Beyond Surviving - It's Time to Thrive!

World Vision's Sector Approach for Health & Nutrition 2020-2030

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 with an emphasis on CHILD NUTRITION.

In alignment with World Vision Child Protection minimum requirements, programmes should ensure meaningful participation of older children 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.

World Vision 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.

World Vision 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 specialty 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.

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.
• 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.