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CHILD SURVIVAL

Concern is fostering a simple yet innovative community-based revolution in maternal and child health.

Child survival

The statistics are staggering.

Globally, 7.6 million children die before their fifth birthday; approximately 40 percent of these deaths occur within the first month of life and are concentrated in sub-Saharan Africa and Southeast Asia. Most are caused by preventable, treatable illnesses such as infection, diarrhea, malaria, pneumonia, and malnutrition.

When children get sick, every minute between infection and treatment counts.  For children under five, the risk is especially acute.

For decades, the only choice for mothers across the developing world was to bring a sick child to the nearest hospital or clinic that, in most cases, was hours away on foot. That meant at least a day away from home and work, resulting in lost household income and driving the entire family deeper into the cycle of poverty and hunger.

Breaking the Mold

The immense challenge was to reduce both the time required and the risks involved by increasing proximity, access, and quality of care.  We found a solution in the form of an approach known as ‘child survival.’

Our child survival programs break the mold of the traditional model of care and treatment.  Instead of relying on services provided by health clinics, Concern works with local partners, ministries of health, and trained community volunteers to bring basic health care into homes and work with traditional providers to achieve a better standard of care.

“These approaches seem straightforward, but Concern’s experience has shown that the process is far from simple. The work is hard, unglamorous, and mostly unpublicized. It requires thousands of hours of community consultations, education, training, and community outreach.”
– Jennifer Weiss, former Health Advisor, Concern Worldwide US

This community-based approach dramatically increases the numbers of children treated for basic illnesses by saving mothers time, encouraging sustainable community ownership, and improving access and quality of care.  By treating more children and extending care into communities where none was previously available, we have helped prevent illness, provide cures, and save lives.

It’s a unique but common-sense approach that puts women in the driver’s seat in the fight against deadly but highly preventable diseases and gives them a voice that was traditionally unheard in many cultures.

How It Works

Concern’s child survival teams first assess locally available resources and identify key people of influence.  These are the core components that together form a unit that will drive the response to the specific needs of their community. They often include health providers, volunteers, village health committees, teachers, community-based organizations, social and religious leaders, government officials, and traditional health providers.

Community health workers in Gasambu village, Rwanda.

Community health workers in Gasambu village, Rwanda, meet to exchange ideas and challenges, and to improve their practice. Photo: Esther Havens.

Next, community health volunteers are elected by their communities and Concern invests in strengthening the health system through education and training programs. At the same time, Concern supports each country’s Ministry of Health to train the volunteers on the identification and treatment of disease in children, and counseling mothers on simple but life-saving behavior changes.

Networks of Care

Once fully prepared, the volunteers are outfitted with a sturdy wooden box containing approximately $50 worth of critical health supplies. In one fell swoop, the homes of volunteers become life-saving first-aid posts for their neighborhoods. Continuous education and refresher training are also provided to health professionals, improving the quality of service delivery at hospitals and health centers. Community health volunteers and health facility staff are encouraged to collaborate by maintaining a referral system, sharing and monitoring routine health information, and providing supportive supervision visits.

“I first thought of the program in terms of tangibles such as clinics or ambulances. It took me some time to shift my paradigm and understand it is primarily a capacity-building effort. Now I am committed to child survival and leading the effort in Bangladesh.” – Mayor of Dinajpur, Bangladesh

The ultimate success of Concern’s child survival programs is to help transform local and national health care systems by transferring the management and full ownership of the programs to the responsible ministries of health and communities themselves.  So far, we’ve instituted these programs in Bangladesh, Rwanda, Burundi, Haiti, Niger, and Sierra Leone.