Every minute 12 children die
In the two minutes you take to read this page, more than 24 children under the age of five will die. In 24 hours, the total will exceed 17,000. Most of them will be victims of diarrhoea, pneumonia, malaria or complications before, during and after birth. Nearly half of these deaths are linked to undernutrition.
None of these children need to die. More than 100 million deaths are preventable between now and 2035.This is why World Vision works alongside communities globally, finding new and innovative ways to improve the lives of children in poverty and put an end to needless deaths and ill health. Our health work includes in-the-field programmes that prevent and treat undernutrition, support mothers and newborn babies, strengthen local healthcare systems and make access to healthcare easier.
Why women and children are dying
In 2011, almost seven million children didn’t reach their fifth birthday. Every day 800 women die from causes related to pregnancy and childbirth. And of these maternal deaths, half occur in fragile and conflict-affected states, most of them are girls under the age of 15.
These preventable deaths are mainly caused by:
- Limited or no access to nutritious food
- Limited knowledge or ability to practice good maternal and childcare practices, both preventative and care
- Weak health systems – including access to appropriate and skilled care before, during and after childbirth
- Poor access to water, sanitation and healthcare services
- Unfair systems and structures that keep women and children in poverty.
All of the above affect critically the health of women and children, especially those living in the world’s poorest places.
Understanding why these preventable deaths happen enables us to work to overcome them, to help bring good health back to affected children, families and communities.
Helping women and children live healthier lives
To help address the underlying causes of preventable deaths, World Vision UK has developed a range of initiatives and projects that sustainably improve nutrition and food security and support maternal, newborn and child health in some of the world’s most difficult places to live.
Based on research, programming experiences and internationally recognised best practices, we support and develop policies, strategies, programmes and resources which:
- Help protect children living in the hardest places from undernutrition and ill health
- Meet the basic health service needs of pregnant women and children, ensuring availability of appropriately trained staff and resources ed to provide basic services like vaccinations
- Promote healthy behaviour and care seeking with appropriately trained providers, including skilled birth attendants
- Support the protection of women’s and children’s health and nutrition during emergency responses, both in the immediate response and in longer term rehabilitation
- Call for all governments, multilateral agencies and other stakeholders to be accountable for their maternal and child health commitments.
Working in partnership
To strengthen our health projects and policies, World Vision works at local, regional, national and international level – from educating and empowering individuals and communities to advocate for quality healthcare to influencing government bodies to help ensure the delivery and reach of quality health and nutrition services.
In the UK, we work to ensure that our government, multilateral agencies and other stakeholders are making appropriate commitments to maternal, newborn and child health commitments and are accountable for their effective delivery.
WE HELPED MAKE ALMOST 1.5 MILLION CHILDREN HEALTHIER
During 2013, our work in 66 projects, based in 25 countries, contributed to the improved health of 1,459,040 children, now less fearful of hunger and sickness.
Understanding that good nutrition is fundamental to good health, we ran 23 nutrition projects in 11 countries in 2013. The work of these projects ranged from supplying food supplements and treating undernourished children to supporting breastfeeding mothers and educating communities about the value of good hygiene. 18,000 children were treated for acute malnutrition, with results well above international standards. This included the most vulnerable children in Angola during times of severe food shortage.
Mothers and newborns
Protecting the health of mothers and their vulnerable newborns is paramount. Our mother and newborn health programmes help women have a healthy pregnancy, safe birth and provide early vaccinations against diseases for babies. These projects are showing signs of success, with evaluation reports showing the following over the programme cycle (three to five years):
- The number of underweight children reduced by an average of 8.7%
- Children who were breastfeed increased by an average of 6.5%
- Births attended by a skilled birth attendant increased by an average of 1.3%
- The number of children immunised increased by an average of 22%.
Agriculture and livelihoods
While we do all we can to improve nutrition and support pregnant and nursing mothers, poverty remains the biggest cause of ill health. In 2013, we worked in 20 countries to improve the livelihoods and food supply of 672,381 people by introducing irrigation schemes and diversifying crops, enabling communities to grow more nutritious food.
Here are two examples of how we have contributed to the improved maternal health of women in Pakistan and to reducing undernutrition among children living in Bolivia.
Shaheen (pictured above) is a young mother of two from Pakistan. When she had her first baby, there were complications, which made her anxious about the birth of her second child. Her anxiety was exacerbated by her earlier experience with a Traditional Birth Attendant (TBA) who, due to lack of sufficient knowledge, tried to deliver her first baby when she wasn’t actually in labour.
Although many TBAs in the region where Shaheen lives are not medically trained and lack the right experience, unfortunately the practice of using them is common. For many women, because of lack of awareness or facilities, giving birth in hospital is not always an available option.
As the birth of her second child approached, Shaheen’s increasing anxiety became a cause of concern. Fortunately for Shaheen, a World Vision Social Mobiliser was able to intervene during a routine visit. She provided Shaheen and her family with information that explained how a hospital delivery would be safer. This encouraged her family to support a hospital delivery. Shaheen delivered a healthy baby boy in a hospital labour room assisted by a trained midwife.
Alfredo’s home is in Moscoma, a remote mountainous community in Bolivia. He lives there with his wife (pictured above) and two children. Unfortunately, the soil in Moscoma is ill suited to growing the nutritious food that children need for good nutrition and growth.
Because of this, the malnutrition of children here is a health concern, but with the support of World Vision and the engagement of community members like Alfredo – who has been trained to identify malnutrition, to encourage use of the health centre and share knowledge about nutrition with families – the health of children is improving.
Alfredo says: “It is very clear when a child is not well fed…when I see it, I notify the health centre. I’ve seen many cases of malnutrition and we have recovered many little children who would be dead by now”.
With World Vision’s help, Afredo’s community has learned about family planning, about preventing, identifying and treating malnourished children and how to grow more nutritious crops – building a better, more hopeful future for Moscoma’s children.
World TB Day
24th March marks World TB Day. The below article from Dr Sarah Morgan takes a look at how children can be treated successfully even in the most challenging of places such as Somalia.
Reaching the unreached - Tackling Multiple Drug Resistant Tuberculosis (MDR TB) in the one of the most challenging places on earth
"I would like to be a doctor in the future. I will not stop taking the TB drugs as if I do I will not be able to be a doctor” says Aisha, aged 11.
Every year 9 million people fall sick with Tuberculosis (TB) despite it being a preventable and curable disease. Current global efforts to find, treat and cure everyone who gets ill with the disease are woefully insufficient. This year’s World TB day aims to raise awareness of the 3 million people a year who are “missed" by public health systems and don’t get the care they need. Many of these three million people live in the world’s poorest, most vulnerable communities. Children are among those most neglected by TB services, especially children with a form of TB resistant to the normal drugs used to treat TB. However, in Somalia, one of the most challenging places to deliver health services including TB services, World Vision is helping get treatment to the most vulnerable. Aisha’s story shows what can be achieved with commitment to reach the unreached.
Multidrug-resistant tuberculosis (MDR-TB) is TB that does not respond to Isoniazid and Rifampicin, the two most powerful anti-TB drugs. MDR TB is on the rise, there are roughly 630000 cases worldwide and in 84 countries a form of MDR TB which is resistant to even more drugs has emerged (extensively drug-resistant TB ), bringing with it the possibility of virtually untreatable TB. Although children can be successfully treated for MDR TB access to treatment is severely restricted, and few MDR treatment programmes offer treatment to young children.
In Somalia two decades of civil war, severe drought, floods, famine and mass population movements have given rise to many of the factors making MDR TB more likely such as a weak health system, unregulated private TB clinics, unregulated TB drugs on sale meaning patients receive inadequate or interrupted TB treatment.
Despite the challenges in Somalia, World Vision and partners have recently started delivering MDR TB treatment. One of the first patients was Aisha, an 11 year old girl.
Aisha was diagnosed and treated for standard TB in 2012 in her home town in Somaliland. After finishing treatment she deteriorated, suffering from a high fever and convulsions. As Aisha was so unwell she was brought hundreds of kilometers to the TB hospital in Hargesia. In August 2013 a laboratory in Kampala, Uganda was consulted to help with diagnosis and confirmed she had MDR TB. When she first arrived in Hargesia, Aisha was very underweight due to the infection, but now on treatment she has gained weight and is feeling well. Her family confirm that she finished the entire eight month course of standard TB treatment, so Aisha’s doctors concluded her original TB infection must have been resistant to the medication.
It is not easy for Aisha to be far from home for such an extended period taking MDR TB treatment but she is committed to finish the treatment to become well and return to school.
Worldwide children make up 10–15% of TB cases. Accurate statistics for children with MDR TB are lacking, but it is thought children also make up 10 – 15% of global MDR TB cases. The highest proportion of childhood MDR TB is in low income countries. Children pose particular challenges for health staff when it comes to this form of the disease. The most effective measures to diagnose and treat MDR TB in children are unclear. Children’s doses of medication are unavailable for most drugs needed for MDR TB and the side effects of these drugs are a major concern in children. Children are likely to develop MDR TB where transmission is poorly controlled. Somalia is a perfect storm when it comes to poorly controlled TB transmission. Levels of MDR TB in Somalia are higher than global averages and higher than neighbouring Ethiopia or other countries in the eastern Mediterranean region. MDR TB presents a serious challenge for TB control in Somalia.
World Vision coordinates all TB activities undertaken with Global Fund grants across the whole of Somalia. The first shipment of MDR TB medications was received in July 2013. Hargesia in Somaliland was chosen as the initial location for MDR TB referrals due to its relatively secure environment. 66 health staff has now been trained or retrained on MDR-TB. A 30 bed admission ward has been established and an MDR TB laboratory is in progress. So far 45 MDR TB cases have been confirmed and started on treatment. A laboratory in neighboring Uganda is still relied upon for diagnosis. This is still a complex disease to tackle in a very difficult setting.
Children with MDR TB are a neglected concern, with few children being treated relative to the estimated disease burden. However, children with MDR TB can be treated successfully even in the most challenging of places such as Somalia. Globally, current levels of funding hamper serious efforts for MDR TB control. The Somalia TB programme has shown that strategic commitment and funding can begin to impact the most neglected and difficult to reach patients. However, as Dr Rusagara, World Vision Somalia Global Fund Programme Director, says “The response has picked some momentum, but it has a long way to go.”
Somalia TB programme information given by Dr Rusagara Vianney and Dr Anthony Abura, World Vision Somalia Global Fund Programme
Aisha’s story was recorded by Abdulkadir Abdulahi Osman, ACSM Field Coordinator Hargeisa, Somaliland and Dr. Hergeye Abdi MDR Management Focal Point, Somaliland
Treatment outcomes for children with multidrug-resistant tuberculosis: a systematic review and meta-analysis Ettehad et al. Lancet Infect Dis 2012; 12: 449–56
Drug-resistant tuberculosis: time for visionary political leadership. Abubakar et al. Lancet Infect Dis 2013;13: 529–39
Multidrug-Resistant Tuberculosis, Somalia, 2010–2011. Sindani et al. Emerging Infectious Diseases Vol. 19, No. 3, March 2013
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