How do developing countries… develop? While the causes of poverty are fairly common, the solutions — in order to be effective and sustainable in the long run — generally need to be tailored to a community’s specific needs. Here are 5 examples from our five decades’ worth of experience (including a couple of countries where we have, happily, worked ourselves out of a job).
1. Microfinance in Cambodia: From savings and loans to Shining Light
The first modern credit card was born in the 1950s, and by the late 1970s, the idea of using a similar concept of buying on credit was introduced to the humanitarian world. Microfinancing models establish savings, loans, insurance, and cash transfer services in communities that need them the most, allowing people to purchase the tools and services they need in order to become self-sufficient.
We’ve seen tremendous success with microfinancing in our work at Concern, one of the finest examples being in Cambodia. Concern set up a small savings and loan initiative there in the early 1990s and by the end of the decade it had grown into the Bank of New Shining Light. That in turn would eventually be spun off into a separate, independent company, Anghkor Mikroheranvatho Kampuchea (AMK), which today is the largest provider of credit in Cambodia. Offering a full range of financial services to hundreds of thousands of Cambodians (87% of whom are female), a five-person acorn has grown into a mighty oak.
2. Education in Kenya: Going where it’s needed most
Kenya has provided free primary education since 2003, increasing enrollment by nearly 2 million over the following decade. However, this initiative has not been able to reach many of the families that need it the most.
By 2016, Nairobi’s informal settlements —slums — were home to 3 million people (60% of the city’s entire population). Because of their unofficial status, the settlements had no public schools, meaning 40,000 children were outside the education system. Parents set up community-run academies, but many of these schools lacked resources, had few trained teachers, and there was no system of quality control.
A campaign for public recognition was launched in 2004, led by Concern Worldwide, and within a few years the Kenyan government began to respond. 343 of these informal schools received capitation grants, meaning that they would receive some money per child to pay for books, school materials, and maintenance. The passing of a new constitution for Kenya in 2010 provided further opportunity for change. A new advocacy campaign resulted in landmark legislation, which should ensure that over 400,000 Kenyan children will have access to a free, quality education they may have otherwise been denied.
3. Famine in Ethiopia: Saving lives, for peanuts
During the hunger emergencies of the 1980s and 1990s, children with severe acute malnutrition required around-the-clock care at dedicated feeding centers. Nutrients were delivered through therapeutic milk, which required on-site preparation and clean water. The centers were few and far between and mothers would often need to leave their homes for weeks at a time, meaning lost income and an adverse impact on other kids in the household. Often children under treatment were exposed to other illnesses in crowded wards.
In the late 90s Concern Worldwide and research organization Valid Nutrition were given government permission to set up a pilot program to test a ready-to-use therapeutic food (RUTF) that could be used at home.
The result was a nonperishable peanut-based paste that stores well, travels easily, and can be administered to infants and children alike to build up their nutrients. Christened Plumpy’nut, it was designed to be administered as part of a program called Community Management of Acute Malnutrition (CMAM). Mothers could bring their malnourished children to a local clinic or mobile site, where they would be measured and weighed. The moms would then receive an appropriate quantity of Plumpy’nut, some basic training, and be free to return home to care for the child themselves. Weekly follow-up visits would continue until the danger had passed.
When famine struck Ethiopia in 2000, the combined use of CMAM and Plumpy’nut saw dramatically reduced under-5 mortality rates than otherwise might have been expected. Less children were dying. In the 20 years since that event, CMAM and RUTF have become a revolution in the management of acute malnutrition, literally changing the world.
4. Maternal and child health in Rwanda: Bringing community care to scale
Extreme poverty and poor health often go hand-in-hand, especially among mothers and children. Health challenges or undernutrition during pregnancy often lead to nutritional deficiencies during childhood, thereby diminishing childrens’ potential to reach their fullest capacities.
Building on the success of earlier “Child Survival” programs, Concern Worldwide (along with the IRC and World Relief) formed a consortium in Rwanda in 2006 to implement a program called Kabeho Mwana, or “Life for a Child.” This targetted 3 deadly but preventable illnesses — malaria, diarrhea, and pneumonia. 6,100 community health workers were trained in diagnosis and treatment and also promoted key preventative actions.
Over the course of 5 years, the program benefited more than 724,000 women and children, including more than 318,000 children under the age of 5 and over 405,000 women of reproductive age. This represents nearly ¾ of a million people who received vital treatment for and changed their behaviors in a sustainable way to prevent future outbreaks.
Kabeho Mwana is now in the hands of the Rwandan Ministry of Health, and continues to save lives and improve health outcomes for women and children around the country.
5. Health hotlines in Malawi and nurse apps in Ghana: Going the extra mile without moving an inch
At Concern, we’re often in the hardest-to-reach places of the world, but our goal is to not be needed in any one area forever. The Gates Foundation funded two initiatives that demonstrated how mobile phones can not only help us find the news and the weather, but also help save lives.
In Malawi, they’ve been used as part of a Concern-inspired initiative called “Chipatala Cha Pa Foni” or Health Center by Phone. The hotline service for pregnant women and families of young children in the country gives access to trained operators who can advise on what to do in case of illness and provide a referral to a health center if necessary.
There’s also a text messaging service for parents (and parents-to-be) who need timely health information and advice, thereby reducing unnecessary trips to hospitals and clinics. Families also receive text or voice messages with tips and reminders tailored to a week of pregnancy or child’s age.
In 2013, two years after its inception, an evaluation showed that the service led to more women seeking prenatal care, breastfeeding their newborns, and using bed nets to protect themselves and their children. By 2018, it had spread to 9 districts across in Malawi, accessible to 5 million citizens (over 25% of the population).
Phones have also served healthcare providers. In Ghana, where frontline nurses often go to remote villages to care for new mothers and their young children, a second opinion can be a luxury. Using the app “CHN on the Go”, community health nurses can get advice in minutes by uploading a photo or video showing symptoms. By 2016 CHN on the Go was serving 270 nurses and supervisors in 5 districts in the Volta and Greater Accra regions of Ghana.
Your Concern is an investment in these successes
A tax-deductible gift to Concern Worldwide isn’t just a donation — it’s an investment in ending extreme poverty. With stories like the above, you can see that investment in action, working in partnership with communities to meet the needs they identify through practicality and innovation. We’ve done it for over 50 years — and hope to not be here in another 50. Help us work ourselves out of a job by joining our community of investors below.