Concern’s Child Survival programming model was founded 10 years ago in Bangladesh, when the organization made a radical switch from running health care clinics directly to engaging communities to manage and implement their own health services. By training local community members and engaging local leaders as active partners in service delivery, Concern is building a large—and growing—network of people committed to improving child health with minimal external involvement.
This model has been successfully scaled up and is now revolutionizing the planning and delivery of health services targeting more than 319,000 women and children under five in Bangladesh. This scalable approach, also applied in Haiti and Rwanda, and now Burundi, now impacts the lives of close to three million women and children.
In 2008, the United States Agency for International Development (USAID) awarded Concern a grant to expand its Child Survival program to Burundi and make significant improvements in the lives of 52,900 women and 31,200 children under-five, a segment of the population with very limited access to basic health care in this small, impoverished central African country that is slow in recovering from 12 years of civil war.
“Nearly two out of every 5 children die from preventable diseases in Burundi. This is unjust and has to change. With this funding we can change the future for thousands of Burundi’s most vulnerable children,” says Michelle Kouletio, Concern’s health advisor.
Concern is combating the leading causes of early childhood mortality in Burundi—malaria, pneumonia, diarrhea, and malnutrition—and demonstrating the positive impact of investment and innovation in maternal child survival programming.
The Mabayi Child Survival Project (MCSP) supports health services in the newly-formed Mabayi Health District, which is comprised of Mugina, Bukinanyana and Mabayi communes. A solid decade of partnership with the Cibitoke province and the opportunity to expand Concern’s experience and learning in Mugina Commune to the two neighboring communes were important factors in the selection of Mabayi health district. Major health threats include elevated risk of malaria (due to spread to previously less exposed mountainside communities) and high levels of anemia and stunting among children under five.
Key interventions: focus on the four leading causes of child mortality:
- Infant and young child feeding
- Vitamin A/Micronutrients
- Prevention and treatment of malaria
- Control of diarrhea diseases and pneumonia case management
A particular emphasis is placed on the innovation of a nutrition promotion model and the documentation and sharing of learning on the effective delivery of MCH services in a post-conflict setting.
Concern’s strategic objective is the sustained and equitable uptake of key child health and nutrition services and practices to reduce infant and child morbidity and mortality due to the leading burdens of disease in the new health district of Mabayi.
Project strategies and intermediate results encompass the strategies and activities required to achieve outcomes:
- Improve household maternal and child health caring and nutrition practices
- Improve access to quality of basic child health care services with a balance of provision at the health center and community levels
- Strengthen community leadership in health
Success
During the first year of the project from December 2008 – February 2009, the project completed the Knowledge, Practice & Coverage (KPC) household survey and a rapid child health service provision assessment to establish baseline levels for Mabayi District. Being a newly established district, there is need of the project assistance as they develop their capacity in monthly data collection, analysis and general management and use of health information.
The project’s current design captures the key elements of health outcomes, quality health services, and community capacity. Ultimately the Mabayi District will lead the continuation of child survival interventions well beyond the life of the five-year project.