Our initial project was to have women in Nepal take folic acid to prevent birth defects.  We wanted to educate Nepali people about the importance of micronutrients (MN) in their diet. We proposed a system in Nepal to distribute supplemental folic acid in the form of prenatal multivitamins to women of childbearing potential in order to prevent neural tube birth defects.  The additional MN in the multivitamin might also help anemia and other deficiencies.

By 2009, Dr. Long and GNE had identified local resources in Nepal and partners in the project.  The Nepal government was willing to let GNE do a research study on women’s health and the effect of prenatal vitamin supplements. Nine districts were selected for study based on local leadership and accessibility in Myagdi and Nawalparasi.  Vitamins were provided by Vitamin Angels of Santa Barbara, CA.  Bi-annual trips were arranged through Narayan Bhandari, trekking guide and so much more.

September 2011 to October 2014: Micronutrient Distribution & Research Project “Multivitamin and mineral supplementation in women of childbearing age and assessment of perinatal outcome in Nepal."

• 50,000 women in 9 locales received 200,000 micronutrient supplements and nutrition education.

• Local leaders and female community volunteers were trained to provide flip-chart and electronic tablet nutrition education (benefits of proper nutrition and prenatal MN supplementation).

This study project demonstrated that it was possible to obtain prenatal multivitamins, import them to rural Nepal, convince local leaders of the benefits of MN supplementation, educate women to take them and develop a system to distribute the vitamins.  Strong relationships were forged with the “female community volunteer leaders” (FCVLs) in each village who are the community health leaders. The results of the study were inconclusive as to any health benefit and the results were published.(link)

An important part of this project was also developing educational materials that would be used by the FCVLs to teach their village about nutrition.  The typical diet in Nepal of dal (lentils) and bhat (white rice) is deficient in folic acid and other MN.  Sources of folic acid available to local people needed to be identified.  The information had to be presented in an understandable manner in Nepalese.  We developed a flip chart in a printed form and a PowerPoint presentation with audio in Nepalese for an electronic tablet.  We left these with the FCVLs.

At this point GNE felt that we had demonstrated that vitamins could be imported and distributed by local village programs with enthusiastic acceptance.  We had educated the people about the importance of folic acid and empowered them to improve their health.  We wanted to expand the programs.

The government in Nepal balked in 2015 on importing supplements.  Nepal does not have the capacity to manufacture its own vitamins.  It does not have laboratory testing facilities to certify the safety of imported supplements and does not recognize outside labs.  We were at a regulatory impasse.  We still had our network and our education programs, but no vitamins to distribute. Then the earthquake happened…

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