Stories can help bring an issue to life. By sharing stories we help people understand why addressing issues like maternal and child health is so important and why responding through campaigns like Child Health Now and the Global Week of Action are vital. These stories help capture what the issues are all about.
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Every year 6.9 million children under the age of five lose their lives
to preventable illnesses like pneumonia and diarrhoea. We know the
causes and we know the simple and cost effective treatments that will
save these lives. All we need is will. Join hands so all children can
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Getting out of the red zone
Malnutrition can be a problem in cities too. In parts of Guwahati, India, World Vision found a 7 per cent rate of severe malnourishment in children under age 5. A simple way to track the problem is to measure the circumference of an infant's arm to see if they are in the red zone. Read more
Local citizen advocacy improves health in Uganda
Several years ago, ordinary people in communities in Uganda began
working together to start talking with health and government staff about
things like number of staff and availability of midwives and medicines
in local health clinics. Read more
Youth advocate for better health services in Albania
A health centre is supposed to save lives, not expose people to even
more health risks, but since 2006 anyone attending the health centre
that served Spiten village in Albania was being exposed to a higher risk
of infection just by being there. Now, because of many years of
cooperative advocacy with the people of Spiten and World Vision, they
have a modern centre that will provide the health services the people
deserve. Read more.
Mapping technology showing health gaps in Africa
In Sierra Leone and Uganda, World Vision is using global information system technology to provide data to governments and the international community around
health care, in particular showing where there are gaps in coverage. Read more.
Three wise women make an impact - India
There are few women as passionate about their community as Mangi and Monica. Along with Sushila, Mangi and Monica care for and counsel the pregnant women, young mothers and children in their small village community in northern India. Read more
Mangal Das works in a chicken farm transporting chickens from the farm to various shops. He earns about 5000INR (US$100) a month. His wife Sharada takes care of their children, including their six-year-old son Sandeep and their daughters: five-year-old Sonia , two-year-old Jyothi and nine-month-old Kushi.
They live in a bamboo sheet walled house, which is a part of a row of homes located in a settlement in the north-eastern city of Guwahati in India.
When Jyothi was one-and-a-half years old, she began to lose weight and her skin wrinkled up like a raisin.
World Vision conducted a malnutrition survey in the area to see how many children below the age of five were malnourished. Jyothi was one of the 7 per cent of children who were identified to be severely malnourished. Another nearly 17 per cent were found to be moderately malnourished or in danger of being severely malnourished in the near future.
There is a simple way to identify malnourished children using a mid-upper-arm circumference strip, which measures an infant's arm. If the strip measures in the red, then the child is severely malnourished. Jyothi needed immediate attention.
"We worry about money, so we did not want to go to the hospital, but [World Vision staff] told us not to worry and act fast," says Mangal.
Mangal is not alone, as most of the children of who fall in the severely malnourished category have parents who lack the resources for providing not only the medical attention required when there is an emergency, but also the basic resources to provide for a balanced diet for the child. Jyothi was immediately admitted to a hospital, and after medical treatment she recovered and her growth is back on track.
"Within the first two years if the child's growth gets stunted because of malnutrition, the brain and other body parts remain less developed for the rest of their life," says Santhosh Soren, a World Vision staffer who works in this area.
World Vision will be working in various parts the city of Guwahati for the next fifteen years.
"This year we have been introducing ourselves to the various communities. Who are we? Why have we come to work here?” Santhosh says.
Malnutrition was identified as one of the major issues that needed to be addressed by World Vision in partnership with communities.
"We do not want a single one of our children to be malnourished," says Santhosh.
Several years ago, ordinary people in communities in Uganda began working together to start talking with health and government staff about things like number of staff and availability of midwives and medicines in local health clinics.
With the help of World Vision, the community members started measuring the quality of the services that they received. They pressured the authorities to improve services in 17 health clinics in Uganda. As a result, in the majority of these clinics, there has been an increase of between one and 12 staff and several clinics have appointed midwives. In some clinics, the monthly attendance of women coming in for their pregnancies has more than doubled. This has led to a decline in child deaths in these areas.
John Willy Mungoma, a health education promoter in the Tororo District, said, “Politician--at times they come and talk fast … we … act on what they have told us, but now as communities also raised their voices ... it was a combination of forces, so it .. forced us to [recruit more staff].”
Charles Wamala, Mpigi District Assistant Chief Administrative Officer, said, “There was a lot of pressure on the district, including from the politicians and the Health Management Committee of the facility. The dialogue was that we [were not acting on the] needs of the community members.”
David Wambura, Mbale District Chief Administrative Officer said, “All of us are on our toes now. We are under pressure to deliver and if we don’t, we have to explain why. We are waking up. We have taken them [the community] for granted for a long time.”
Because people in the communities decided to stop being silent, because they decided to learn about their rights and to start talking to the authorities about their rights, they were able to make sure that the government provided adequate health services. This means better care for children and increased opportunity for children to survive the first five years of life.
A health centre is supposed to save lives, not expose people to even more health risks, but since 2006 anyone attending the health centre that served Spiten village in Albania was being exposed to a higher risk of infection just by being there. Now, because of many years of cooperative advocacy with the people of Spiten and World Vision, they have a modern centre that will provide the health services the people deserve.
In an effort to empower the community, World Vision taught villagers about their rights and duties, how to monitor public services, and how to demand action from their government.
In Spiten, the major problem was lack of space in the community health facility. At the time, there were four health professionals working at the clinic, but the space was enough for only one to operate properly.
“There were many times when we did not have the physical space for the patients to sit down while giving them first aid,” said Almir Keli, a doctor who worked at the old centre.
Community leaders wanted to press for change, and their first step was to form a health advocacy team which consisted of youth and adults from the village. These teams gathered community members to talk about the problems with the health clinic. Villagers were able to discuss issues and concerns in an orderly manner, and then sign up a petition addressing the commune (the local government unit).
“[People used to tell us]: ‘You are like insects in the eyes of the government, so tiny and invisible. You never will reach out to convince them to do their job’ and it is true, the government did not take us seriously [back then],” said Elton Pepa, 22, one of the most active youth advocacy members.
The initiative changed things. It allowed the community to engage with their local government in a series of meetings in which citizens were able to voice their concerns and suggestions. The process was not an easy one, but community members followed through with advocating for better services.
Almost three years later, the commune delivered a plan for a new building and took care of all legal documentation and procedures for the acquisition of a permit. The Ministry of Health then allocated funds for the construction of the health clinic on a piece of land that had been donated by a community member.
The community members continued to monitor the construction and delivery of the health centre.
“My wife worked as a nurse at the old centre for years and she always brought the medicines home, putting them in our own refrigerator to keep them fresh as there was no refrigerator or other medical appliances at the centre,” said World Vision’s Zef Pepa, one of the members of the Health Advocacy Team.
“My child was sick [during that] period, but I decided I could take care of her better at home than by taking her to the old centre where the risk of getting an infection was much higher,” said Florina, 30, a mother from Spiten. “Conditions were very bad there. I have been waiting patiently for health services to get better and finally they have.”
“Now when I look back to where we started I feel very proud for what we did,” said Elton Pepa, as he reflected on the long journey, troubles and the great success.
“I don’t understand where we found all that power to keep on fighting and defeating the problem, while everybody [was] ignoring us. […] But it was worth [it]! This situation reminds me [of] a very beautiful verse – ‘Knock and it will be opened’. You need to have passion to finish until the end...and if you start something, I would like to go until the end," said Elton, on behalf of the health advocacy team.
Before, the government was not providing adequate health services because it was not listening to the needs of its people in the village of Spiten. After years of speaking out on behalf of their children and neighbours, the community finally had the attention of their leaders and were able to see a change.
How can geographic information systems (GIS) mapping technology help to improve people's health? In Sierra Leone and Uganda, World Vision is demonstrating innovative uses of GIS to provide data to governments and the international community around health care, in particular showing where there are gaps in coverage. GIS means an electronic system used to store, process and display geographic information, especially maps.
As part of World Vision’s Child Health Now campaign, World Vision Sierra Leone is using GIS to track factors like staffing levels at clinics in the Bo district.
More than a quarter of health facilities in Sierra Leone are understaffed and health professionals prefer to work in cities. Many rural health facilities are staffed by nurses or midwives with only basic training. After the country recently decreased the share of the national budget devoted to healthcare, World Vision and partners successfully lobbied for an increase by showing the government how other countries have helped to reduce child and maternal deaths by making sure that the right people with the right training are in the right places.
Now that the healthcare portion of the national budget has been increased from 7.4 per cent to 10.5 per cent, World Vision’s focus has shifted to helping ensure that this increased budget also means an increase in the number of well-trained staff in the places that need it most, especially in villages.
In the Bo district, World Vision has begun collecting data using global positioning system equipment, camera phones and a questionnaire and uploading this information to World Vision’s GIS system. The data revealed gaps, such as situations where areas with a larger population had fewer health staff than other areas with a smaller population. World Vision is sharing this data with government units and decision makers in the country.
World Vision Uganda has been working with the World Health Organization at points during the last two years to map health services availability in the Kiboga and Kyankwanzi districts. The initiatives have had multiple goals – these have included both providing World Vision data on which it could base its own health interventions and providing information on successes and gaps for decision makers. The findings and recommendations have been wide ranging. Among other things, in Kyankwanzi World Vision discovered a need for the district's single ambulance to expand its coverage area to serve the whole district. They also determined that more health facilities in Kiboga needed to start school health programmes, as only one health facility was doing this.
Child Health Now
Local-level and national-level advocacy are major focuses of Child Health Now, World Vision’s global campaign on child health. By bringing both the voices of children and communities and concrete data to decision makers, World Vision national offices are making a big impact in countries around the world to improve child and maternal health. The GIS initiatives in Uganda and Sierra Leone have demonstrated how good data, especially when mapped, can prove invaluable to the decision makers that World Vision tries to influence.
There are few women as passionate about their community as Mangi and Monica. Along with Sushila, Mangi and Monica care for and counsel the pregnant women, young mothers and children in their small village community in northern India.
The women make a formidable team. They work out of an Anganwadi centre, a combined childcare and health clinic funded by the government; often they need extra help to service all needs. Mangi is an Anganwadi worker, Sushila an Anganwadi helper and Monica an Accredited Social Health Activist or ASHA.
Mangi loves working with the children in her community. With Sushila’s help they care for 94 children, aged between six months and six years of age. Mangi is paid a reasonable wage by Indian standards, but she doesn’t do this work for the money. Instead she has her eye on the bigger picture. When asked what motivates her to do her job Mangi passionately replies, ‘I am happy to know that the children in the village will grow up well nourished, healthy and happy. Iknow that I am impacting the future of my community.’
Monica is similarly excited about her work in the village. Away from the Anganwadi centre, she spends a lot of time visiting women in their homes. She is proud that there have been no deaths during childbirth in her community for a significant period of time. ‘Now all mothers understand why they shouldn’t give birth at home. All of them go to the hospital to have their children.’ Monica’s job is crucial for pregnant mothers in her community. Not only does she educate women about birth practices, rest, nutrition and immunisations, she is often the only contact these women have outside their families.
‘Many women don’t come outside of their houses,’ Monica says. ‘Sometimes I am the only person they see during the whole day.’
While the Anganwadi workers and ASHAs are funded by the government, World Vision has played a critical role in coordinating, supporting and monitoring the workers and centres. World Vision has helped renovate the centre to provide recreational opportunities for the children and continues to work closely with the regional authorities to ensure the health of women and children in the area continues to be a priority.
A functioning local community centre and trained health worker have helped improve health outcomes for women and children in this rural community. Training accessible, skilled health workers is a key means to supporting maternal and child health and is a central aim of the Child Health Now campaign.