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2HealthProm works to ensure that vulnerable children have the best start in life. We envision a world where every child, and their mother, has secured the right to a healthy and socially included life.

Established in 1984, our mission is to work together with local partners to promote health and social care for vulnerable children and their families where we operate. Our work is guided by the principles of building local capacity for sustainability, evidence-based practice and working through partnership.

About us

The Challenges HealthProm works to address three key challenges where it operates:

1. Poor maternal and child health (Afghanistan, Central Asia);2. High levels of child institutionalisation;3. Social exclusion of children with disabilities.

What We DoWe support: services to improve maternal and child health and better support vulnerable families, schools to improve inclusive education for children with disabilities, civil society organisations and community groups to prevent child abandonment and to provide family-based support, and Governments in their efforts towards de-institutionalisation of care and inclusive education of children.

Where We WorkHealthProm currently works in Afghanistan, Kyrgyzstan, Tajikistan and Russia, and has recently secured funding to start a new project in Belarus in 2015/2016. We also carried out two small seed projects in Moldova and Ukraine in 2015.

AFGHANISTAN

KYRGYZSTAN

TAJIKISTAN

RUSSIA

MOLDOVA

UKRAINE

BELARUS

3It is widely recognised, from all the evidence, that committing young children to long-term institutional care causes permanent damage to their physical and psychological development. Yet finding alternative ways to care for them that are safe and effective is a long and complex process involving changing attitudes, developing new skills and reforming the way care for vulnerable children is organised. This poses a major challenge in countries such as those in Eastern Europe and Central Asia where vulnerable children have traditionally been entrusted to the care of the State. Yet things are changing. A growing number of local organisations, care providers and parents groups are working with their local authorities to open up new ways to ensure vulnerable children get the best start in life.

In Afghanistan, giving vulnerable children the best start begins with helping mothers in childbirth. This means not only ensuring the support of community health workers and skilled birth attendants, but tackling underlying causes of poverty and the physical realities of isolated communities. Simple low-cost initiatives that involve the local people have been shown to have dramatic impact in reducing maternal and infant mortality.

This report shares how HealthProm has been working with local partners over the last year and the impact that has been achieved. It shows that viable and sustainable alternatives to institutional care for children are emerging. UNICEF has reported on a number of promising practices, including early years help provided by Family Support Centres in Tajikistan, which was initiated by HealthProm. More children are being cared for by their own families or foster parents, more are getting access to services which they were previously denied, and more are being included in local education. Parents own perceptions of their ability to care for their children, monitored in projects, have shown positive results. New skills have been acquired and ideas adopted. Beyond the statistics, the stories of individuals and how their lives have been affected speak for themselves.

HealthProm is proud to be part of supporting this local effort. We have been involved in the region for more than 30 years and are planning to go beyond current activities to assist with new activities in Belarus, Ukraine, Moldova and Russia.

The Board and staff of HealthProm remain fully committed to the challenge of giving vulnerable children in the region the same start in life that we would wish for our own. We are grateful to all those organisations and individuals whose financing and support have made these achievements possible.

Simon RayChair of the Board of HealthProm

Foreword

4Local Partners: HealthProm Afghanistan, Bakhtar Development Network, Provincial Directorate of Public Health

In Afghanistan, we have been working to improve maternal, newborn and child health in rural areas of Balkh Province since 2008. HealthProms approach is through a range of inter-related and participatory initiatives at community level. These include promoting knowledge and skills about pregnancy and safe delivery, health and hygiene; improving links with government health services; increasing access to clean water; and facilitating opportunities for better nutrition and livelihoods. In 2014-15, our project reached 45 villages of Charkent district, one of the poorest in Balkh Province with a population of over 32,000.

Maternal and newborn health: Our project provides a range of services for pregnant and postpartum women and their babies. One of such services is providing transport for midwives from local government health centres to visit pregnant women in the participating villages every two months. These visits offer basic antenatal care and assist women in making birth plans, involving husbands wherever possible, to ensure they can travel to a health facility for delivery. This has contributed to a significant local increase in the proportion of deliveries attended by a skilled birth attendant. Our work also facilitates regular Safe Motherhood Groups for women to share and discuss important skills and knowledge, and has even piloted an innovative method of transporting a pregnant woman to a health facility, in the form of a specially designed donkey saddle. There has not been a single maternal death in the project districts since January 2014, a remarkable achievement given the high rate of maternal mortality locally prior to this period.

Community health: 56 volunteer Community Health Workers (men and women) received training, equipment and basic supplies in line with policies set out by the Ministry of Public Health to provide basic primary healthcare in their own villages. Training provided by HealthProm Afghanistan and specialist trainers covered priorities in preventive health care, treatment and referral resulting in an easily accessible form of basic healthcare that had never been available before.

Water: In seven villages new to the project, where water supplies have been a long-standing problem, HealthProm Afghanistan repaired five damaged water reservoirs, dug four wells and built two water tanks. In each case the project provided materials and villagers contributed their labour. In total this work improved access to water for 4,049 people, and in one village ended a daily trek of up to three kilometres to fetch water from springs.

Afghanistan

Saddle design by SaddleAid

5Zahras storyZahra attends HealthProms Safe Motherhood Group in Nonvoi village. She has five children. Her first three children all had pneumonia in early childhood, but her last two, who were born during the time of HealthProms project, are healthy and have never been ill. Zahra told us that thanks to the Safe Motherhood Group, she has learned about good nutrition for mothers and babies and the importance of breast-feeding regularly. She has gained the confidence to advocate for her own and her babies health within the household, by telling her mother-in-law and husband that she cannot do all the work in the house and that she and her children need to eat well. She can see the importance of her role as a mother in keeping her children healthy and safe.

HealthProms approach is through a range of inter-related and participatory initiatives at community level

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6Local Partners: Kelechek Plus, ICCO, Uplift

HealthProm has been working in Kyrgyzstan since 2008, most recently running a project aimed at the prevention of institutionalisation of children with disabilities. It achieves this through improving community-based services that support children with disabilities and their families, improving access to education for children with disabilities by enabling local Day Centres to provide pre-school educational programmes, strengthening capacity for parent-led advocacy through regional and national information exchange and training, and raising awareness of the need to include and integrate children with disabilities within local communities.

The last year has seen significant achievements. Working with our local partners, we have helped to develop a network of community-based support across seven regions of Kyrgyzstan. Through this network, we provided community-based services and pre-school support to over 1,000 children with disabilities. We organised visits of mobile medical teams to remote regions of Naryn, Batken and Osh to assess children in isolated communities.

As a result, nearly 800 children were assessed, many of whom were diagnosed with a disability for the first time and referred to relevant specialists for on-going care. We have facilitated partnerships between many Day Centres and local government, which help to promote a continuity of care between different social services. And as a result of this collective work, 28 children with disabilities were able to successfully start mainstream school in September 2015.

Kyrgyzstan

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7Nurzhigits storyNurzhigit is a 7-year-old boy (pictured right, in centre) who was born with a mental disability in Jalal-Abad, in the south of Kyrgyzstan close to the border with Uzbekistan. Nurzhigit came to the Ariet Day Centre for the first time in 2013. He had limited speech and difficulty understanding simple instructions. He also had difficulty with fine motor skills. After an initial assessment, he was accepted into the Ariet Day Centre where he received one-to-one support from a speech therapist to develop his communication skills. Nurzhigits mother also met with the speech therapist to learn techniques to develop these skills at home. He was also evaluated by a Psychologist, and with support from the Centres special needs teachers, Nurzhigit was gradually included into group therapy sessions and educational activities with other children.

Nurzhigit has been attending the Day Centre for two years, resulting in very positive changes. His speech has developed considerably he has even learned several poems. He now participates in group activities, has less frequent bouts of crying and has developed important skills in self-care, such as putting on his own shoes. His mother now proudly speaks of her son, who is able to understand and follow simple instructions such as going to the shop to buy bread. But his main achievement is that, following assessment of his school readiness by Day Centre staff, he is expected to start school later this year.

Working with our local partners, we have helped to develop a network of community-based support across seven regions of Kyrgyzstan

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8Local Partners: Sarchasma, Hayot Dar Oila, Iroda

Our work in Tajikistan centres upon supporting the transformation of social services for vulnerable children and their families, and helping to turn the tide away from institutionalised care of young children. It strives to reform existing social services such as residential institutions, or Baby Homes, to enable them to provide more comprehensive services to children and families, as well as to create innovative new services such as Family Support Centres, Mobile Outreach Teams, and community-based alternatives to institutional care. Carried out in partnership with local partners, our work seeks to support the local government in their own commitment towards gradual de-institutionalisation.

2014-15 saw several key achievements. The new Marvorid (which means pearl) Family Support Centre was opened on the grounds of an existing Baby Home in Khujand, the second largest city in Tajikistan located in the north of the country, providing a range of new services for children and their families. A befriending service was developed and launched, which selects and trains volunteers to provide support to children and families within Baby Centres and Family Support Centres.

Mobile Outreach Teams now operate in the capital city of Dushanbe and Khujand, making care more accessible to vulnerable families. In addition, a foster care programme was developed in close collaboration with UNICEF Tajikistan and local authorities and is being piloted.

Shahs StoryShah was only a few days old when she was abandoned and sent to the Baby Home in Khujand, Tajikistan. Having spent most of her life in a residential institution, an opportunity for a family care alternative became available for the first time when she was 15 months old. HealthProm worked with UNICEF, local partners and authorities, to develop and pilot Tajikistans first ever foster care programme. Shah has now joined a new family with her foster mother Dilafruz (pictured), who was selected and trained by HealthProms partners. This is the first time in Tajikistan that a baby without parents has left institutional care to become part of an alternative family. We are very grateful to UNICEF, our local partners, consultants and the Child Rights Unit who have helped make this happen.

Tajikistan

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9Capacity-building and information exchange are central to our work, and 2015 saw a range of training provided to staff from Baby Homes, maternity hospitals and Mobile Outreach Teams. These included trainings from international experts in post-natal depression screening, supportive parenting practices and early intervention methods. We also facilitated knowledge exchange through two international study visits, one to the UK and one to Russia, to develop a deeper understanding among professionals of care planning, crisis intervention and alternative pathways to care such as respite and foster care.

Our work strives to reform existing social services, as well as to create innovative new services

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Russia

From 2014-2015, we implemented a pilot project dedicated to the development of inclusive education in Siberia, Opening school doors for disabled children in Krasnoyarsk, Russia. Together with our local partners we worked with school teachers, social workers, parents of disabled children and disability-related NGOs to raise awareness and understanding of inclusive education and how it can be implemented. We developed learning materials for local schools and created an open-access electronic resource hosted locally.

As a result of this project, each of the six pilot schools that participated have expressed serious commitment to developing inclusive education in their schools. They have included elements of inclusive education into their strategies and action plans, improved their teaching practice and organised a number of inclusive community events. More than 400 children with disabilities have directly benefited from this project in Krasnoyarsk.

Local Partners: Krasnoyarsk Centre for Community Partnerships, Open Hearts

Smaller projects

Moldova

Observing national and international examples of best practice is a critical component of participatory learning. Meeting and interacting with international counterparts not only inspires new ideas, it also highlights important challenges and lessons learned. In June 2015, HealthProm organised a study visit to the UK by six Moldovan educators and policy makers as part of a seed project. The policy makers included the Director and Deputy Director of the Centre for Psychological Assistance at the Moldovan Ministry of Education. The aim was to observe the support services for early years inclusive education available in the UK with a view to informing the decision making process for implementation of services in Moldova from 2015 onwards.

Local Participants: Centre for Psychological Assistance, Ministry of Education; educators from Nisporeni and Ungheni

Ukraine

As part of a second seed project, HealthProm organised a Parents Advocacy Strategy Meeting in Kiev in June 2015. The aims of this project were to understand and progress the early intervention agenda in Ukraine, and to develop a strategic approach to parent advocacy and peer support. Working with local partners, the meeting led to the formation of the All-Ukrainian Parents Forum for Early Intervention (AUPFEI), which aims to bring together parent advocates to support the development of early intervention across Ukraine, and to enable dialogue with key stakeholders.

Local Partners: Early Intervention Institute, Kharkiv; National Assembly of People with Disabilities

Seed projects

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500+parents of children with disabilities across our projects have been actively engaged in training, mobilisation and advocacy activities.

Key achievements

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33Kyrgyz families at risk of giving up their children to State care because of their disabilities, kept them in their own care as a result of our support.

6,500+people, predominantly children, were treated or referred to health centres for specialist care as a result of our trained Community Health Workers in Afghanistan.

50+teachers and child disability specialists were trained in the development of inclusive education in Russia.

With our local partners in Tajikistan, we also established an open-access website www.ecdtaj.tj which provides technical information about early child development.

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Over the past year, our generous supporters have contributed their time, skills and money towards HealthProms work to ensure that vulnerable children have the best start in life. Whether through concerts, coffee mornings, one-off donations or the odd pub quiz, we are immensely grateful for your support.

2014-15 saw a range of charitable events hosted in support of our work. Several music recitals took place at venues around London featuring classical, jazz and traditional Russian folk music. Our sporty champions participated in charitable Fun Runs and even the London Marathon in our name.

Your support

Pippas Story:A family dedicated to HealthPromPippas family has been involved both in fundraising and working for HealthProm for many years. Her sister climbed Kilimanjaro in 2013 to raise money for HealthProm, and her mother is one of the organisations long-standing consultants.

In February 2015, Pippa co-organised a classical jazz concert held at St. Dominics Priory in Gospel Oak, London, featuring young musicians from the Royal College of Music, Royal Academy of Music and Guildhall School of Music.

Pippa (pictured) then undertook the incredible challenge of running the 26.2 miles of the London Marathon in April 2015. The HealthProm cheering station was on Tower Bridge (pictured) along with BBC cameras filming the marathon live. It was Pippas first full-length marathon and she was cheered on by family, friends and the thousands of people who came out to support those who took part.

Through her events, Pippa raised an amazing 3,900 with Gift Aid for HealthProm and we are both touched and grateful for her support.

All photos on this page courtesy of HealthProm staff

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Make a donationAny donated amount, no matter how small, helps to support our work helping vulnerable children. Donate online at: justgiving.com/health-prom

Fundraise for usYou can host an event, take part in a sports challenge or be creative and organise your own event to raise essential funds for our work.

facebook.com/HealthProm

@HealthProm

www.healthprom.org

How you can help

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1414

International activities 593,511

Cost of generating funds 50,523

Financial summary

All photos Ellie Kealey unless otherwise stated

Statutory 417,229

Trusts & Foundations 94,616

Events 7,308

Individuals 103,369

Others 35,527

2014 Revenue 2014 Expenditure

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Our work would not be possible without the generous support of our partners. We would like to thank the following donors for their support:

And the following Trusts and Foundations:

British and Foreign School Society

Bryan Guinness Charitable Trust

Bryan Lancaster Trust

Cauda Trust

Doris Pacey Charitable Foundation

Dr Michael & Anna Brynberg Charitable Foundation

Evan Cornish Foundation

GV & SJ Britten Trust

The Funding Network

Karen Woo Foundation

Linda Norgrove Foundation

Oakdale Trust

Peter Stebbings Memorial Charity

Purley Overseas Trust

RA & VB Reekie Charitable Trust

Rotary Club of London

Society for Protection of Animals Abroad (SPANA)

Souter Charitable Trust

St James Place Foundation

T & J Meyer Family Foundation

Tarim Charitable Trust

Toy Trust

Wallace Bell Charitable Trust

W F Southall Trust

Thank you

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