Can Locally-grown Crops Replace Nonfat Dry Milk in Ready-to-Use-Therapeutic Foods? Innovative Malnutrition Solutions for Haiti

Ready to use therapeutic foods (RUTFs) are employed when individuals reach levels of malnourishment that are immediately life-threatening or that undermine long-term quality of life. RUTF formulation, preparation, distribution, and administration is complex, technically demanding, and input specific. It can also engage horticulturists operating in multidisciplinary, outcome-oriented teams. Nourimanba—effective but expensive—has been prepared, distributed and administered by Abbott Nutrition and its partners in Haiti. Nonfat dry milk (NFDM) is the most expensive of the four ingredients in Nourimanba and it is imported. At Abbott Nutrition's invitation, this team set out to identify a crop-based alternative to NFDM that can be grown in or near Haiti's Central Plateau. Our specific objectives were: 1) identify candidate crops with a composition profile that may qualify them for use in a re-formulated Nourimanba; 2) identify a smaller subset of candidate crops that also appear to be adapted to the production conditions of Haiti’s Central Plateau; and 3) estimate the amount of acreage required to produce one or more candidate-adapted crops in quantities allowing for a substantial reduction in NFDM use and related increases in Haitian farm-based income opportunities. Objectives one and two were met by employing research-based data in a two-stage screening process. First, the universe of available crops (nearly 7000 as listed in the USDA Nutrient Data Laboratory nutritional database) was narrowed to twenty candidate raw crops calculated to possess a weighted, unit-less, four-component "formulation potential index" value equal to or greater than NFDM. Next, consulting authoritative texts and reference information and employing information therein in calculating a weighted, unitless, seven-component "crop potential index" revealed that four crops (teff, chickpea, sesame, and winged bean) may be most adapted to production conditions common to Haiti's Central Plateau. Finally, consulting publically available, coded satellite images and references regarding land use patterns in areas near an existing Nourimanba manufacturing facility and assuming certain levels of crop use (NFDM replacement) and yield suggested that land availability near the facility is unlikely to limit efforts to develop a lower-cost and locally-enriching reformulated version of Nourimanba.