In the conservative Terai region of Nepal, strict patriarchal norms dictate family decisions. Women in the region—especially those from ethnic minorities and with low social status—experience high levels of poverty, social exclusion, and marginalization and are unable to freely exercise their economic, reproductive health, and political rights.

These challenges are evident in the life of Nita Patel, a young mother whose three-year-old daughter was diagnosed with severe acute malnutrition one year ago. Today Nita remains unsure whether her daughter is out of danger, as she could not attend either her child’s second screening or the regular nutrition meetings she once eagerly enrolled in. Smita Pal, who works with FORWARD Nepal under the Nutrition Smart CommUNITY program, says health workers often struggle to retain rural women like Nita in such programs. “They cannot go out without permission or without a man’s company. They lack the space and opportunity to make their own decisions,” Pal explains. Any form of change often meets resistance from in-laws or families, making it essential to advocate for behavior change among both men and women.

The Nutrition Smart CommUNITY approach combines systemic interventions at various levels to address the root causes of chronic hunger and malnutrition through four key strategies: fostering behavior change at the household level, strengthening and supporting community-based institutions, activating and improving nutrition-relevant services, and advocating for a multisectoral, community-based approach to realizing the right to food.

The program aims to build the skills of caregivers to prevent malnutrition in both the family and the wider community. This includes training to prepare Super Cereals—a highly nutritious prepared food containing a selection of locally available, climate-resilient food items such as maize, millets, pulses, peas, wheat, soybeans, brown rice, and various seasonal fruits. Nita learned this recipe and has incorporated it into her daughter’s daily diet. “I don’t have to beg or ask for extra money from my husband or in-laws. These ingredients are readily available at our farm or at home,” says Nita. Men migrate for work, often leaving financial control of the family to their own fathers. Women thus frequently lack financial freedom or purchasing power. Promoting low-cost recipes and improving women’s access to knowledge on the linkages between agriculture, natural resource management, and water, sanitation, and hygiene is vital to increase women’s agency and address malnutrition. To create lasting change, the program also trains men on the importance of nutritious food.

Through farmer field schools, both men and women in the community learn about diversified crops and healthy diets as well as sustainable farming practices that enhance nutrition and climate resilience. These practices include the use of traditional, local, and climate-resilient crop varieties like millet as well as homemade bio-fertilizers and bio-pesticides known as jholmal. Nita and her father-in-law practice these techniques together on her farm, contributing to climate resilience. Training is also provided to government entities to institutionalize change sustainably and enhance service delivery in line with community needs. To improve the status of women in the communities and beyond, the program also strengthens women’s leadership skills and agency as they take on decision-making roles in local governance, such as micro-planning processes, savings groups, or water committees.

Challenging patriarchy and fostering behavior change takes time, especially in regions like the Terai, where it faces resistance. Yet seeing women like Nita become more conscious of their children’s and their own health shows that education, training, listening, timing, and empowerment of families to pick up new behaviors in order to overcome resistance do indeed pay off.

1. This case study was prepared by Welthungerhilfe (WHH). Nutrition Smart CommUNITY is a multisectoral approach designed to help village communities tackle the complex causes of hunger holistically through self-help and sustainable practices. In Nutrition Smart CommUNITYs, people, local organizations, and authorities collaborate to improve nutrition by advancing agriculture, health, natural resource management, and water, sanitation, and hygiene (WASH), integrating best practices from nutrition projects all over the world. Initially starting with two villages, the program has since expanded to 670 model villages in Bangladesh, India, and Nepal. Over a four-year period, the villages have become centers of knowledge and learning, including for neighboring communities. WHH is now extending the concept to Burundi, Ethiopia, Malawi, Sierra Leone, and Tajikistan. The initiative is funded mainly by the German Federal Ministry for Economic Cooperation and Development (BMZ) and Irish Aid.