Goal 1 Eradicate extreme poverty and hunger

Preventative healthcareFood SecurityPoverty Reduction Strategy

This goal aims to reduce by half the number of people whose income is less than $1 a day, and those who suffer from hunger.

A new approach to caring for malnourished children
by Ed Walker. 

In southern Sudan, drought and the effects of 20 years of conflict led to a severe food shortage in 2002, with many children very malnourished. Tearfund responded to this emergency with a new approach called community-based therapeutic care.

Traditional feeding programmes treat children suffering from severe malnutrition in feeding centres. Children and their carers usually stay in the centre, so only a limited number can be treated at any time. This new community-based approach involves setting up many smaller distribution points, often in remote areas. Local people help build and staff them.

All the malnourished children admitted to the programme are examined. If they have a healthy appetite and no medical complications, they are given supplies of a special food called Plumpynut® and sent home, to be looked after by their mothers. They get regular supplies of Plumpynut from the local distribution point when they go for a weekly check up. This community-based approach reduces the time mothers have to spend away from their other children, and from their household and farming work. This was especially appreciated at the start of the planting season. Plumpynut also proved very popular with the children.

Severely malnourished children with serious health problems or no appetite are admitted to a stabilisation centre for medical care until they have recovered enough to return home.

This new community-based approach was a success in South Sudan, and very popular with local people. The programme was able to cover a much wider area. Hundreds more children were treated than in previous, centralised programmes. There was a high recovery rate and a very low mortality rate. Nurses who had spent over five years in feeding programmes initially found it strange to let severely malnourished children leave the treatment centre. However, they soon became the strongest advocates for the new approach. Mothers attending the distribution points also received health education and supplies of seeds. Some have now formed women’s groups that meet each week to receive further health education.

Ed Walker was Deputy Programme Director of Tearfund's South Sudan programme, and is currently Programme Director of the North Sudan programme.


Plumpynut® is a balanced food made of peanuts, oil, minerals and vitamins. It does not need to be mixed with water to use, avoiding the risk of infection from waterborne diseases in weak, malnourished children.

If supplies of Plumpynut are unavailable, substitutes can be made. In Malawi a local version was made with groundnuts, dried skimmed milk powder, sugar, oil, vitamins and minerals. Local cereals and pulses can be used instead of groundnuts and milk.

Other ideas to meet Goal 1

  • Encourage access to micro-credit.
  • Provide free school meals for all school children, using locally produced foods.
  • Improve soil fertility through adding manure, making compost and using green manures.
  • Plant trees like moringa and leuceana that add nutrients to the soil.
  • Encourage the use of door-sized homegardens. 

Progress on Goal 1

The number of people living on less than $1 a day will probably be halved due to progress in India and China. The incidence of malnutrition is falling. However, in sub-Saharan Africa the number of people living on less than $1 a day is increasing. 

The number of people suffering from hunger, though reduced, is unlikely to be halved by 2015.