International Initiative for Pediatrics and Nutrition (IIPAN)

Kathmandu, Nepal

Kanti Children's Hospital (KCH)

Nepal is a lower-middle income country in Southeast Asia and has a high burden of non-communicable and communicable diseases. Malnutrition is among the highest in the region and in the globe. The national prevalence of children under-five with stunting and wasting is 36%, 9.6%, respectively.  In pediatric oncology, more than half of patients are diagnosed with wasting or stunting at the same time as the diagnosis of cancer. The incidence of malnutrition further increases among older children and adolescents with 43.6% classified with undernutrition. There is no formal cancer registry database in Nepal, but expected childhood cancer cases in Southeast Asia during 2015 was around 30,079 and approximately 900 new cases of childhood cancer are diagnosed every year in Nepal.

IIPAN Center & Collaborators

Kanti Chidren's Hospital

The IIPAN site in Nepal is Kanti Children's Hospital, who provides care to approximately 200 new diagnoses each year. The hospital is administered and regulated by the Ministry of Health, Government of Nepal. KCH is the only tertiary level children’s hospital of the nation, where underserved patients receive access to high-quality, free medical care.

The IIPAN nutrition program is overseen by Dr. Bishnu Rath Giri, IIPAN's collaborating pediatric oncologist who works alongside the team in New York developing an evidence-based nutrition program for the hospital. There are only two pediatric oncologists at KCH and only one dietitian for the pediatric unit. The IIPAN nutritionist, Ms. Juna Dunghana, has been trained in the recommended IIPAN protocols at KHC and works alongside Dr. Giri to establish a nutrition program for the children and adolescents receiving care at KHC. Ms. Dunghana also provides consultation and support on evidence-based interventions for the entire pediatric ward at KCH.

Site Challenges

  • No local non-governmental organization partnership.
  • Limited to no access to essential nutritional supplies.
  • High rates of side effects due to cancer treatment.
  • High financial burden for families.
  • High prevalence of severe acute malnutrition further complicating treatment for childhood cancer.
  • High provider:patient ratio.

Site Needs

  • Support to establish a nutrition education program for pediatric oncology.
  • Improved variety of food options for children.
  • Consistent supplies for medical nutrition therapy, including RUTF, F-75, F-100, specialized formulas and multivitamin micronutrient powder.
  • Building capacity to serve the increase in pediatric illness.
  • Fostering a network to support the health and well-being of communities.
  • Technological support.