in 2014 as a pilot program for children living in institutions, Holt’s child nutrition program teaches caregivers how to properly feed and nourish the children in their care — especially children with special needs. To date, the program has trained caregivers at 60 sites across six countries, and has expanded to serve children in foster care as well as children living with their families in vulnerable communities.

The impact on children’s lives has been nothing short of transformational. Initial nutrition screenings showed 85% of children at CNP sites to be experiencing malnutrition. But after one year in the program, malnutrition rates reduced among all children — with 41% no longer experiencing feeding difficulties and 20% of children no longer experiencing any malnutrition at all. Through CNP trainings, caregivers have also become empowered to make smart nutrition and feeding decisions — and advocate — for the children in their care.

In 2021, Holt’s nutrition team received an update on Analyn that moved Emily to tears. A gastroenterologist had visited her care center and suggested that Analyn be put on a feeding tube — a drastic measure that would severely limit Analyn’s interaction with other children, increase her risk of infection, and likely shrink her world back to the space of a few ceiling tiles. But Analyn’s caregivers knew they could do better by Analyn.

Because of the child nutrition

program, we learned how to feed

her safely. She’s healthy.

She’s not aspirating.

And she’s doing really well.

“They said, ‘No, we are not going to do that. If we put a tube in her, she can’t go to therapy. She can’t leave the site. We can’t have her playing with other children,’” Emily says. “‘She’ll never receive the essential development that eating provides children. … And because of the child nutrition program, we learned how to feed her safely. She’s healthy. She’s not aspirating. And she’s doing really well. We are going to say no.’”

Today, Analyn is leading a healthier, happier life— all because of Holt’s child nutrition program, the generosity of donors, and the love of her caregivers. As Emily says, “That whole little girl’s life is going to be different because she will be able to fully participate in all the activities children need to grow and develop to their full potential.”

A Malnutrition Crisis Caused by COVID-19

Holt’s child nutrition program is a key part of Holt’s efforts to improve the health and wellbeing of children around the world, and as Analyn’s story shows, it continues to impact the lives of children years after initial intervention. Every year, Holt supporters also make it possible to provide direct nutritional support to children and families through everything from regular school meals and emergency food assistance to livestock and seedlings that empower families to produce their own food. In 2021, a total of 48,505 children received nutritional support through Holt programs. For the first time, Holt also surpassed one million meals provided to children and families, including emergency food delivered due to COVID-19.

two photos side by side showing mother and twin babies before nutrition support and after
Found to be acutely malnourished, twins Anika and Kia — and their mother — received emergency intervention at Holt’s mother and child hospital in Shinshicho, Ethiopia.

This past year, the global COVID-19 crisis continued to endanger children and families in vulnerable communities — and for many, the most pressing issue was food. “Holt’s families are definitely having a hard time of it,” Emily says. “We’re seeing steep declines in household incomes. Nutritious food is not available or affordable. Even month-long COVID restrictions have caused a dramatic number of children to become malnourished.”

For the first time, Holt also

surpassed one million meals

provided to children and families,

including emergency food

delivered due to COVID-19.

In Ethiopia especially, pandemic-caused inflation led to a steep increase in hunger and malnutrition. As this crisis emerged in April 2021, Holt began emergency nutrition assessments and interventions across rural Ethiopia. Out of the more than 13,000 children assessed, over 5,790 of them were found to be acutely malnourished.

“Right away, Holt’s community health workers delivered emergency nutrition packets high in calories, fat, electrolytes and micronutrients, or referred children to our hospital,” Emily says. “Families received regular follow-up visits to learn more about nutrition, and Holt teams provided ongoing support until the children’s nutrition status improved.”

Nutrition and Health Services Growth in 2021

Around the world, the COVID-19 pandemic placed a tremendous strain on Holt teams as they strived to meet the needs of children and families. But thanks to generous donors, Holt’s nutrition and health services not only met the most urgent needs — they also continued to grow in 2021. Adapting to COVID restrictions, Holt’s teams trained another 4,692 caregivers — enabling them to provide over 124,000 health screenings to children living in families, foster homes and care centers. In countries such as Haiti and Ethiopia, Holt created new clean water access stations to ensure children have safe water to drink and wash their hands. And in rural Uganda, the impact of Child Health Days campaigns more than doubled from the previous year.

“We started with a plan in 2018 to serve about 1,000 children,” Emily says of the campaigns to address nutritional deficiencies among children in hard-to-reach areas. “Last year, we provided essential vitamins and parasite treatment for over 49,000 children and pregnant women in Uganda.”

Whether through emergency food, clean water, parasite treatment, health screenings or child nutrition program trainings that empower caregivers to properly feed the children in their care, Holt’s nutrition and health services made an incredible impact in the lives of children and families in 2021. But none of this would be possible without the generosity and compassion of Holt supporters.

Without your support, hundreds of thousands of children would not benefit from essential, lifesaving nutrition and health services. Holt donors make all the difference.

As Emily says, “Without your support, hundreds of thousands of children would not benefit from essential, lifesaving nutrition and health services. Holt donors make all the difference.”

*We obscured Analyn’s face and changed her name in compliance with child protection laws for children in orphanage care in the Philippines.

Support Holt’s Child Nutrition Program

Your gift to Holt’s child nutrition program will provide life-changing nutrition and feeding support to children living in poverty and in orphanages around the world.

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