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Perin J.,Food for the Hungry | De Calani K.J.N.,Food for the Hungry | Norman W.R.,Food for the Hungry | Perry H.,Food for the Hungry | And 2 more authors.
American Journal of Tropical Medicine and Hygiene | Year: 2014

This study examined the relationship between childhood diarrhea prevalence and caregiver knowledge of the causes and prevention of diarrhea in a prospective cohort of 952 children < 5 years of age in Cochabamba, Bolivia. The survey of caregiver knowledge found that more than 80% of caregivers were unaware that hand washing with soap could prevent childhood diarrhea. Furthermore, when asked how to keep food safe for children to eat only 17% of caregivers reported hand washing before cooking and feeding a child. Lack of caregiver awareness of the importance of practices related to hygiene and sanitation for diarrhea prevention were significant risk factors for diarrheal disease in this cohort. The knowledge findings from this study suggest that health promotion in these communities should put further emphasis on increasing knowledge of how water treatment, hand washing with soap, proper disposal of child feces, and food preparation relate to childhood diarrhea prevention. Copyright © 2014 by The American Society of Tropical Medicine and Hygiene.


Background: Globally, less than half of Countdown Countries will achieve the Millennium Development Goal of reducing the under-5 mortality rate (U5MR) by two-thirds by 2015. There is growing interest in community-based delivery mechanisms to help accelerate progress. One promising approach is the use of a form of participatory mothers' groups, called Care Groups, for expanding coverage of key child survival interventions, an essential feature for achieving mortality impact. Methods: In this study we evaluate the effectiveness of Care Group projects conducted in 5 countries in Africa and Asia in comparison to other United States Agency for International Development-funded child survival projects in terms of increasing coverage of key child survival interventions and reducing U5MR (estimated using the Lives Saved Tool, or LiST). Ten Care Group and nine non-Care Group projects were matched by country and year of program implementation. Results: In Care Group project areas, coverage increases were more than double those in non-Care Group project areas for key child survival interventions (p∈=∈0.0007). The mean annual percent change in U5MR modelled in LiST for the Care Group and non-Care Group projects was -4.80 % and -3.14 %, respectively (p∈=∈0.09). Conclusions: Our findings suggest that Care Groups may provide a promising approach to significantly increase key child survival interventions and increase reductions in U5MR. Evaluations of child survival programs should be a top priority in global health to build a greater evidence base for effective approaches for program delivery. © 2015 George et al.


PubMed | Food for the Hungry, FHI 360 and International Relief and Development
Type: Journal Article | Journal: Global health, science and practice | Year: 2014

Undernutrition contributes to one-third of under-5 child mortality globally. Progress in achieving the Millennium Development Goal of reducing under-5 mortality is lagging in many countries, particularly in Africa. This paper shares evidence and insights from a low-cost behavior-change innovation in a rural area of Mozambique.About 50,000 households with pregnant women or children under 2 years old were organized into blocks of 12 households. One volunteer peer educator (Care Group Volunteer, or CGV) was selected for each block. Approximately 12 CGVs met together as a group every 2 weeks with a paid project promoter to learn a new child-survival health or nutrition message or skill. Then the CGVs shared the new message with mothers in their assigned blocks.Household surveys were conducted at baseline and endline to measure nutrition-related behaviors and childhood nutritional status.More than 90% of beneficiary mothers reported that they had been contacted by CGVs during the previous 2 weeks. In the early implementation project area, the percentage of children 0-23 months old with global undernutrition (weight-for-age with z-score of less than 2 standard deviations below the international standard mean) declined by 8.1 percentage points (P<0.001), from 25.9% (95% confidence interval [CI]=22.2%-29.6%) at baseline to 17.8% at endline (95% CI=14.6%-20.9%). In the delayed implementation area, global undernutrition declined by 11.5 percentage points (P<0.001), from 27.1% (95% CI = 23.6%-30.6%) to 15.6% (95% CI=12.6%-18.6%). Total project costs were US$3.0 million, representing an average cost of US$0.55 per capita per year (among the entire population of 1.1 million people) and US$2.78 per beneficiary (mothers with young children) per year.Using the Care Group model can improve the level of global undernutrition in children at scale and at low cost. This model shows sufficient promise to merit further rigorous testing and broader application.


Globally, less than half of Countdown Countries will achieve the Millennium Development Goal of reducing the under-5 mortality rate (U5MR) by two-thirds by 2015. There is growing interest in community-based delivery mechanisms to help accelerate progress. One promising approach is the use of a form of participatory mothers groups, called Care Groups, for expanding coverage of key child survival interventions, an essential feature for achieving mortality impact.In this study we evaluate the effectiveness of Care Group projects conducted in 5 countries in Africa and Asia in comparison to other United States Agency for International Development-funded child survival projects in terms of increasing coverage of key child survival interventions and reducing U5MR (estimated using the Lives Saved Tool, or LiST). Ten Care Group and nine non-Care Group projects were matched by country and year of program implementation.In Care Group project areas, coverage increases were more than double those in non-Care Group project areas for key child survival interventions (p = 0.0007). The mean annual percent change in U5MR modelled in LiST for the Care Group and non-Care Group projects was -4.80% and -3.14%, respectively (p = 0.09).Our findings suggest that Care Groups may provide a promising approach to significantly increase key child survival interventions and increase reductions in U5MR. Evaluations of child survival programs should be a top priority in global health to build a greater evidence base for effective approaches for program delivery.


PubMed | Food for the Hungry, World Relief Mozambique, Feed the Children, Concern Worldwide U.S. and ICF International
Type: Journal Article | Journal: Global health, science and practice | Year: 2015

In view of the slow progress being made in reducing maternal and child mortality in many priority countries, new approaches are urgently needed that can be applied in settings with weak health systems and a scarcity of human resources for health. The Care Group approach uses facilitators, who are a lower-level cadre of paid workers, to work with groups of 12 or so volunteers (the Care Group), and each volunteer is responsible for 10-15 households. The volunteers share messages with the mothers of the households to promote important health behaviors and to use key health services. The Care Groups create a multiplying effect, reaching all households in a community at low cost. This article describes the Care Group approach in more detail, its history, and current NGO experience with implementing the approach across more than 28 countries. A companion article also published in this journal summarizes the evidence on the effectiveness of the Care Group approach. An estimated 1.3 million householdsalmost entirely in rural areashave been reached using Care Groups, and at least 106,000 volunteers have been trained. The NGOs with experience implementing Care Groups have achieved high population coverage of key health interventions proven to reduce maternal and child deaths. Some of the essential criteria in applying the Care Group approach include: peer-to-peer health promotion (between mothers), selection of volunteers by mothers, limited workload for the volunteers, limited number of volunteers per Care Group, frequent contact between the volunteers and mothers, use of visual teaching tools and participatory behavior change methods, and regular supervision of volunteers. Incorporating Care Groups into ministries of health would help sustain the approach, which would require creating posts for facilitators as well as supervisors. Although not widely known about outside the NGO child survival and food security networks, the Care Group approach deserves broader recognition as a promising alternative to current strategies for delivering key health interventions to remote and underserved communities.


PubMed | Food for the Hungry, World Relief Mozambique, Concern Worldwide U.S., Feed the Children and ICF International
Type: Journal Article | Journal: Global health, science and practice | Year: 2015

The Care Group approach, described in detail in a companion paper in this journal, uses volunteers to convey health promotion messages to their neighbors. This article summarizes the available evidence on the effectiveness of the Care Group approach, drawing on articles published in the peer-reviewed literature as well as data from unpublished but publicly available project evaluations and summary analyses of these evaluations. When implemented by strong international NGOs with adequate funding, Care Groups have been remarkably effective in increasing population coverage of key child survival interventions. There is strong evidence that Care Groups can reduce childhood undernutrition and reduce the prevalence of diarrhea. Finally, evidence from multiple sources, comprising independent assessments of mortality impact, vital events collected by Care Group Volunteers themselves, and analyses using the Lives Saved Tool (LiST), that Care Groups are effective in reducing under-5 mortality. For example, the average decline in under-5 mortality, estimated using LiST, among 8 Care Group projects was 32%. In comparison, among 12 non-Care Group child survival projects, the under-5 mortality declined, on average, by an estimated 11%. Care Group projects cost in the range of US$3-$8 per beneficiary per year. The cost per life saved is in the range of $441-$3,773, and the cost per disability-adjusted life year (DALY) averted is in the range of $15-$126. The Care Group approach, when implemented as described, appears to be highly cost-effective based on internationally accepted criteria. Care Groups represent an important and promising innovative, low-cost approach to increasing the coverage of key child survival interventions in high-mortality, resource-constrained settings. Next steps include further specifying the adjustments needed in government health systems to successfully incorporate the Care Group approach, testing the feasibility of these adjustments and of the effectiveness of Care Groups in pilot programs in government health systems, and finally assessing effectiveness at scale under routine field conditions in government health programs.


News Article | November 2, 2016
Site: www.realwire.com

Partnership to tackle poverty in region by helping female entrepreneurs start their own businesses Wakefield, MA and Maidenhead, U.K. – November 2, 2016 – SDL (LSE: SDL) today announced that, as part of its continued work with the MicroLoan Foundation (MLF) over the past eight years, it is partnering with MLF to help the charity expand its presence into Zimbabwe. MLF currently provides small loans to women in rural Malawi and Zambia, enabling approximately 50,000 female entrepreneurs every year to set up their own self-sustainable businesses and work themselves and their families out of poverty. Support for charities like MLF is central to the SDL Foundation’s mission of supporting structural and sustainable projects that are income-generating, helping people to help themselves. SDL grants have effectively enabled MLF to help a significant number of these women set up businesses and provide for their families. MLF’s model has experienced a successful repayment rate of about 98 percent. “At MLF, we provide small amounts of investment for groups of women who otherwise have little chance of employment, entrepreneurship or simply being self-sufficient and taking care of their families,” said Peter Ryan, Founder and CEO, MicroLoan Foundation. “The grant from SDL allows us to extend our work into Zimbabwe, a country with great needs and immense potential. As our work in Malawi and Zambia demonstrates, relatively small sums of money generate large returns for the women we work with. With SDL Foundation’s contributions, we look forward to transforming the lives of Zimbabwean women.” In addition, a number of SDL employees have provided creative support to the design of MLF’s marketing materials and will provide their technical expertise in web engineering for MLF’s new website. Earlier SDL Foundation funding also enabled MLF to introduce a sophisticated management information system (MIS) and accounting system to improve operational efficiency, reporting and assessment. “We are immensely proud to be working with the MicroLoan Foundation to help fund the establishment of MLF in Zimbabwe,” said Alastair Gordon, Chairman of the SDL Foundation. “Enabling people who want to help themselves and who have the determination to generate income and be released from a reliance on aid goes to the heart of the SDL Foundation’s mission. The fact that these small businesses consistently repay the loans and also create further employment in their communities gives the SDL Foundation Trustees great confidence in this exciting new initiative in Zimbabwe.” Other projects undertaken by the SDL Foundation include a ten-year partnership with Food for the Hungry, where the Foundation is helping the charity to turn around the impoverished community of Maisa Bora, Kenya. In Paraguay, the SDL Foundation is working closely with the Santa Maria Education Fund and recently financed a full-time employee to help manage a network of volunteer teachers. The aim of the partnership is to help students significantly improve their lives and those of their wider families. About the MicroLoan Foundation MicroLoan helps some of the poorest women in the world feed their families, send their children to school, and pay for life saving medicines. It’s a very different kind of charity, offering hope – not handouts. By providing small loans (average $100) and ongoing business training and support, MicroLoan helps women in rural Malawi and Zambia to set up their own self-sustainable businesses, enabling them to work themselves and their families out of poverty. About the SDL Foundation The SDL Foundation forms parts of the Corporate Social Responsibility activities of SDL plc, a company that helps to eliminate communication barriers by managing and translating content across websites and devices. The SDL Foundation is committed to supporting charities and projects across the world that work with disadvantaged communities. About SDL SDL (LSE: SDL) is the leader in global content management and language solutions. With more than 20 years of experience, SDL helps companies build relevant digital experiences that deliver transformative business results on a global scale. Seventy-nine of the top 100 global brands trust SDL to simplify the complexity of managing content across multiple brands, websites, languages, and devices. Go global faster with SDL. Learn more at SDL.com and follow us on Twitter, LinkedIn and Facebook.


Kariger P.,University of California at Berkeley | Frongillo E.A.,University of South Carolina | Engle P.,California Polytechnic State University, San Luis Obispo | Britto P.M.R.,Yale University | And 2 more authors.
Journal of Health, Population and Nutrition | Year: 2012

Indicators of family care for development are essential for ascertaining whether families are providing their children with an environment that leads to positive developmental outcomes. This project aimed to develop indicators from a set of items, measuring family care practices and resources important for caregiving, for use in epidemiologic surveys in developing countries. A mixed method (quantitative and qualitative) design was used for item selection and evaluation. Qualitative and quantitative analyses were conducted to examine the validity of candidate items in several country samples. Qualitative methods included the use of global expert panels to identify and evaluate the performance of each candidate item as well as in-country focus groups to test the content validity of the items. The quantitative methods included analyses of item-response distributions, using bivariate techniques. The selected items measured two family care practices (support for learning/stimulating environment and limit-setting techniques) and caregiving resources (adequacy of the alternate caregiver when the mother worked). Six play-activity items, indicative of support for learning/stimulating environment, were included in the core module of UNICEF's Multiple Cluster Indictor Survey 3. The other items were included in optional modules. This project provided, for the first time, a globally-relevant set of items for assessing family care practices and resources in epidemiological surveys. These items have multiple uses, including national monitoring and cross-country comparisons of the status of family care for development used globally. The obtained information will reinforce attention to efforts to improve the support for development of children.

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