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Focus on newborn and child survival
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cOnTenTs
01 Directors’ letter
02 EVERY ONE Campaign A word from the campaign Director
04 Ethiopia Improving the nutritional status of Ethiopian mothers and children
06 Ethiopia EVERY ONE Ethiopia goes artistic
07 Ethiopia The second edition of the EVERY ONE Hawassa race
08 Uganda Using Audit, Cellphones and Technology to ACT for birth
10 Uganda Boosting Uganda’s EVERY ONE campaign
12 Kenya Racing to save children’s lives
14 Malawi Malawi’s First Lady kicks off the EVERY ONE campaign
16 Malawi Reaping the power of community involvement
18 Malawi Mothers’ fun run
20 Mali EVERY ONE campaign in the Sahel
24 Mozambique Community case management: saving lives in rural Mozambique
26 South Sudan Maternal health in South Sudan
30 Tanzania Partnership for nutrition in Tanzania
32 Nigeria Hunger and child survival in the Sahel
06 18 20 26 32
impact Newborn and Child Survival 01
welcOMe TO iMPacT
dear colleagues and Friends,
we are pleased to bring you the February 2012 edition of iMPacT, focusing on save
the children’s global campaign for child survival and maternal health—everY One.
child survival and maternal health in africa remains a challenge for governments and
development partners, and as we get closer to the deadline for achieving the
Millennium development Goals (MdGs), the imperative to accelerate our efforts to
ensure newborns, children and their mothers survive, and thrive has never been more
urgent.
The everY One campaign in africa is gaining momentum, and we are cautiously
optimistic that we are making a contribution to reducing the number of children dying
before their fifth birthday. we also know that we need to accelerate our efforts to
ensure that newborns—representing 40% of the under-five deaths—and to address the
underlying cause of these deaths, malnutrition.
we are inspired and encouraged by the important role that african First ladies and
leaders are playing in endorsing the campaign (and the melding of this with the au
campaign for the accelerated reduction of Maternal Mortality in africa—carMMa—
campaign). More countries are pledging, hiring and training additional health workers
on the front line—at the reach of every child. important partnerships have been
developed to help sustain our campaign efforts—with communities, private sector, with
athletes around sporting events, with singers and celebrities, as well as civil society and
international organizations across africa. innovation in our programming has become a
rallying cry as we look for new and creative ways to tackle child and maternal deaths.
For us, the campaign progress in africa is encouraging, but much needs to be done
still—governments need support to increase financing for health care in national
budgets which will include training and hiring even more health workers.
Join us, and be part of the everY One campaign across africa, so we can end child and
maternal deaths by 2015.
sincerely,
save the children directors in africa
2012 is a critical year for our EVERY ONE campaign, as we must do all we can to inspirethe breakthrough we want by 2015, and by contributing a concerted effort to stop children going hungry we’ll be tackling a third of all these preventable deaths. …Childrendying from hunger in the 21st century? It is a travesty that must be challenged.
—Jasmine Whitbread, CEO, Save the Children
everY One caMPaiGn
save the children’s first truly global campaign, everY One, has one simple, ambitious
and urgent goal—to catalyse action that will save millions of children’s lives. around the
world and across africa, save the children staff and partners are working in diverse
and innovative ways to press for policy and political breakthroughs that will accelerate
progress towards the un Millennium development Goal (MdG) of a two thirds
reduction in under-five mortality rates by 2015.
everY One was launched in 2009, driven by outrage over the fact that despite
steady progress, 7.6 million children died in 2008 from preventable causes. africa is at
the centre of this challenge—roughly half of these children are african (up from one
third of the global total in 1990)—which is why most of the countries our campaign is
prioritising are in the region. at the national and global levels, we are pushing
governments, international institutions, civil society and the private sector to work to
ensure a health worker within reach of every child, vaccines for all, and adequate
nutrition for children and pregnant and breastfeeding mothers. experience from
countries that are on track to achieve the child mortality MdG shows that, taken
together, these changes will have a dramatic impact on children’s prospects of surviving
and fulfilling their potential.
The campaign has already contributed to important progress. For example, in sierra
leone, our health budget tracking report, backed up by dozens women mobilised
outside state house and a concerted media campaign, persuaded the President to
reverse his planned cuts to the health budget in late 2011. in nigeria, we worked as
part of a broad coalition of civil society organisations to campaign for the passage of a
national health bill that promotes maternal and child health care at the primary level,
and which now sits with the President. in ethiopia, we worked with partners to change
the rules so that community health workers could tackle pneumonia—one of the two
biggest child killers in africa.
at the global level, save the children played an important role in advocating for a
new un global strategy on women and children’s health, ‘every woman, every child’
(ewec), and for governments to make specific commitments. in 2011, several
governments made significant new commitments on health workers as a result of save
the children campaigning around ewec. at the Global alliance for vaccines and
02 impact Newborn and Child Survival
a wOrd FrOM The caMPaiGn direcTOr
EVERY ONE was launched in 2009, driven by outrage over the fact thatdespite steady progress, 7.6 million children died in 2008 from preventablecauses. Africa is at the centre of this challenge—roughly half of thesechildren are African, up from one third of the global total in 1990.
immunisation conference in london in 2011, we worked with others to secure
substantial new funding from governments and the private sector to roll out new
vaccines with the potential to save 4 million children’s lives by 2015.
in 2012, we will be focusing on the importance of nutrition in ensuring that children
survive and thrive. Malnutrition is an underlying factor in one third of all child deaths,
and 170 million children around the world are chronically malnourished—‘stunting’ not
only increases the risk of an early death; it also consigns millions of children to a
lifetime of missed opportunity, as their bodies and brains fail to develop fully. we will be
campaigning to raise the political visibility of stunting, and press for global and national
level targets to reduce chronic malnutrition. we will be calling on governments to
provide a minimum package of direct nutritional interventions that, taken together, can
address one third of cases of stunting. we will also be working to ensure that the
demand and supply-side barriers to progress are overcome—through social protection
policies that enable families to secure nutritious diets for their children, and through
changes in agriculture and food markets that ensure nutritious food is both available
and affordable.
by making progress on these issues, we have a genuine opportunity to turn the
needle on progress towards the child mortality MdG, and end the scandal of preven-
table child deaths. already, countries like Malawi are showing that, even where resources
are scarce, progress is possible. The challenge in the remaining four years to the MdG
target date is to draw on those success stories, and spread success across africa.
Patrick watt
Global campaign director
impact Newborn and Child Survival 03
Improving the nutritional status ofEthiopian mothers and children
Photo
s: s
ave
the
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iopia
/2012
04 impact Newborn and Child Survival
in February 2012 save the children hosted iron chef, cat cora, founder of chefs for
humanity, as she visited ethiopia to promote save the children’s nutrition
programming (Food by Prescription and enGine) with the Ministry of health, donors
and the ethiopian public sharing messages that cross borders—the importance of
eating healthy and nutritious foods and a balanced diet.
cora spoke passionately in support of the everY One campaign, saying, “we know
the most cost effective nutrition interventions are those that reach women and
children up to the age of two. healthy nutrition and a healthy life start within the first
1,000 days. Mothers too must have the necessary foods to ensure a healthy birth.”
cora will take back the messages she heard in ethiopia as she works with save the
children to promote the launch of “a life Free from hunger” report issued on
February 15 (http://www.savethechildren.org/site/c.8rKliXMGipi4e/b.7980641/k.c98/
nutrition_report_2012.htm).
in October 2011 save the children launched “empowering new Generations to
improve nutrition and economic opportunities (enGine),” a five year usaid
supported integrated nutrition program aiming to improve the nutritional status of
women and young children. The largest save the children program of its kind in africa,
the 53 million usd program is implemented by save the children and its partners and
was designed in line with ethiopia’s national nutrition Program (nnP) and the health
sector development Plan.
Chef Cat Cora learns how tomake injera, a main staple ofmeals in Ethiopia.
eThiOPia
impact Newborn and Child Survival 05
The program will contribute to reducing malnutrition—an underlying factor for
more than fifty percent of all child deaths in ethiopia and a contributing factor for low
birth weight resulting mainly from the poor nutritional status of women before and
during pregnancy. ethiopia’s low birth weight incidence—14%—is one of the highest in
the world.
according to ned Olney, country director for save the children, “ethiopia has
taken a number of steps that have brought positive outcomes in terms of addressing
challenges associated with nutrition over the past several years. Today, nutrition is one
of the packages of the health extension Program (front line health workers)—with
over 11 million children under five years old receive bi-annual doses of vitamin a
supplementation and mass de-worming.
according to ethiopian popular singer chachi Tadesse, “every one of us has a role to
play in helping to improve the nutritional status of women and children. i am
committed to doing what i can to save lives and to support the life changing impact
that nutrition has on education, health and economic outcomes for ethiopian women
and girls.”
For more information, please contact Getachew Dibaba, Save the Children, Ethiopia,[email protected]
Chef Cat Cora appears on Giordana, the premiere cooking show in Ethiopia.Together, they share tips on simple, affordable, healthy recipes for families.
in december 2011, after months of preparations, grueling rehearsals and three
screening shows for partners and the Ministry of health, the Maternal and child
health awareness artistic Tour with a local youth talent group, Music May day ethiopia
was launched. Taken to the heart of communities, the performances are aimed at
educating communities on the availability and accessibility—through their community
health workers—of life-saving vaccines and drugs for killer childhood illnesses like
pneumonia, malaria and diarrhea.
The 58 person troupe travelled to 13 selected districts in the north and south of
ethiopia, staging a series of performances including community drama, the official
everY One ethiopia Jingle: ‘lemin Timut enat?” (why should a Mother die?),
monologues, a dance routine and musical performances.
The halls were packed beyond capacity with eager audience members. One of the
plays, “Tiguaz Muzikegnoch” (Musicians on the Move”) showed a group of street
children who lost their mothers in child birth, challenging traditional birth attendants
and traditional views about institutional delivery. another, “azmari bet” (house of the
singers), was particularly prepared for the rural community. it portrayed a group of
villagers debating varying views on early marriage and long-held misconceptions about
maternal and child death through traditional songs.
at the end of each performance, a ceremony recognizing the role of two outstanding
health workers was held. The prizes were portraits of the recipients painted on the
day of the show by Music May day artists.
Over 13,000 people were directly reached through this 13- district tour pushing the
official number of direct hand raisers through pledge cards for the campaign in ethiopia
to 49,473. The tour secured unrelenting support and cooperation from the Federal
Ministry of health and regional offices, improving relations between the campaign
coalition and the government partners considerably.
For more information, please contact Tesfu Gessesse, Campaign Director, Save the ChildrenEthiopia, email: [email protected]
EVERY ONE Ethiopia goes artistic
06 impact Newborn and Child Survival
eThiOPiasa
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he
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eth
iopia
/2011
impact Newborn and Child Survival 07
save
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eThiOPia
The second EVERY ONE Hawassa raceas part of the everY One campaign in ethiopia, save the children and its campaign
partners hosted a second race in hawassa on May 1st 2011. Over 3,600 participants
took part including more than1,000 people who came from addis ababa to support the
race and promote its cause—child survival and maternal health. There was a 21 km race
for elite and fun runners, a seven km mass run and a two km children’s run. around
200 athletes from clubs in addis ababa and Kenya participated in the 21 km race.
everY One ethiopia’s champion and world-renown marathoner, haile Gebresilassie
flagged off the race, hosted the press and viP receptions and presented prizes to the
winners. haile, alongside Gebregziabher Gebremariam, the reigning new York
Marathon champion, again expressed his support for the everY One campaign in
ethiopia: “every child deserves a chance to survive and thrive, and we owe it to our
children to ensure their mothers survive child birth.”
high profile participants at the race and side events included adrian lovett (former
everY One campaign Global director), Thomas staal (usaid ethiopia Mission
director), ato shiferaw shigute (President of the southern nations, nationalities and
People’s region), ato ahmed emano (director, Pr and communications directorate at
the Federal Ministry of health), ato shibiku Megane (Mayor of the city of hawassa) and
celebrities, including singer chachi Tadesse.
Other activities on race weekend included a viP reception for donors and partners
at haile resort, a press conference, a technical roundtable discussion on child survival
and maternal health in ethiopia. in addition, media and viPs visited a local community
health facility and frontline health workers supported and trained by save the children.
Over 10,000 everY One Pledge cards were distributed and the events were
covered by at least ten local and four international media outlets including The
Guardian, daily nation and international association of athletics Federation.
The final race in the everY One series will be held on 6 May 2012 in hawassa.
For more information, please contact Tesfu Gessesse, Campaign Director, Save the ChildrenEthiopia, email: [email protected]
save
the
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ren/u
ganda/
2011
08 impact Newborn and Child Survival
each year millions of births, including those in facilities, occur without effective
monitoring or appropriate response to danger signs that may arise. The baby’s heart
rate is the most important signal of distress during labour. inadequate heart rate
monitoring and failure to respond to distress is an important determinant of almost 1
million newborn deaths and 1.2 million stillbirths each year globally. effective
monitoring during labour in challenging settings depends on rugged, reliable, and simple
devices which can be used without electricity or batteries, as well as trained health
workers who can recognise danger signs during labour and take appropriate action.
in 2011, u.s. secretary of state hillary clinton and usaid administrator rajiv shah
awarded around us$14 million to innovations aimed at saving the lives of mothers and
children around the world. “saving lives at birth” is the first in a series of Grand
challenges for development led by the u.s. agency for international development, the
norwegian Ministry of Foreign affairs, the bill & Melinda Gates Foundation, Grand
challenges canada, and the world bank. This project brought together doctors, health
workers, engineers and entrepreneurs from around the world to showcase innovations
with the potential to prevent maternal and newborn deaths. awardees’ projects
included gadgets and health care delivery models, but all utilized creative, simple and
inexpensive techniques designed for the developing world.
save the children in uganda was one of the successful recipients of saving lives at
birth with the acT for birth, uganda (a=audit, c=cell phones, T=technology and
training) project. act for birth, uganda involves testing an innovative fetal heart rate
monitor powered by human energy (winner of the global indeX design award) and a
mobile-phone based mortality audit system to improve timely and appropriate action.
The new national paper-based mortality audit process will be adapted to a mobile
phone platform to capture maternal and neonatal deaths and stillbirths, and health
workers will be empowered to use this data to improve intrapartum monitoring and
Using Audit, Cellphonesand Technology to ACT for birth
impact Newborn and Child Survival 09
uGanda
response. Facilities collecting this data will be linked to communities using cell phones
to request emergency transport and report births and deaths.
dr hanifah sengendo, saving newborn lives program manager in uganda, explains
that the project has the potential for far-reaching implications beyond helping individual
infants. it also encourages mothers to seek care at a medical facility by ensuring they
receive quality care. in a setting where around half of all births still take place at home,
this is an important change. “These are mothers who will go back and spread the
gospel that something can be done to make sure that my baby and myself survive,”
sengendo said.
acT for birth, uganda will be tested in one district hospital linked to surrounding
communities and village health teams of community workers. The combination of novel
technology in the robust, human-powered fetal heart rate monitor and quality
improvement using cell phone-enabled mortality audit for maternal and neonatal
deaths and stillbirths in facilities linking in communities, places save the children in an
important position as an innovator and pioneer for improving the health of mothers
and newborns.
For more information contact Dr Hanifah Sengendo, Program Manager, Saving NewbornLives, Uganda, email: [email protected]
The Act for Birth project involves testing an innovative fetal heart ratemonitor (pictured opposite) designed for challenging settings andpowered by human energy and a mobile phone based mortality auditsystem to improve fetal monitoring for timely and appropriate action.
Carolyn Miles, CEO Save US, admires a newborn at Nakaseke Hospital.
10 impact Newborn and Child Survival
UGANDA
Boosting Uganda’s EVERY ONE campaignin January 2012 the ceOs of save the children us, carolyn Miles and norway, Tove
wang, made a visit to uganda to help raise the visibility of the everY One campaign
and save the children programmes in uganda. The delegation also included anne
Mulcahy, save the children us board chair; bill haber, sci board Member; and henry
McGee, scus board Member, and ceO of hbO home entertainment.
during the visit, save the children organized a meeting for the delegation with
members of the uganda business community, government and donors to discuss how,
collectively; we could reduce child and maternal deaths. The response from
corporations was quite impressive. standbic bank, airtel uganda (Mobile telephone
company), Madhvani Group (sugar corporation), and The vision book (communication
and publishing company) all expressed their interest to be part of the campaign. save
the children in uganda team is now working with these corporations to follow up on
specific interventions that provide a “win win” for mothers, children and business.
The delegation also met with uganda Members of Parliament and deliberated on
ways that policymakers, with the support of save the children, could influence fellow
policymakers and their constituents to join the campaign. The MPs made a similar
commitment as the corporate, promising to support the campaign.
in one of the field visits the team interacted with young people living with hiv/aids.
The young people, especially mothers, have enrolled in a peer support programme run
by health alert uganda, one of save the children in uganda partners. The young
mothers shared their experiences on dealing with disclosure and stigma, working with
communities to encourage voluntary testing for hiv, encouraging the infected on the
importance of disclosure, drug adherence, preventing spread of the virus, reducing
chances of transmitting the virus to newborns, living a healthy life and much more.
save the children us donated 10,000 usd to nakaseke hospital to support the
neonatal unit in an effort to enhance efforts to save lives. nakaseke hospital is one of
the government hospitals in nakaseke district (central region) where the saving
newborn lives programme has made interventions including training health workers in
identifying the causes of maternal and newborn death—with the idea of learning from
these mistakes.
The visit was a boost for uganda’s campaign. The team is now busy following up with
corporate, Parliamentarians, and other campaign partners on a 2012 work plan.
For more information contact Esther Banyenzaki, email: [email protected] and CarolMiller, email: [email protected]
impact Newborn and Child Survival 11
Racing to save children’s lives
12 impact Newborn and Child Survival
school students in 13 countries raced to break the Marathon world record, currently
held by Kenyan, Patrick Makau. The world Marathon challenge in Kenya was held on
October 5th 2011. The chief guest at the race was none other than the marathon
world record holder, Patrick Makau. his presence inspired the young children who
turned up in large numbers to call for more live-saving health workers. Makau’s record
is currently 2 hours 3 minutes and 38 seconds. The children were invited to beat the
record through a relay.
in the largest event of its kind in Kenya, two teams of 31 children from 5 schools in
Kiambu district ran the 42.195 kilometre relay race in 200 metre stages. They ran
simultaneously with thousands of children in 12 other countries across the globe. The
event marked the world’s children’s demand for more health workers for the world’s
poorest communities. it was part of save the children’s child survival campaign, whose
focus is to stop the needless deaths of eight million children under the age of five every
year.
The event was held just two weeks after world leaders met at the un General
assembly in new York to discuss how to save mothers and children’s lives and address
the global gap of 3.5 million health workers—doctors, nurses, midwives and community
health workers—in the poorest countries. Makau said, “so many of our children are
dying in our communities every day from diseases we know how to treat or prevent.
Mothers are not getting access to trained health workers and medicines. The solutions
are simple: we need more medicines, more nurses and midwives and more good food
for children facing starvation. The world Marathon challenge is giving our children a
(Left to right) Patrick Makau takes the challenge team through a warm up exercisebefore start of the race; Boy from Uhai team sprints to beat the world marathonrecord; Patrick Makau leads the boys team in a warmup exercise before the relay.
KenYa
chance to show their solidarity with their peers who face a daily struggle to survive. it
is a small step. hopefully it will be followed by a bigger and stronger one. i am using
this opportunity to join pleasant noises of thousands of little footsteps and voices, to
kindly ask all governments, humanitarian organizations, non-governmental agencies,
businesses and individuals, to act together, from tomorrow, if not from today, to make
sure that quick action is made. no child is born to die.”
The results for the marathon challenge have been posted online and via Twitter using
#worldmarathon. Kenya emerged on top, with an impressive 1hour 51min 51sec
record. They were closely followed by spain at 1:57:31 and botswana at 1:57:59.
“health workers are everyday heroes—they save lives. without them, no child
receives vaccines, no life-saving drugs are prescribed and no woman can be given the
care she needs during childbirth,” says Ms wanja Gitonga, every One campaign
Manager in Kenya. “but to address the shortfall we need concrete action from
governments, both in the developed and the developing world.”
The children ran to call on their leaders to follow through on commitments made at
the un to improving child and maternal mortality. in norway, for instance, the child
mortality rate is one of the lowest in the world, but in Mali nearly one in five children
die before their fifth birthday. “Though they might be separated by thousands of km,
children in norway and Mali, new Zealand and Kenya, all raced for the same goal,”
continues Gitonga. “They told world leaders that every child deserves a chance.”
For more information contact Olivia Mwongera, Information & CommunicationsCoordinator, Every One Campaign Kenya, Email: [email protected]
impact Newborn and Child Survival 13
save
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/2011
(Left to right) Patrick Makau with race starters just before the start; Childrenenjoying themselves during the challenge in Nderu Pry Sch in Kiambu; EveryOnecampaign manager, Save the Children, hands out gifts to children after the race.
Malawi’s First Lady kicks off the EVERY ONE campaignFirst lady, callista Mutharika, national coordinator for Maternal, newborn and child
health launched save the children’s state of the world’s Mothers report before a
crown of more than 1000 guests. These included Members of Parliament, the Minister
of Gender, Principle health secretary, diplomats and nGO partners. she also broadcast
several times on national television and radio as she committed to accelerate efforts to
reduce maternal, newborn, and child deaths in Malawi and support the everY One
campaign.“i call on each of you to help create a movement here in Malawi to protect
and support the lives of our mothers and children. i congratulate and support save
the children, the Ministry of health and all the partners of the everY One campaign
for helping support maternal, newborn and child survival.”
The report features champions for children, a collection of essays from leading
voices from academia, politics, religion, business and the arts to celebrate the great
progress made in recent decades to reduce deaths among children under the age of
five all over the world. The President, ngwazi Professor bingu wa Mutharika is among
the eminent essayists of the report.
according to President Mutharika the under-5 death rate in Malawi has been cut by
more than half, from 234 deaths per 1,000 live births in 1990 to 112 in 2010. infant
mortality has showed the same decline.
The First lady reviewed the specific intervention leading to Malawi’s success including
the fact that the Malawi Growth and development strategy has provided a road map
for treating the biggest threats to children—pneumonia, diarrhea, and malaria.
likewise, the newly developed five year health sector strategic plan includes many of
the conditions that affect under five children. “and in the face of hiv and aids,”
continued the First lady, “strengthening linkages of hiv/aids prevention and treatment
within our health system is very important just as vaccinating our children against
measles, polio and other preventable diseases.”
noting the important role that health workers play in reducing child and maternal
deaths in Malawi, the First lady recognized Government efforts to train health
surveillance assistants—hsas—“to deliver care in rural communities and many places
where doctors, clinical officers, and nurses are unavailable.” Madame Mutharika also
gave recognition to serra chanache, a midwife from Kasungu district hospital, who
has been nominated to represent Malawi at the international conference of Midwives.
14 impact Newborn and Child Survival
Malawi
save the children’s senior health Manager, Mr. Joby George, warned against
complacency, sharing that in Malawi over 4,000 women die every year in child birth—
13 women every day. as Mr. George pointed out, “this is equivalent to one minibus full
of women dying every day.”
Mr. George shared that 186 children under-five die in Malawi every day—50 of
whom die in the first month of life. continued George, “This is the same as four
minibuses full of children dying every day -- and is this acceptable? no!” he concluded.
visiting chief Operating Officer for save the children, carolyn Miles, congratulated
Malawi on the success that has been made and spoke of the importance of
commitment to reduce child and maternal deaths at all levels. “From the First lady, the
Ministries, the district hospitals, the health centers, to the health surveillance
assistants and the village community core groups; i’ve seen this commitment
demonstrated during my short visit to Malawi and i will take this message back, that
the us and other donors must continue to invest in lifesaving maternal and child health
programs.”
save the children interim country director, carol Miller, called for those assembled
to join everY One, the campaign to reduce child and maternal deaths, saying,
“remember your own mother, as we make a commitment to strengthen our efforts—
everY One of us—to keep Malawi on track for Millennium development Goal 4 and
to reach our goal of reducing maternal deaths—Millennium development Goal five.”
For more information, contact MacPherson Mdalla, Communication Manager, Save theChildren Malawi, [email protected]
impact Newborn and Child Survival 15
“I call on each of you to help create
a movement here inMalawi to protect and
support the lives ofmothers and children.”
—First Lady of Malawi save
the
child
ren/M
alaw
i/2011
Reaping the power of community involvementFacilitating referral to main health facilities for pregnant women and children under the
age five is key to improving the survival of mothers and children in Malawi. Our
newborn health program is working with communities in dowa to identify problems
facing pregnant women and come up with solutions to solve those problems.
Mkukula community action Group is one such community group working towards
solving problems facing pregnant women and newborn babies. after its formation in
2008, the group started exploring maternal and newborn health problems affecting the
community and come up with a solution. Transportation of pregnant women to attend
antenatal care and when in labour was identified as one of the major problems. in the
spirit of self-help, the community resolved to do something to address this problem.
The community made financial contributions to buy a bicycle. being a mere bicycle, it
could not offer comfort to a pregnant woman in transit to a health facility.
in recognition of the group’s self-help initiatives, save the children through the
newborn health Program, saving new lives Project came to assist the group with a
bicycle ambulance specifically designed to transport pregnant women. arrangements
were made that the bicycle which was initially bought by the group be dedicated to
transporting sick children (under the age of five) who were referred to the facility from
the community case Management clinic. The bicycle donated by the save the children
was fitted with appropriate covering to ensure utility even during the rainy seasons.
eight months after save the children President carolyn Miles presented the bicycle
ambulance to Mkukula community action Group during her tour of duty, the donation
is in good condition and in use. a lot of women have already benefitted from the
comfort of this gift. absolute care and responsibility among the users remains evident.
aness Kaliati, chairperson of the group shared the secret behind the group’s
attachment to the bicycle ambulance.
“we know how these ambulance bicycles are helping us. we know the gravity of our
problems in the absence of this gift. Therefore, care and responsibility remain absolute
and we cannot afford to abuse this life saving gift.”
having taken the common stand to look at their health related challenges, the
people of Mkukula are now reaping the fruit of their efforts to work together. There is
indeed power in community involvement.
For more information, contact MacPherson Mdalla, Communication Manager, Save theChildren Malawi, [email protected]
16 impact Newborn and Child Survival
Malawi
impact Newborn and Child Survival 17
(Above) The ambulancebicycle. (Right) Members ofthe Nkukula CommunityAction Group celebrate indance after receiving the
ambulance bicycle. Photo
s: s
ave
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i/2011
18 impact Newborn and Child Survival
Mothers’ fun runOn October 8, 2011 people from all walks of life came together in Thyolo to run for
mothers. The aim was to raise money for equipment at the maternity wards of Thyolo
district hospital and Thekerani health centre in the same district and also to raise
general awareness on issues affecting safe motherhood in the country.
a privately owned media house, nation Publications limited partnered with a
number of organizations including unFPa, save the children and the everY One
campaign, Malawi Police service, Press Trust, limbe leaf Tobacco company, dossani
Trust and many others who participated in the run and donated some of the required
equipment.
The 2.5 kilometer run from number One trading centre to Thyolo district hospital
attracted about 200 people. invited guests went round the maternity ward, where they
handed out assorted gifts to mothers and visited the Kangaroo Mother care which is
supported by save the children. This was followed by a ceremony at Thyolo
community centre Ground. The occasion was graced by his excellency the
norwegian ambassador asbjorn eidhammer.
senior Program Manager for newborn health, evelyn Zimba represented everY
One campaign at the event and she talked about how women and children are dying
from causes we know how to prevent and cure. she called on every one to play a role
in ending needless maternal and child deaths.
There was also performance by namileme core Group, who sang songs on safe
motherhood. They encouraged women to seek skilled health care during pregnancy
and after delivery and also take their children to a health worker when they are not
well. Men, including a chief from this area joined their women in the dances.
Thyolo being an impact area for newborn health Program, nurses from the hospital
demonstrated Kangaroo mother care services. They explained why and how they do it.
Finally, save the children donated a bicycle ambulance to namileme core Group,
through the district health Officer dr andrew likaka.
everY One campaign partners agreed with nation Publications limited to work to
procure some of the needed items at the two health facilities from their various
donors before the end of 2011.
For more information, contact MacPherson Mdalla, Communication Manager, Save the Children Malawi, [email protected]
EVERY ONE campaign in the Sahel
The Build-Up
Capacity Building and pre-launch events
last spring, saleck Ould dah, Mali’s everY One campaign advisor, organized
individual meetings with over 20 potential partners, including the Minister of health,
the Minister of women and children, uniceF and Plan. after numerous months’
worth of work, he succeeded in creating a pilot group, consisting of a coordination
committee and an executive committee led by the Ministry of health. Together, the
groups created a 2011 action Plan.
Presidential SupportThe President of Mali, amadou Toumani Touré, along
with the First lady, the Prime Minister, eight
ministers (including the Minister of health), joined
save the children country director, uniceF’s
country representative and world vision’s country
director formally endorsed the everY One
campaign last June by signing a petition with the
message: “everY One for urgent action in Favor of newborns and children”. This
gesture brought public attention to the campaign and the health gaps in Mali. Their
signatures also represented political resolve towards ending child mortality in Mali.
20 impact Newborn and Child Survival
Photo
s:
save
the
child
ren/M
ali/2011
Mali is an EVERY ONE Campaign priority country. One in five childrendon’t live to see their fifth birthday. Preventable diseases, such asdiarrhea, malaria and pneumonia, are the main causes of infant mortality.According to The Partnership for Maternal, Newborn and Child Healthin Africa’s report, Mali ranks 9th in newborn mortality and maternalmortality. Achieving the 4th, 5th and 6th Millennium Development Goalwill represent, therefore, an immense struggle with enormously positive results.
Mali
Community SupportThe everY One team partnered with Mali’s
athletics association in order to bring the
campaign to a local level. On July 30th, save the
children staff members helped prepare the
athletics championship event. They shared
information on the campaign, and urged the
audience and athletes to become activists by talking
rto their family and friends. dozens of athletes at
the event signed an everY One petition, agreeing
to become advocates for the cause.
Moreover, save the children organized an everY
One world Marathon challenge. The event was
well attended, and the team did very well: the
children completed the race in 2 hours and 10 minutes! all of the participants wore t-
shirts that informed the public on the campaign’s goals, and local government officials
opened the event by giving a speech on the importance of reducing child and maternal
mortality in Mali.
The Campaign’s Launch
The campaign began with a bang in the Presidential Palace, with international artist
Oumou sangare performing for a group of west and central african First ladies. Many
speeches were made on the importance of the everY One campaign, linked to the
african union campaign for the accelerated
reduction of Maternal Mortality in africa—
carMMa including one from the First lady of Mali.
The group of First ladies present agreed to adopt
the everY One campaign as the continuation of
their vision 2010 campaign. The Malian national
television station covered the event, sharing the
impact Newborn and Child Survival 21
22 impact Newborn and Child Survival
important launch with the entire nation. Many newspapers also published articles on
the launch and the campaign’s goals, thereby promoting the campaign as well.
The launch was also organized at the community level, where drama and musical
performances entertained a large crowd of onlookers and participants. all of the acts
stressed the importance of good hygiene practices and clinic visits in reducing child and
maternal mortality.
Campaign Events To Date
World Pneumonia Day
On world Pneumonia day on november 12, 2011, save the children successfully
organized an event to raise awareness about the disease in Mali. Over 500 people,
principally composed of women and children, crowded around the community health
center where the event took place. The ceremony was presided by the Minister of
health, Mrs. Madeleine ba—diallo, and save the children’s country director, Thomas J.
Mccormack. The Minister of health thanked and congratulated save the children on
their initiative. in her speech, she stated that, “Pneumonia is considered as the 4th
cause for child mortality in Mali, with 14% of deaths. among newborns, pneumonia is
the primary killer (responsible for 32% of newborn deaths), well before malaria (21%)
and diarrhea (19%).”
The national theme for the world Pneumonia day was, Pneumonia, a pediatric
emergency; it was reinforced through three main acts: a discussion with the audience
on pneumonia, a theatrical
performance, and the
releasing of blue balloons,
symbols of pneumonia.
Music and dance
performances served as
entertainment between the
acts. babani Kone, one of
the everY One campaign’s
ambassadors and a much-
loved singer, performed for
Mali
impact Newborn and Child Survival 23
the crowds. her poster was plastered everywhere around the event. it showcased her
main message, “be careful! coughs and colds can be a sign of pneumonia among
children!”
Young volunteers from the school of Public health (which also trains midwives)
placed themselves at busy points across the city to raise awareness of the day and the
causes, signs, consequences and treatment for pneumonia.
The Caravan
a bus, filled with journalists, artists, government officials, aid representatives and child
parliament representatives, traveled across the country during 10 days to spread the
word on the everY One campaign.
every stop consisted of a
concert, followed by
speeches on the needed
behavior changes that could
prevent infant, child and
maternal deaths. villages,
towns and cities responded
overwhelmingly: the events
were well attended, and the
audience often offered gifts
to the everY One caravan
participants. along the way,
the group also visited villages benefiting from nGO-funded health initiatives. Journalists
were encouraged to write about the work currently taking place as part of the
country’s effort to achieve the Millennium development Goals.
2011 has been a very busy and encouraging year! save the children hopes that we
will be as successful in 2012 in promoting the everY One campaign to reduce child
and Maternal Mortality in Mali.
For more information contact Stephanie Rademeyer, Program Assistant, Princeton in AfricaFellow, Save the Children Mali, [email protected] and Saleck Ould Dah, CampaignAdvisor, Save the Children Mali, [email protected]
24 impact Newborn and Child Survival
save
the
child
ren/M
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2011
Community case management: saving lives in rural Mozambiquein the nataleia Mesa community in Malema district of nampula Province, mothers and
children are sitting in the shade patiently waiting to be attended by the local
community health worker. it is eight o’clock in the morning and José chapalia, the
community health worker (chw), has already attended five mothers and their sick
children. Most of the children have fever, cough, or diarrhea. Fever and cough are
symptoms of malaria and pneumonia, two of the most common killers of young
children in Mozambique.
José chapalia is one of the 326 community health workers who have been trained by
save the children’s community case Management (ccM) project, in collaboration
with the Ministry of health. Through community health workers, community case
management increases access to treatment for pneumonia, malaria and diarrhea in
remote communities with poor access to health clinics. Treatment of these childhood
diseases by community health workers is known to significantly improve the chances of
child survival in these hard-to-reach areas and is an important contribution to the
everY One campaign here in Mozambique.
while examining three-month old cristina agostinho, her mother explains that the
child has had a fever for three days. José does a malaria test and takes the child’s
temperature. The malaria test is negative, but since cristina’s mother says she has had a
fever, José refers her to the nearest health center just to be sure.
Community health worker José Chapalia.
impact Newborn and Child Survival 25
MOZaMbiQue
cristina’s mother explains, “i came to the community health worker because my
child is sick. i had heard from many of my fellow community members that he is very
helpful and since his health post is much closer than the hospital i came here. if the
community health worker says my child needs more medical attention, then i can make
the long journey to the hospital. having a community health worker in our community
has improved our lives because we cannot always walk the long distance or pay for
transport to the hospital. but knowing that Mr. chapalia is here, we can bring our
children to him and they have a better chance of getting better again”.
having a community health worker in distant communities has increased access to
life-saving health services in Mozambique. not only are the distances that people have
to travel for health care significantly reduced, they have a trusted community member
to whom they can turn when their child is sick. community case Management is a
community based initiative that is saving the lives of young children every day in rural
Mozambique. it only takes one community health worker to make a difference in the
lives of hundreds of children.
For more information contact, Erica Wetzler, Community Case Management ProgramManager, Save the Children Mozambique, email [email protected] or DominiqueBovens, Community Case Management Monitoring and Evaluation Consultant, Save theChildren Mozambique, email [email protected].
Having a community health worker in distant communities hasincreased access to life-saving health services in Mozambique. Not onlyare the distances that people have to travel for health care significantlyreduced, they have a trusted community member to whom they canturn when their child is sick.
26 impact Newborn and Child Survival
Photo
s: s
ave
the
child
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outh
sudan
/2011
Aroun with her newborn twin daughters in the new Lomeyen
Primary Health Care Unit (PHCU).
sOuTh sudan
a woman in south sudan is more likely to die during pregnancy than anywhere else in
the world. One in every seven women who gets pregnant here is expected to die from
pregnancy-related complications, leaving thousands of children motherless and
vulnerable. Many of these deaths are due to lack of access to health facilities, and low
utilization rates of existing, poor quality, facilities.
New health facility
Originally built by the community of Kapoeta north a few years ago, the first lomeyen
Primary health care unit (Phcu) was a simple mud and thatch structure,
unfortunately destroyed during a forceful storm. later, the community adopted an
abandoned shack. The existing two-room metal container has been serving as the local
health facility for over one year now. There is no space for privacy, check ups, antenatal
care or deliveries. because of this, the lomeyen Primary school donated a small, dirty
room for antenatal care and deliveries.
On July 1, just eight days before south sudan’s historic independence, save the
children sent out a capital appeal to thousands of individual donors across the uK.
The appeal called for people to donate just £5, the cost of one brick, to build three
new Primary health care units in south sudan. The response was phenomenal. The
british public raised even more than the set target—£210,000.
Most clinics in south sudan are built out of mud and thatch because nothing else is
available. it is difficult to stop the spread of infection and the space is too small to treat
all the patients in need. The planned new Primary health care units (Phcus) are
permanent, hygienic and will help save thousands of children and their mothers in
Kapoeta north, Mvolo and rumbek east counties.
The first facility, the lomeyen Primary health care unit, was officially handed over
to the community on december 2, 2011.
deputy executive director for Kapoeta north county, Tito abbas lomoro, says,
“The community is relieved. Mothers used to be taken to Kapoeta, and some would die
on the road. women can now deliver safely.”
Maternal health in south sudan
impact Newborn and Child Survival 27
sOuTh sudan
28 impact Newborn and Child Survival
Mother Moya evaristo cheche adds, “The new centre is good. Mothers are already
seeking assistance, and slowly by slowly, we will have a good number of deliveries at
the clinic.”
First safe delivery
at 5am on the first day that the new lomeyen Primary health care unit (Phcu) was
opened, aroun longolio (see box on opposite page) made her way to the clinic to give
birth. aroun had gone for her antenatal care (anc) visits in the small primary school
room. The midwife told aroun that she was going to have twins, and she knew that she
would need assistance during the delivery. she was the first mother to give birth at the
facility.
aroun safely delivered twin girls, adele and Jennifer, and returned home at 5pm
the same day. For the first four to seven days, until the babies’ umbilical cords fall off
naturally, aroun must stay in a small tukul (mud and thatch hut). she is only allowed
to drink water and broth, while tending a fire that continues burning throughout
the week.
Making a healthy difference
The lomeyen Primary health care unit is one of many facilities, and programs, that
save the children supports in this community.
save the children has been working in Kapoeta north county since 2008, and
currently supports one Primary health care centre (Phcc) and seven Primary
health care units.
The riwoto Phcc sits in the centre of the county, sharing land with the main
primary school, and offers specialized staff, antenatal services, inpatient care, laboratory
facilities, immunizations, and inpatient nutrition stabilisation.
The Phcus provide free consultations, basic medicines and antenatal care, to
communities further away from the town centre, who would not otherwise have
access to proper health care.
For more information contact Jenn Warren, Information & Communications�Manager, Save the Children in South�Sudan, email [email protected]
Aroun’s story
My name is aroun longolio, and i am mother to six children now. i just gave birth to
twins at the new lomeyen Phcu. i realized early this morning because of pain that i
was going to give birth soon. i live in a boma called loriwo, about 20 minutes walk to
the clinic.
i used to deliver at home before this facility. if this place were not open, i would have
gone to the other facility at the school. The women used to fear giving birth there.
here it is so much better. it is like a big facility where i could think that if a mother had
difficulty, she could even be operated on. The community is now aware of this facility
and they will make use of it. any person can rush to this facility and be okay.
now that i am home i am feeling a bit better, although i am hungry and weak. it is
tradition that a new mother cannot eat until the baby’s umbilical cord naturally falls off.
That sometimes takes four days. i have asked my husband to kill a goat for me, so that
i can drink the broth. i am worried that i won’t have enough breast milk for the babies,
but for now it is okay. My co-wife is helping me. i have to stay in this small hut until the
umbilical cords fall off, and these fire embers will continue to burn for that time.
Traditionally the piece of baby’s umbilical cord will then be buried in the cows’
stable. it signifies that the child will grow big and will take care of the cows.
i am worried about hunger, and suckling two children like this may be a problem
for me. i have sorghum, but the sun has already destroyed the crops and there is not
enough. This is my only worry. i eat twice a day, once in the morning and once in the
evening. The other children are still at home, and now i wonder how will all of them
really survive?
There are a few key ingredients that make the partnership work:
1. it has a solid foundation: The Tanzania development Partners Group for nutrition,
including usaid, un agencies and others, mobilised non-state actors to participate
more meaningfully in policy and planning processes around nutrition. uniceF funded
the nutrition partnership, and PaniTa as it came to be known, became the main
banner under which all actors agreed to operate.
2. visibility: On 4th august 2011, the Minister for agriculture, Food security and
cooperatives, launched PaniTa on behalf of the Prime Minister of Tanzania. This
high level visibility adds more power to what the coalition can achieve. children from
our programmes were also able to participate at the event.
3. Policy heavyweight: Professor Joyce Kinabo from sokoine university of agriculture is
our “nutrition ambassador”. she is the President of the Forum of african nutrition
societies (Fanus). when she speaks out in support of nutrition, people listen.
4. independence: PaniTa functions as an independent body, not aligned to any private
or political interests.
30 impact Newborn and Child Survival
Tanzanians are beginning to care about good nutrition. and, we are trying to spur on
that process, because hunger and under-nutrition accounts for nearly 30% of child
deaths worldwide. about 42% of all Tanzanian kids are stunted, and Tanzania remains
one of the ten worst affected countries in the world.
PaniTa is like a small army of ordinary and influential people who can make sure
that every Tanzanian family and its children can have its basic food and nutrition needs
met. it is a coalition made up of 106 organisations in Tanzania, both local and
international, and it works on issues of nutrition, hunger, food security and general
development. what they say in the field, generally counts. This is why we think that
building and supporting PaniTa is a good recipe for winning the fight against child
poverty, malnutrition and death.
PANITA’s mission is to advance advocacy efforts, improve coordinationand reduce malnutrition by strengthening the capacity and increasedmobilization and coordination of the CSOs, private sector organizations,the media and other development partners to facilitate a more effectivenational and local response to addressing malnutrition.
Partnership for nutrition in Tanzania
impact Newborn and Child Survival 31
TanZania
Young people participate in PANITA’s launch, August 2011.
Photo
s: s
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the
child
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/2011
5. international links: PaniTa hopes to move forward the sun (scaling up nutrition)
movement in Tanzania. it has a seat at the high level nutrition steering committee,
which is formally in charge of the sun Movement in the country. The movement
comprises of governments and members all over the world who are fighting hunger
and under-nutrition, and it is supported by the united nations.
6. working at national and local levels: examples include advocating for prioritising
nutrition in national and local community development plans, participating in high-
level nutrition policy and planning discussions, and advocating for implementation of
the national nutrition strategy.
What is next?
• PaniTa is a newly established network, but already has a high profile amongst the
advocacy targets in Tanzania. The vision for the next few years is this:
• PaniTa is formally registered by mid 2013
• PaniTa is one of the main representatives for nutrition policy debates, and will
engage closely with the national nutrition strategy dissemination
• PaniTa is the main official civil society network for sun/1,000 days in Tanzania
• 100% of PaniTa supported districts will plan, budget and implementing at least 3
priority nutrition interventions by the end of 2014.
• continuing to raise the public profile of nutrition as an issue and inspiring action
among key population groups.
For more information contact Jasminka Milovanovic, Everyone Campaign Manager, Save the
Children in Tanzania, email [email protected]
in October 2011, when i met Jamila (not her real name), she was shaking and crying
softly. she was so thin i could see all of her bones. her mother was very thin, too. i was
afraid to pick her up in case i hurt her. she was shivering and her teeth were
chattering. Moving with a real sense of urgency, the workers at the health facility we
were at, wrapped her up in a thermal foil blanket. within half an hour, her temperature
improved. she was hypothermic when she was brought in, but now she was safe. before
she went home that day, Jamila ate some of the therapeutic, nutrient enriched milk and
had been treated to ensure she didn’t get diarrhoea.
The next day, Jamila was looking a little better. she had stopped shaking and was
more alert. Four days later, Jamila is asking for water and yogurt quite audibly. she was
chatty! a marked difference from before. her mother hajara said that Jamila had had
fevers, vomiting and diarrhoea. despite visits to the doctor, she slowly began to lose a
lot of weight. “her body now is different from her body then… i could even count her
bones, this really worried me.” Jamila had completely stopped wanting to eat.
Jamila now accesses ready-to-use therapeutic food provided by save the children.
The food is making her well again. hajira says her husband is too faraway in nigeria and
isn’t sending any money to support the family, even while Jamila has been ill. “i can’t say
exactly how long it took me to come here, but what i can remember is i had to go by
car from our village to the nearest town, then in another car, and then when i came
here i came on motorbike, but i can’t say the actual distance, ” says hajira. she knows
that the doctor in the clinic run by save the children will treat her daughter and make
her well. “That is why i made up my mind to bring her here,” she says.
The clinic hajira refers to is the inpatient Therapeutic Programme ward at a save
the children-supported health facility that treats children with severe acute
malnutrition. This ward is set up in an existing Ministry of health comprehensive
health centre in northern nigeria. Part of the sahel, the landscape is dry and sandy.
Malnutrition levels are very high in this area: the acute malnutrition rate in children
32 impact Newborn and Child Survival
Hunger and child survival in the Sahel
impact Child protection 33
niGeria
aged between six months and five years is high at 16.9%, which is above the
internationally recognised emergency threshold of 15%.
Practices around feeding infants and young children are poor in this region.
according to a recent survey, these practices linked to cultural norms are the
underlying reason why younger children (6-29 months) are at higher risk of acute
malnutrition and older children risk being stunted. The same survey found that none of
the children aged under six months were exclusively breastfed. all received supplemen-
tary foods or liquids, most frequently water. Malaria and measles are also common and
contribute to and compound malnutrition in an area with low vaccination coverage.
save the children started implementing the nutrition programme in this part of
northern nigeria in september 2010, in collaboration with the state and local
government to reduce the number of children dying before their fifth birthday and
address the problem of child malnutrition. save the children’s entry point has been the
community Management of acute Malnutrition (cMaM). The Ministry of health
provide wards with inpatient care for children suffering from severe acute malnutrition
with other complications, such as malaria or measles. Outpatient care is provided in
the form of weekly sessions where children are measured, examined, and prescribed
treatment for uncomplicated cases.
The root causes of malnutrition here relate to poverty, however cultural norms and
feeding practices are contributing factors. Our teams work with community volunteers
to teach mothers and the wider community about the practices that can harm
children, and explain healthier ways of caring for children. we also advocate with the
local authorities and government for prevention of malnutrition, and treatment to be
included in their healthcare, agriculture, social protection and other policies.
Story by Jess Crombie, during assignment to Nigeria in October-November 2011. For moreinformation, contact Hadiza Aminu, Mobilization and Campaigns Adviser, Save the Children,Nigeria, [email protected]
Why are we tackling hunger and malnutrition?
impactIMMEDIATE AND LASTING IMPROVEMENTS FOR CHILDREN IN AFRICA
Impact is a magazine to highlight the work of the ten different Save the Children members workingin Africa. Save the Children undertakes or supports projects in about forty different African countries.Enjoy impact three times a year. It is available in both electronic and printed versions. This issue wasedited by Brenda Kariuki and Madhuri Dass. For more information email [email protected].
www.savethechildren.net
20 years ago the number of children under five who died needlesslyevery year was more than 12 million. Now that figure has comedown to 8 million—having dropped by 2 million a year since 2008.
Every year 7.6 million children under the age of 5 dieneedlessly. The major reason behind nearly a third of these deaths is
children not getting the food they need. Our world has enough foodfor everyone but millions of children face a life sentence ofhunger. They’re born hungry. They grow up hungry. They die hungry.
Every hour of every day 300 children die because of malnutrition.It is an underlying cause of more than 33% of child deaths—2.6million every year—but is not recorded on death certificates andnot addressed effectively as a result.
The children that survive are often left so weakened by relentlesshunger that their bodies can’t fight off illnesses like diarrhoeaor pneumonia. The damage from malnutrition in their first few yearslasts a lifetime.