World Vision International

7-11 Approach

What is 7-11?

The heart of World Vision’s Global Health and Nutrition Strategy is a package of preventive interventions targeted to mothers and children under two years old. This package is called  7-11 because there are seven interventions for mothers and 11 for children.

Pregnant Women: 0-9 Months

  1. Adequate diet
  2. Iron/folate supplements and deworming
  3. Infectious diseases prevention: Tetanus toxoid immunisation, PMTCT of HIV, and STI/TB screening
  4. Malaria prevention, treatment access and intermittent preventive treatment
  5. Healthy timing and spacing of pregnancy
  6.  Birth preparedness
  7. Facilitate access to quality maternal health services

Children: 0-24 months

  1. Appropriate breastfeeding
  2. Essential newborn care
  3. Adequate diet (includes appropriate complementary feeding and vitamin A supplementation)
  4. Adequate iron
  5. Full immunisation for age
  6. Hand washing with soap
  7. Oral rehydration therapy(ORT)/Zinc
  8. Prevention, care seeking and treatment for acute respiratory infection and malaria
  9. Prevention, care seeking and treatment for acute malnutrition
  10. Prevention, care seeking and treatment for paediatric HIV
  11. Deworming (+12 Months)
 

Nutrition in 7-11

Most 7-11 interventions impact nutritional status, but there are six that directly address nutritional issues. Find out more about World Vision’s guidelines, capacity-building tools and programming experience to help you implement these interventions in your project area. 

Pregnant Mothers

Adequate diet: Increasing the quantity and nutritional quality of foods eaten during pregnancy and lactation benefits both mother and infant. World Vision uses the ‘timed and targeted counselling’ approach to promote improved care and nutrition of pregnant mothers. Learn more from the experience of the Pragati Child Survival Project in India. 

Iron/folate supplementation: World Vision promotes the provision of iron/folate supplements to pregnant mothers as part of routine antenatal care. This is explained in the Nutrition Centre of Expertise’s guideline on antenatal iron-folic acid supplements. World Vision’s experience in the MICAH programme shows that significant reductions in anaemia can be achieved through high coverage of iron/folate supplementation.

Children Under 2 Years Old

Appropriate breastfeeding: Optimal breastfeeding, which includes early initiation, exclusive breastfeeding for six months and continued breastfeeding with complementary feeding for two years or more, is a critical, life-saving nutrition intervention. Be inspired by the story of Maksi, a World Vision Indonesia staff member who ensured his daughter was exclusively breastfed, contrary to local cultural practices. Learn how World Vision implements the World Health Organization’s Guidelines on Infant Feeding in HIV Contexts and promotes breastfeeding in emergencies

Appropriate Diet includes Appropriate complementary feeding: After six months of age, complementary foods of age-appropriate quantity, variety and frequency are needed along with continued breastfeeding to maintain healthy growth and development. World Vision’s Ovata project in Mozambique successfully improved complementary feeding practices using locally available foods.

Appropriate Diet also includes Vitamin A supplementation: World Vision works with local ministries of health to strengthen the coverage of semi-annual high-dose vitamin A supplementation to children six to 59 months of age. The Vitamin A Add-On programme is one example of this approach.

Adequate iron: Meeting the iron needs of young children is challenging but essential in order to prevent anaemia. World Vision has successfully used micronutrient Sprinkles in Mongolia and Haiti to significantly reduce childhood anaemia. Other strategies to improve iron intake include fortification of complementary foods and supplementation. World Vision has guidelines for iron supplementation in Malaria-endemic areas.  

Prevention, care seeking and treatment for acute malnutrition: World Vision treats acute malnutrition through the Community-based Management of Acute Malnutrition (CMAM) approach. 

7-11 Delivery Approaches

The 7-11 Delivery Approaches aim to strengthen existing community-level structures and assets, building the capacity of families and communities to prevent and manage maternal and child malnutrition.

Household: empowering community health workers, volunteers and families to improve nutrition practices. Example: timed and targeted counselling delivers time-sensitive behavioural change communication to families during the first 1,000 days of a child’s life. Pragati story.

Community: creating an enabling environment for good nutrition and healthy children. Example: Positive Deviance/Hearth uses local wisdom to treat and prevent child malnutrition.

National: partnering with government and other stakeholders to ensure the delivery of quality health and nutrition services at the community level. Example: World Vision Uganda is shaping the national nutrition agenda through Child Health Now and the Uganda Civil Society to scale up nutrition.

Evidence-Based

The 7-11 Approach is based on global knowledge of the primary causes of death and ill health in mothers and young children, and the interventions that can best prevent these. This foundation of evidence has been published in several series of The Lancet journal over the past decade:

The 2003 Child Survival Series provided a first-time consolidated epidemiological analysis of global child mortality. It also prioritised 23 evidence-based and cost-effective interventions (15 preventive and eight treatment) to improve child survival. 

The 2005 Neonatal Survival Series and 2006 Maternal Survival Series described the high proportion of deaths that occur in the intra-partum and neonatal period. Saving the lives of mothers and newborns depends on the health and nutrition of pregnant mothers and the continuum of quality health care.

The 2008 Maternal and Child Undernutrition Series provided new insight into the high prevalence and far-reaching impact of undernutrition. The series also presented a package of 25 interventions for addressing maternal and child undernutrition. If implemented at scale in all high-burden countries, the full intervention package could prevent one-quarter of child deaths and reduce the prevalence of stunting at 36 months by about one-third. This series helped put nutrition on the global health and development agenda and identified the 1,000 days of a mother’s pregnancy until her child’s second birthday as the priority window for impact.

Five years later, The Lancet published the 2013 Series on Maternal and Child Nutrition, featuring new data and policy recommendations. The four papers look at nutrition-specific and nutrition-sensitive interventions, as well as providing a new conceptual framework for actions to achieve optimum foetal and child nutrition and development.

Even though The Lancet requires a login to access these articles, access is free.