Hearth Malnutrition Rehabilitation Program

The Hearth Program (called ‘Ti Foye’ in Creole) is a low-cost nutritional model used in many resource-poor countries designed to rehabilitate the moderately-to-severely malnourished child. The Nutrition Program began the Ti Foye (meaning ‘little kitchen’) Program in 2000, and is continually expanding it to new villages. The CNP uses a "Postive Deviance" approach, whereby program staff learn from poor mothers who manage to keep their children healthy. Specific recipes and behavior of these "P. D." mothers are practiced at hearths.

The Nutrition Program has hired and trained ‘Monitrices’, or female health monitors, to supervise the program in their own villages and collected information on every household-including weighing each child under 5 years old. Monitrices work with volunteer mothers who offer their homes for the Ti Foye, and mothers of all children who are moderately malnourished are invited to participate for two weeks. Each day mothers spend time together preparing a meal and discussing local foods and their nutritional value, the importance of vaccinations, and care-giving practices to bring their children back to good health. After the two weeks, mothers notice visible improvement in the child’s weight and demeanor, which encourages them to continue what they have learned in their own homes. After the Ti Foye has concluded, the monitrices regularly visit the mothers and children to offer encouragement and support.  The Ti Foye program has rehabilitated 80% of participating children in the villages of Leogane, including Wadson and Franz. 

Wadson’s story

When the Nutrition Program staff censused a home in Binot in October 2001, Wadson Durogène was sitting on his dirt floor, quiet and listless. He was almost 2 years old and weighed approximately 10 pounds, was severely malnourished, and could not speak or walk. He had not eaten for two days, and neither had his mother, Miriam, who was pregnant with her second child. Three months later, Miriam and Wadson participated in the Hearth program. The monitrices in their village continued to check up on them regularly, occasionally bringing enriched milk for Wadson and encouraging Miriam to bring him to the monthly vaccination post. By June 2002, Wadson had begun to speak and take his first steps, and by November 2002, Wadson’s health had improved considerably. Today, at 4 years old, he is now walking and talking and the new baby is healthy and of normal weight. Both children are now on a regular vaccination schedule.

Franz’s story

Franz lives in a deforested mountainous village that has little food available, and no drinking water source nearby. When we censused his village to find and weigh all the children, Franz was a little over 2 years old, and exhibiting the classic signs of severe malnutrition: white, patchy hair, and a very swollen body. He was also suffering from a respiratory infection, and had not eaten or drunk water in many days. We traveled back to the hospital and returned with antibiotics for the infection, and put Franz into the Ti Foye program with a group of other malnourished children. The monitrice from his village gave us good reports of his progress, and when we returned to the village for a mobile medical clinic 7 months later, Franz came with both his parents. His hair had returned to its normal color, and the swelling had gone (but he still has fat cheeks!). His mother is now enrolled in the microcredit program, and is earning a bit of money that enables the family to have food more regularly.

Franz and his parents dress up to attend the mobile clinic. He is now walking, talking and eating well.