1. HEARTH/Nutrition Education & Rehabilitation Sessions (NERS) Primary caretakers bring malnourished children to neighborhood kitchens Primary caretakers bring malnourished children to neighborhood kitchens - Preparing - Cooking - Feeding - Interacting assisted by volunteer mothers.

2. Food Contribution Rehabilitation Sustainability Food as Medicine Food as Medicine Contributed by caretakers and/or Program PD Food PD Food Contributed by caretakers

3. Hearth Calendar Six days a week, 2 weeks a month Six days a week, 2 weeks a month JuneJuly Children not yet rehabilitated attend the next Hearth session Weight for age monitoring

4. Sample Hearth Menu from Viet Nam

5. Characteristics of an Hearth Learn by doing in a safe, accepting and interactive environment Focus on behavioral change Focus on behavioral change Witnessing positive visible change in the child Use of peer support to encourage caretakers to embrace new practices Contribution of food

6. Community Management of the Hearth Nutrition Program Assessment AnalysisActions

7. Vital events monitoring - -Births / Pregnancies outcome - -Deaths: <1, <3 - -Migrations: in / out

8. Growth Monitoring Promotion Growth Monitoring Promotion Periodically weighing all children in target group - -Enables families to know the current nutritional status of their children - -Identifies malnourished children for rehabilitation - -Enables the community to monitor & evaluate the nutritional status of all targeted children - -Links to other child health activities such as deworming

9. Program Impact- Hearth Participants (example from Viet Nam) Entry status of participants 8/1993 to 5/1994 100% 2 nd and 3 rd degree Entry status of participants 8/1993 to 5/1994 100% 2 nd and 3 rd degree Nutritional status of same participants 7/1995 3% 2 nd and 3 rd degree Nutritional status of same participants 7/1995 3% 2 nd and 3 rd degree 59% of all Hearth participants rehabilitated to normal status 38% of all NERS participants 1 st degree AND REMAINED SO 14 to 23 months after ending participation in Hearth 701 children

10. Community Education & Awareness through a Living Demonstration of Nutritional Impact HNP

11. Program Impact –Community level-VN Program Impact –Community level-VN Weight for Age - Children < 3 years NERS discontinued – remaining malnourished children receive home visits from Health Volunteers

12. Sustained Impact Sustained Impact Quang Trung Commune, Viet Nam

13. Lasting Impact via Individual Behavior and Social Change Program participants and neighbors experience impact of HNP… Program participants and neighbors experience impact of HNP… …and repeat newly acquired behaviors with younger siblings.

14. Success and Sustainability through Community “Ownership”

15. Replicability 4 villages (pop. 20,000) A National Program 260 villages (pop. 2,200,000) In Vietnam

16. The Living University

17. Demonstrated Replicability PD/Hearth Model Implemented Bangladesh Myanmar Vietnam Mozambique Tanzania Mali Egypt Haiti Bolivia Guatemala India Senegal Indonesia Nicaragua Argentina US Nepal Bhutan Cambodia Congo DRC Rwanda