Muluwork Tesfaw runs a small shop in Mergech kebele, East Gojam, Ethiopia. When health extension workers—government employees who provide primary health education and services at village level—approached her about selling complementary food for infants, she saw an opportunity. This isn’t just about one entrepreneur. It’s about building the market systems that make nutrition services sustainable and accessible long-term.

Selam Tesfaw, 40, now walks to Muluwork’s shop to buy complementary food for her youngest daughter, Hanna. “Instead of preparing it myself, I’d rather buy it from the shop because it saves me time and energy,” she said.

Health extension workers teach mothers how to prepare complementary food for infants and young children. Some mothers implement what they learned, but most do not buy all the ingredients and prepare it themselves. This is the gap that programmes often miss: knowledge doesn’t automatically translate into practice when the enabling market infrastructure doesn’t exist.

Muluwork saw this gap as a business opportunity. She started with 15 kilos of complementary food and sold it all in a couple of months. She did not make the profit she expected because the community does not yet have full awareness of complementary food. “I don’t want to worry about the profit now, because I know I am selling something beneficial to the community,” she said. “The more people get accustomed to it, I know I will be able to make a profit then. And I will increase my production to 50-100 kilos.”

Muluwork did not have awareness of nutrition before health extension workers approached her. “Having this nutritious meal helps children to be healthy and it prevents stunting. I want to learn more about raising healthy children,” she said. “In my community, I wish to see children being fed proper nutrition so that they can grow physically and mentally healthy.”

Selling the complementary food has created an additional source of income. Beyond her shop, she also has livestock (one ox, three sheep, one donkey) and two chickens whose eggs she sells at the shop.

Muluwork is not focused on immediate profits. She understands that building demand for nutrition products takes time. As awareness increases, she expects sales to grow. “When individuals’ lives are changed, the country as a whole can change,” she said. “If healthy children are raised, they will have a better future.”

Max Foundation’s Healthy Village approach in Ethiopia, implemented in partnership with Plan International in Tigray region, and with iDE in East Gojam, s strengthens child health outcomes by combining nutrition, WASH, and maternal health interventions with systems strengthening,including through local entrepreneurship—so that sustainable delivery infrastructure remains embedded in community economies.

Shahera Khatun is a single mother of 3 children. She also runs her own sanitation business. It requires hard labour, and is more commonly done by men.

Shahera started small a few years ago, and steadily grew her business. She now has expanded to sell a variety of sanitation and hygiene products.

Last year during COVID-19, her business suffered as people couldn’t afford to invest in sanitation. Luckily business is picking up again.

We are happy to see Shahera’s business grow!

No community development effort will be
sustainable unless local government is involved.
In the case of Bangladesh, we work with the Union Parishad (municipality).

We are happy that our Healthy Village Tracker, developed in 2020, is already adopted  by the Chairman of the Jainkathi Union Parishad.

“For achieving a Healthy Village, it is crucial to know the real-time progress of the community and to be aware of the challenges they are facing to achieve their target regarding WASH and Nutrition. With the Healthy Village Tracker, this data can be tracked automatically. Based on this data, the Union Parishad can easily determine what actions need to be performed to improve the health status of the community.” 

– Chairman of the Jainkathi Union Parishad.

Rubina Begum lives in Chalitabunia village in Patuakhali, Bangladesh. Her first child is 6 months old. His name is Hasib. Rubina is so happy since the pregnancy and birth of her child. She signed up for growth monitoring.

Soon after, Rubina participated in a courtyard meeting about stunting. Her son’s height and weight were measured in the session. The results were not good. Hasib was in the yellow zone in both height and weight charts. Rubina became very concerned. She heard from the meeting that it is possible to change this within the first 1,000 days of a child’s life (from pregnancy to 2 years).

Rubina took steps immediately: washing her hands with soap and water before feeding her child and after cleaning his bottom. Washing the  family’s clothes and sheets regularly. Cleaning her baby’s hands and trying to keep him from putting dirty objects into his mouth.

Since then, Hasib has moved from the yellow zone to the green zone on the growth charts. Rubina is now quite happy. She will continue monitoring Hasib’s growth through visits to the nearest health clinic.

Kanchan Khan and his friends collect water at the new well in Golachipa Upazila in Patuakhali District (Bangladesh).

Before the well was installed, people from the community used water from the next closest well – an hour walk from the village.

This water was often contaminated and the iron level too high. Many people in the community suffered from water related diseases.

The village chief says: “The clean water we now have access to contributes to a healthier community. We see many positive changes”

Jibon is the youngest of three brothers living in the north-east of Bangladesh. His mother has her hands full running the household and looking after her children. Jibon’s father leaves the house early in the morning to seek work. As a day laborer, he has a hard time providing for his family. When his parents found out Jibon was severely stunted during a growth monitoring session, they realized they had to improve their baby’s health.

Together with other family members, they improved their hygiene habits to help Jibon grow healthy.

His mother attended courtyard sessions of the community health promoter. There she learned about good sanitation, hygiene and nutrition habits. Jibon loves to eat foods like eggs, milk, and khichuri, which have high nutritional value. Jibon’s health is gradually improving, from severely to moderately stunted, and on the right track.

Jibon’s parents saved money to build a latrine. Later on, the family invested in a handwashing device and soap. These healthy practices improved the well-being of the whole family.

Suisaya is in class four of the Yangsa School in Golkhali (Bangladesh). One year ago, there were no water and sanitation facilities at her school. She did not have anything to drink all day and when she had to go to the toilet, she walked into the field. As a girl, she always felt vulnerable. Max Foundation worked with school management to fix this.

Now, there is a water well in the school yard and separate latrines for girls and boys. Since then, children at her school suffer less from diarrhoea. Hygiene education also contributed: all children learned to wash their hands after visiting the toilets.

When we ask Suisaya about this, she says with a big smile: “I wash my hands when I have visited the latrine. You get ill if you don’t. I like to wash my hands.”