impact february 2012 edition

February 2012

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On newbOrn and child survival

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

[email protected]


Improving the nutritional status ofEthiopian mothers and children

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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


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


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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]

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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


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.


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]


Racing to save children’s lives


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]


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(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.


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]


“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

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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]


Malawi


(Above) The ambulancebicycle. (Right) Members ofthe Nkukula CommunityAction Group celebrate indance after receiving the

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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]


Malawi

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.


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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



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


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]


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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.


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.


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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


sOuTh sudan


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.


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


TanZania

Young people participate in PANITA’s launch, August 2011.

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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


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.

impact february 2012 edition

Documents

campaign director

global campaign

campaign progress

child andmaternal deaths

south sudan maternal

children directors

maternal healthevery

health care