Preventable child and maternal deaths have decreased significantly in the last 30 years. However, children in the poorest households globally are twice as likely as those in the richest households to die before their fifth birthday, indicating that – despite the progress made for many children – the most vulnerable continue to face a similar burden of health and nutrition challenges as they did decades ago.

Almost half of under-five deaths now occur during the newborn period, and the most vulnerable children are still exposed to diseases such as pneumonia, diarrhoea and malaria, which together account for over 43% of under-five mortality. Malnutrition remains an underlying cause of 45% of all under-five deaths, as well as 20% of maternal mortality, yet only 20% of young children with severe wasting receive assistance. We now see a triple burden of malnutrition, whereby undernutrition, micronutrient deficiencies, and overweight are overlapping in their long-term effect on children, increasing their risk for health problems now and in the future.

Undernourishment of adolescent girls and women, and child marriage, are leading to low birth weight and premature babies – the leading cause of newborn mortality. We now know that caregiver mental health plays a significant role in the health and nutrition of children under five. It is clear that we need to work further back in the chain of causation, including with adolescent girls, to reduce deaths and malnutrition in children under five. Given this, our deepening focus on child health and nutrition must bridge the “survive” and “thrive” continuum.    

We can leverage our work with more than 184,000 Community Health Workers and 400,000 faith leaders to achieve more multisector impact in young children, including using them to prevent and respond to the violence that affects 1.7 billion children annually, to promote improved caregiver mental health, to promote positive parenting, and to assure all children have a safe, secure and loving home environment.

Our main target group is children 0 to 5 years. Emphasis is on child nutrition.

STRENGTHEN | In alignment with WV child protection minimum requirements, WV field offices should ensure meaningful participation of older children in WV programmes and address intergenerational health challenges such as the effects of adolescent malnutrition on low birth weight and prematurity and the effects of child marriage on maternal and under-five mortality.

This Sector Approach promotes an increased emphasis on additional determinants of newborn and child health through the holistic nurturing care of young children; integrated, multisector interventions; and interventions to address the reproductive health of women.

WV promotes a new focus on caregiver mental health (especially maternal depression), adolescent nutrition (especially anaemia prevention), prevention of child marriage and other forms of violence against children, child injury prevention, and early childhood stimulation and development, all of which are expected to have an impact on child health and nutrition outcomes.

WV continues to discourage the following services and interventions: annual health check-ups for sponsored children; direct provision of tertiary health care, surgery and other clinical and speciality care; most infrastructure construction (outside of some grants); and pharmaceutical procurement except in grant-funded projects where in-country quality assurance mechanisms are in place and WV has a pharmacist on staff.

CORE PROJECT MODELS

Community Health Workers: Strengthening the impact and reach of this vital cadre to provide basic preventive and treatment support in vulnerable communities, we will work alongside health services and other partners to harmonize and support CHWs.

Timed and Targeted Counselling: A family-inclusive approach to CHW programming that addresses behaviour change communication through the life course, from conception to two years and beyond. 

Community Health Committees (COMM): Empowering community stakeholders and leaders to identify, plan and promote improvements in health and nutrition practices, social norms and services.

Positive Deviance Hearth Plus (PDH+):  An integrated community-based nutrition programme that leverages existing expertise and local foods and agriculture to support caregivers of undernourished children to ensure sustainable recovery.

Community Management of Acute Malnutrition (CMAM): a community-based treatment approach to acute malnutrition, vital life-saving services in humanitarian and development settings. Through CMAM, World Vision supports the community expansion of access to treatment through simplified protocols and CHW engagement. 

Nurturing Care Groups (NCGs):  An integrated cross-sectoral model based on the Care-Groups approach addressing a range of social norms and behaviour change in health, nutrition, WASH, child development and child protection.

Channels of Hope (CoH) for Maternal and Child Health, Ebola, HIV, mental health and COVID-19: An inter-faith approach empowering and equipping faith communities to transform social norms, stigma, discrimination and uphold positive health practices and support for their congregations and wider communities. 

Citizen Voice and Action (CVA) for Health Systems Strengthening: A powerful local level advocacy programme with demonstrated impact in improving health and social services, allocation of resources, and policy change, driven by community members engaging duty bearers and policy-makers for change. 

ADDITIONAL PROJECT MODELS

Go Baby Go: A parenting support model enaging vulnerable families in equipping them with knowledge and skills to promote early childhood development and Nurturing care.

IMPACT+ : A club-based model for adolescents, where they gain confidence, knowledge and lifeskills.

Integrated WaSH: An integrated approach between WASH; maternal, newborn and child health; nutrition; and early childhood development to promote child well-being in the critical first 1000 days, applying interventions at the household and health facility level.

Ultra-Poor Graduation model:  A programme that provides extremely poor households with a pathway out of poverty by helping families engage in a productive and resilient livelihood. 

Within grant-funded programs, we also carry out the following activities

• Healthy Timing and Spacing of Pregnancy: Diverse approaches to promote uptake and access to family planning and birth spacing.
• Interpersonal Psychotherapy for Groups (IPT-G): a group-based mental health programme, which can be facilitated by supervised non-specialized staff and delivered in community settings to support individuals, with a focus on caregivers experiencing depression, especially post-natal depression. 
• Problem Management Plus: a scalable psychological intervention for adults impaired by distress in communities who are exposed to adversity. Aspects of Cognitive Behavioural Therapy (CBT) have been changed to make them feasible in communities that do not have many specialists.
• Grandmother Inclusive Approach: an original methodology for working with communities and promoting change in community norms and practices dealing with the well-being of women and children.
• Women Adolescent and Young Child Spaces (for fragile contexts and humanitarian responses): Women, Adolescent and Young Child-friendly Spaces (WAYCS), also known as Baby-friendly tents or Baby-friendly corners, are safe, low-stress spaces where mothers can breastfeed, rest, eat and receive skilled counselling and targeted advice about breastfeeding and nutrition.