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Nutrition and Hygiene

CARE’s Nutrition and Hygiene project in Mali integrated nutrition; water, sanitation, and hygiene (WASH); and agriculture in the regions of Mopti, Ségou, and Koulikoro to help women and children improve their health and nutrition.

The project addressed the immediate causes of malnutrition – poor diets and infectious diseases such as diarrhea – as well as the underlying causes, such as poor hygiene and inadequate sanitation, that contribute to poor nutrient absorption in children.


The Mopti, Ségou, and Koulikoro regions of Mali suffer from drought and a lack of food because of poor rainfall. Many children can’t get enough to eat, and some even starve to death. Globally, malnutrition is responsible for nearly half of all child deaths each year and is the single greatest threat to child survival. Getting children access to the health care and food they need is the only way to solve this problem.

People struggle to produce enough nutritious food for their families. It is especially hard to grow fruits or vegetables for a diverse diet, and farmers have little money to purchase these foods. The lack of clean and safe water makes it even harder to keep kids healthy and well fed.


The Nutrition and Hygiene project focused on services for children under 2, because that offers the best opportunity to set children up for healthy lifelong growth. Some specific strategies were:

  • Helping families access and eat diverse and quality foods.
  • Improving nutrition and hygiene.
  • Increasing the number of families using nutrition and water, sanitation, and hygiene (WASH) services.
  • Reinforcing and scaling up community‐led total sanitation.
  • Strengthening skills with the National Department of Sanitation and Pollution Control.

To achieve these objectives, the Nutrition and Hygiene project adopted an integrated approach across three pillars:

  1. Nutrition‐sensitive agriculture to ensure that families could access nutritious food.
  2. Nutrition‐specific interventions to promote families eating healthier diets.
  3. WASH interventions to help communities live in a healthy environment and adopt healthy lifestyles.

The project also focused on helping families change behavior and start savings groups to build women’s empowerment.


The project reached 68,300 pregnant and lactating women, approximately 173,000 children under 2 years old, and 17,500 smallholder farmers and their households, and trained 6,100 community and facility‐based service providers in the prevention of malnutrition and poor hygiene.

reduction in stunting

reduction in stunting

reduction in prevalence of underweight children

reduction in prevalence of underweight children

Program achievements

The final evaluation showed that the project reduced stunting by 29%, reduced prevalence of underweight children by 70%, and increased production of nutritious foods. The project also improved sanitation coverage and access to sustainable water supply by helping 223 communities in eliminating open defecation, establishing 33 sanitation shops so people could buy sanitation products, and constructing and rehabilitating 143 water points. Each water point had a management plan and a way to ensure communities could pay for repairs in the long term. The project also supported local planning processes for sanitation and provided training and information platforms for government officials

The importance of Nutrition and Hygiene

By stimulating both the production of and demand for nutritious foods, and addressing key challenges to sanitation and hygiene, the project was able to successfully promote lifestyles that improved nutrition and health. It also helped make sure the activities could last by focusing on building leadership and capacity of community members and government at all levels.