Malnutrition in Children

4 Causes of Malnutrition in Children and What You Can Do About It

As a concerned parent, you are sensitive to the nutritional needs of your child, and that includes avoiding risk factors that could lead to malnutrition. Understanding the major causes of malnutrition can help you form good habits when it comes to your own health as a parent, as well as the health of your child.  Here, we breakdown four major factors that contribute to malnutrition in children.

Poor Quality of Diet 

Malnutrition, at its core, is a dietary deficiency that results in poor health conditions. We typically think of malnutrition as it relates to children not eating enough of the right foods. It can also occur when children eat too much of the wrong foods. Either way, more than 170 million children fail to reach their full potential due to poor nutrition.

At a Save the Children-supported school in Bolivia, young children enjoy healthy snacks.
At a Save the Children-supported school in Bolivia, young children enjoy healthy snacks.

Malnutrition can occur in children of all ages, but young children are the most vulnerable. The World Health Organization has stated that malnutrition is the single most dangerous threat to global public health [1]. It contributes to 45 percent of deaths of children under the age of 5 [2].  This is due, in part, to the critical importance of the first two years of a child’s life.

Maternal Health

The largest window of opportunity for a child’s health occurs in the first 1,000 days-from the start of a woman’s pregnancy to her child’s second birthday. Mothers who are malnourished during their pregnancy can experience complications giving birth. Many children are born small because their mothers are undernourished[3].  Severely malnourished mothers can also have trouble breastfeeding their infants.

We know that breastfeeding for the first six months of a child’s life has health benefits that extend into adulthood. However, if a mother is too malnourished to breastfeed, these health benefits may not be passed on and a child can be at risk for malnutrition. This is especially true in developing countries.

At a Save the Children-supported health center in Tanzania, Zinak*, 24 and 7-months pregnant, receives a prenatal check up.
At a Save the Children-supported health center in Tanzania, Zinak*, 24 and 7-months pregnant, receives a prenatal check up.

Mothers like Zinak*, pictured above, who live in developing countries can be unaware of nutritional benefits of breastfeeding. In Tanzania, for example, the average duration of breastfeeding is only 2.4 months[4].  Tanzania is one of the 10 worst affected countries in the world by chronic malnutrition and is the third worst in Africa.

Global health programs like the ones Save the Children supports works to help maternal, newborn and child health, which ultimately helps end child malnutrition. We work in many of the world’s poorest places, in the United States and abroad, to alleviate child hunger and prevent malnutrition. However, children living developed countries are still at risk for malnutrition if they are born into poverty.

 

Socioeconomic Status

Poverty is the number one cause of malnutrition in developing countries. Often times, families living in poverty lack access to fresh fruits and vegetables. Many communities do not have full-service grocery stores that regularly stock fresh produce.

Even if they do, fresh fruits and vegetables can be expensive. When fresh fruits and vegetables are out of reach for children, they can fill up on less expensive, less healthy foods.

Rebecca, 25, holds her daughter Rachael*, 11 months while she eats high nutrient peanut paste after being treated for severe acute malnutrition at a Save the Children stabilization center in South Sudan.
Rebecca, 25, holds her daughter Rachael*, 11 months while she eats high nutrient peanut paste after being treated for severe acute malnutrition at a Save the Children stabilization center in South Sudan.

War and Conflict

Sadly, the violence of war and political unrest can also lead to severe malnutrition. In South Sudan, for example, conflict and drought has led to devastating conditions for children. Save the Children in South Sudan is the lead health and nutrition provider in much of the region. We run 58 feeding program sites for infants and young children, all powered by the support of our donors.

The crisis in Syria has also shed light on the number of refugee children who are at risk of malnutrition. Children, who make up more than half of the world’s 22.5 million refugees[5], often go without healthy food, health care and an education.

Access to food and water has become a heartbreaking challenge— leaving thousands of Syrian children at risk for malnutrition. There are many ways to help Syrian refugee children. Your knowledge and support can make a world of difference for children around the world.

 

*Name changed for protection

[1] [2] http://www.who.int/mediacentre/factsheets/fs178/en/

[3] https://www.savethechildren.org/content/dam/usa/reports/advocacy/sowm/sowm-2014.pdf

[4] https://www.savethechildren.org/us/what-we-do/events/breastfeeding

[5] https://www.savethechildren.org/us/what-we-do/emergency-response/refugee-children-crisis

An Open Heart

Susan and Claire

By Susan Warner, Senior Manager, Photography & Multimedia Production and

Claire Garmirian, Media Research Analyst

Susan: I made her cry, good tears. Transformative tears of love for the child in her arms. When I showed Rosa the photo I took of her and her granddaughter, she burst into tears. I knew then I had taken a good photo.

Claire: Rosa and I spent half an hour speaking in the director’s office on the second floor of the school. We gathered chairs together so that she, Ivonne from Save the Children Mexico and I could hear each other over the noise from below. The painted concrete patio where teachers lead students in experiential learning was beneath us and the sounds of preschoolers moving, counting and singing ricocheted up into the office. Amid all of this energy, Rosa shared the very personal details of her life with her granddaughter, Valeria*, and how she has found herself to be a primary caregiver for the four-year-old girl.

Susan: I don’t speak Spanish, nor have an ear for languages.  I gesture, pantomime, demonstrate and rely on our local staff to help when I’m on assignment.  I had asked Rosa to directly look into the eyes of her 4-year-old granddaughter.

Claire: As I listened to Rosa talk about her family, it became clear that she is a central figure holding many people together. She lives with her husband and son and daughter, both of whom have children of their own. Due to tensions between different members of the family, Rosa is a person who everyone can talk to. She sees the difficulties on both sides of the disputes. It sounded like her role could be tiring at times. She admitted that Valeria’s tantrums could make her feel desperate, but she also says she knows that they are a result of Valeria missing her mother, who no longer lives with her. As much as raising Valeria can be hard work, Rosa had endless stories about how intelligent and creative her granddaughter is. When I lost my words searching for a question, Rosa volunteered the story of her trip to the theater with Valeria. Valeria could repeat the song from the performance by heart after only hearing it once. And while Rosa’s speech was even throughout our conversation, it became energetic and expressive when she told me about Valeria’s drawings. It is obvious that she is amazed by her granddaughter’s imagination.

After our conversation, Rosa descended the stairs to join Susan on the school’s main level. They found a corner among the cacophony to take the tender portrait of the grandmother and granddaughter.

Susan:  Through talking about her experiences in the interview and seeing the photos on the back of my camera, Rosa was emotional, in a positive way, overwhelmed by her love of her granddaughter. It was a touching experience to witness the love they shared. I had photographed her heart.

*Name has been changed for protection.

Background:

Valeria attends preschool in a rough neighborhood in Mexico City that is fraught with violence, drug gangs, and addiction. Save the Children’s HEART program has helped children in this community cope with their stress, anxiety, fears and anger from being exposed to these activities.

About HEART:
HEART (Healing and Education through the ARTs) uses the arts to help children affected by serious or chronic stress from their life circumstances of poverty, violence or other traumatic events. Through painting, music, drama, and other art forms, HEART helps children find new ways to share their feelings and fears, so they can express themselves in a safe environment with trusted adults and peers, and thrive in the classroom. When children share their feelings they begin the healing process.
Save the Children launched HEART in Mexico in 2016. In the first year of operation, HEART reached nearly 8,000 children affected by poverty, violence and migration in 5 provinces: Baja California, Chiapas, Mexico City, Oaxaca and Puebla. The education program is integrated into Save the Children’s programs existing school curriculums for children, including programs at preschools, early primary schools, child and youth centers, and summer programs, as well as migration prevention programs for children and teenagers.
Save the Children has operated in Mexico since 1973. Today, Save the Children serves children in 18 of Mexico’s 32 states, giving kids a healthy start, an opportunity to learn and protection from harm.

Lubna*, 20 days old, at an IDP camp in Iraq.

Born On The Run: Young Iraqi Mothers Fleeing ISIS Give Birth Anywhere They Can

With the battle for West Mosul still raging, and ISIS increasingly using civilians as human shields as coalition airstrikes continue, many expectant mothers are fleeing for their lives – in some cases even giving birth on the run.

Layla* is just three days old and was born in the ruins of an abandoned house, with shelling and shooting all around. Her 17-year-old mother Rehab* was just days away from her due date when the fighting in her neighborhood got unbearable and forced her and her family to flee in the middle of the night.

Rehab fell repeatedly as they tried to escape and went into labor hours into the journey.

“I went into labor on the road. I was very scared for me and my baby but my mother and another older woman helped me,” said Rehab. “It was very quick, maybe just 15 minutes. We rested for about another 30 minutes and then we started running again.”

The family is now in Hamam Al Alil reception center, the main focal point for those fleeing Mosul, where more than 242,000 have been registered since the offensive began.

Most people are relocated quickly, but with thousands arriving every day and more than 320,000 people displaced since the Mosul offensive began six months ago, families, many with young children, are falling through the gaps.

Save the Children is distributing water, toiletries and newborn kits in the camps and have built and continue to clean latrines in the reception center.

Twenty-day old Lubna* has been in the center for almost two weeks. Her 15-year-old mother Reem* was in labor for more than two days but could not get medical care due to the fighting raging outside. The second she was strong enough, her and her mother Masa* fled with several other members of their family.

“Her delivery was very hard, very hard indeed, but there was nothing we could do because of the fighting. We wanted to leave Mosul,” says Masa.

“My brother has been killed and we wanted to go but Reem was too weak, so we stayed for five days and then we left and walked to safety. Thank God Lubna is healthy but we are very worried about her and that she will get sick in a place like this.”

Marwa*, 5 months, at Hamam al-Alil IDP camp in Iraq. Marwa*s mother Ashna* and her father Salar* fled fighting in Mosul with their six young children, including Marwa*. Marwa* said: "The journey was hard and me and the children were very scared. But all I could think about was how we needed to get to safety and how I needed to keep my children safe – so that drove me and kept me going even though the children were very hungry and they were crying a lot. My older children were able to walk but we had to carry the younger ones in our arms – I carried Marwa*, while my husband carried my son and my uncle my other daughter. Marwa* is sick. Ten days ago she got a high fever and bad diarrhea. We were given medicine but it is not working and then, about two days ago, she got a bad cough that is getting worse. Luckily she sleeps at night, but her diarrhea never stops. It is very difficult to deal with this here. There is no privacy at all. Neither me, nor the baby, have had a shower since we arrived 20 days ago and I have five other young children to look after. We all have to sleep on the floor in the tent with many other families. It is noisy and dirty."
Marwa*, 5 months, at an IDP camp in Iraq. Marwa*s mother Ashna* and her father Salar* fled fighting in Mosul with their six young children.

Save the Children’s Deputy County Director Aram Shakaram says:

“The situation inside the reception center is extremely poor and there is a widespread shortage of food, water and blankets. Whole families sleep on nothing but cardboard, huddling together for warmth at night.

“Very young babies, many just days or weeks old are living in these conditions and their mothers, some who are as young as 15, are not getting the support they need.

“With 325,000 people still displaced since the Mosul offensive began and thousands still fleeing every day, it is imperative that we get more funding to support new mothers and their extremely vulnerable children who are starting their lives off in camps.”

Save the Children provides education and psychosocial support to children displaced from Mosul and our child protection teams work in the reception centers to identify cases needing urgent assistance, like unaccompanied minors.

Since the offensive began, we have distributed 3,740 newborn care packages, which have reached almost 11,500 infants. We have also distributed 7,000 rapid response kits that have reached almost 33,000 people and contain essentials like food, water and toiletries for the newly displaced. In addition we are also working to provide clean drinking water and basic sanitation to tens of thousands of people who have fled from Mosul.

To learn more about our response to the refugee crisis and how you can help, click here.

*Names changed for protection

Keeping a Baby Close to Your Heart

Alicia Adler

Program Officer at Save the Children Malawi

January 9, 2016

Imagine spending at least 20 hours a day, 7 days a week with a baby strapped to your chest. Imagine you must eat, sleep, work and care for your other children along with a tiny baby who depends on your continuous skin-to-skin contact and exclusive breastfeeding for survival. This is the basis of kangaroo mother care (KMC), a costeffective intervention to help meet a premature or low-birthweight babys basic needs for warmth, nutrition, stimulation and protection from infection.blog2

For Malawi, with the highest preterm birth rate in the world (18 per 100 live births), KMC is a critical lifesaving intervention. But too few premature babies receive KMC due to lack of awareness, limited resources, and stigma against both KMC and premature/low-birthweight infants. It is not surprising, then, that direct complications of preterm birth are the second leading cause of child deaths after pneumonia, and result in more than 14 newborn deaths every day in Malawi. 

To commemorate World Prematurity Day 2016 on November 17th, Save the Children staff in Malawi accepted the KMC Challenge. Participants practiced KMC with a baby doll for 24 hours – holding the doll throughout work hours, around town and at home for the night. The challenge was accepted by other partners across the country and globe.

Jessie Lwanda, an IT coordinator said, “By doing this challenge, we are saying, ‘let’s give these babies a chance to survive by showing them love and carrying them close to our heart.’”

I have a passion for every child to survive, said Mavis Khondiwa, a Save the Children grants coordinator based in the United States. Through this challenge I could understand what kind of burden those mothers with premature babies face. I really feel for them.

blog1Over the course of the day, 20 men and women got a glimpse into the life of a mother with a premature baby and all the issues it presents. Through what I experienced as a man doing the challenge, I think women need more help, said Nyashadzashe Kaunda, an awards management officer. Men should also be taking care of the child and helping throughout the whole KMC process, he said

At the end of the 24 hours, colleagues returned the dolls and resumed their normal lives. For women around the country, it isnt so easy, though, as their childs life depends on their continued commitment to practice KMC until the baby reaches a healthy weight. In a country where neonatal mortality accounts for 40 percent of all death in children under age 5, it is everyones responsibility to champion KMC, and not just on World Prematurity Day, but every day. 

Save the Children is helping shift norms around the value of newborns in Malawi through the government’s social and behavior change communication (SBCC) campaign, Khanda ndi Mphatso (A Baby is a Gift: Give it a Chance), helping establish KMC sites of excellence in district hospitals, and collaborating with the Ministry of Health to develop a national routine reporting system for KMC services in health facilities.

To learn more about our work to improve newborn survival, click here.

Alicia Adler is a program officer and Global Health Corps fellow with Save the Children in Malawi.

“We vaccinated children in sandstorms”: How Our Emergency Team Saves Lives

by Dr Nicholas Alusa

Save the children car in Kenya.

Our Emergency Health Unit in Kenya, working on cholera prevention.

Measles is a highly contagious, horrific disease. If left untreated, in a worst case scenario, it can lead to death.

There’s no specific treatment for measles: all that medics can do is isolate the sufferer, give them vitamin A, and hope for the best.

In high-income countries most people infected with the disease recover in a couple of weeks, very few die. But in developing countries it kills up to one in five.

A safe and cost-effective vaccine does exist.  But families in remote areas, in countries with weak health systems, struggle to access it.

An emergency unfolds

Mayom County, in rural northern South Sudan, is one such place. A remote population in a country whose infrastructure has been crippled by civil war, no children have received routine vaccinations here for over two years. In January a few suspected cases of measles appeared, scattered around the main town. By the end of February, the county was in the grip of a fully-blown outbreak.

Nearly three quarters of the cases were children. If someone didn’t act fast, a tragedy of enormous scale was on the horizon: tens of thousands of children were at risk.

Previously in situations like this, we would have to spend time pulling together teams of specialists and supplies – a delay that costs lives. But last year we revolutionized the way we get medical care to children in emergencies, when we launched the Emergency Health Unit.

The unit is made up of fully-formed, world-class teams of medics on standby all over the world, ready to deploy within hours – complete with equipment, supplies, and logistics experts like me with the skills to get everything where it’s needed quickly.

When you have pre-positioned supplies you don’t have to spend time initiating the supply chain process, raising a procurement form, searching for funds, finding suppliers who can take months…while children in emergencies wait. That’s why these kits are so important.

Transforming emergency care

As soon as we heard about the measles outbreak in South Sudan, my team was mobilized. Within two weeks of the outbreak being announced, we were on the ground vaccinating children in 18 clinics and 24 mobile outreach centers.

Tracking the population in South Sudan is difficult, especially since the outbreak of conflict and the huge movement of people it has caused. A rough estimate told us we could expect to vaccinate around 26,000 children. Three weeks later, we had vaccinated 44,447.

We linked up with local staff and infrastructure and worked with the community to raise awareness on our behalf and tell people we were here. Word spread quickly, and after receiving 60 children on the first day, numbers rapidly swelled to up to 400 daily. Reaching out to the community in this way is so important to our work in emergencies – we would never have reached as many children as we did without their help.

South Sudan sandstorm

The Emergency Health Unit team continued to treat children through sandstorms.

A medal of honor

The infrastructure in Mayom is poor – it’s difficult to reach this part of South Sudan, and many NGOs are reluctant to attempt healthcare here. We relied on an array of transport, including motorbikes and canoes, to reach the most remote communities. We travelled across rough, rugged terrain and collapsed bridges, and vaccinated children in the middle of sandstorms.

We hurried, carrying life-saving vaccines that melted at three times the normal speed in Mayom’s 40-degree heat in precious cool-boxes . All while wearing what my colleague Nathalie calls the ‘Mayom suit’: head-to-toe dust.

In one rural cattle ranch our team leader, Koki, was heavily spat on by an elderly man on our arrival. “Hey, what’s this?” Koki said at the time, wiping the slimy liquid from his forehead. It turned out this was a sign of appreciation from the old man, who in his lifetime had never seen any NGO reach his remote community. ‘’Being spat on by an old man signifies immense blessings bestowed upon Save the Children!’’ a local health official told us.

And this salivary medal of honor feels truly earned. It was an incredible achievement: in this most inhospitable of environments, we did whatever it took to protect the vulnerable children in this isolated part of the world. Our new system works: in just three weeks, 44,447 children were permanently saved from a potentially deadly fate. A catastrophe was averted.

Now – what’s next?

 

Nicholas Alusa Dr Nicholas Alusa is an experienced pharmacist and medical logistics expert working as part of our new Emergency Health Unit, a major change in our work. The Unit consists of immediately deployable teams containing the ideal combination of medical and operational specialists, strategically positioned in emergency hotspots around the world and fully equipped with the best tools for the job. We can deploy these teams in a matter of hours, putting them at a child’s side, giving them the treatment they need in those critical early stages of an emergency.

UN General Assembly, June 8-10, 2016

Progress for Children in the Fight against HIV/AIDS

kechiKechi Achebe, MD, MPH

Senior Director, HIV/AIDS, International Programs

Save the Children US

June 27, 2016

UNAIDS and the United States President’s Emergency Plan for AIDS Relief (PEPFAR) released their “AIDS-Free Generation” report at the UN General Assembly High Level Meeting on Ending AIDS June 8-10th in New York, which indicated a 60% decline in HIV incidence among children since 2009 in the 21 sub-Saharan Africa nations most affected by the HIV epidemic. As a distinctive partner of UNAIDS, Save the Children contributed to these achievements through implementation of HIV/AIDS prevention, care, and treatment programs throughout Africa and Asia, helping 11.7 million children in 2015.

UN General Assembly, June 8-10, 2016
UN General Assembly, June 8-10, 2016

The On the Fast-Track to an AIDS-Free Generation report highlights the many recent accomplishments made towards achieving an AIDS-free generation:

  • New HIV infections among children in the 21 sub-Saharan Africa countries dropped from 270,000 in 2009 to 110,000 in 2015.
  • New HIV infections among children have declined globally by 50% since 2010—down from 290,000 in 2010 to 150,000 in 2015.
  • 49% of children living with HIV around the world now have access to life-saving treatment, compared to 32% who received treatment in 2014.
  • Seven countries have reduced new HIV infections among children by more than 70% since 2009 (the baseline for the Global Plan).
  • In India, the only Global Plan country outside of sub-Saharan Africa, new HIV infections in children dropped by 44% and coverage of services to pregnant women increased from less than 4% in 2010 to 31% in 2015.
  • More than 80% of pregnant women living with HIV in the 21 countries in sub-Saharan Africa had access to medicines to prevent transmission of the virus to their child—up from just 36% in 2009.
  • Six countries—Botswana, Mozambique, Namibia, South Africa, Swaziland and Uganda—met the Global Plan goal of ensuring that 90% or more of pregnant women living with HIV had access to life-saving ARVs. Six additional countries provided antiretroviral medicines to more than 80% of pregnant women living with HIV.
  • Access to treatment for children living with HIV has increased more than threefold since 2009—from 15% in 2009 to 51% in 2015.

Despite this groundbreaking progress, the report also highlights prospective areas of improvement:

  • Nigeria reduced new HIV infections among children by only 21%.
  • Still only half of all children in need of treatment have access to ART.
  • Early infant diagnosis coverage remains low. In the majority of the 21 countries in sub-Saharan Africa, less than half of childrenborn to women living with HIV received HIV testing within the first two months of age in 2015.
  • New HIV infections among women of reproductive age declined by 5% below the target of 50%. Between 2009 and 2015, around 5 million women became newly infected with HIV in the 21 priority countries in sub-Saharan Africa, and AIDS-related illnesses remain the leading cause of death among adolescents on the continent.

To continue to address these areas, at the meeting, UNAIDS and PEPFAR—in collaboration with other partners—

Vice President of SC US Global Health, Robert Clay, meets with Myanmar's Minister of Health, Dr. Myint Htwe on June 10, 2016 during the High Level Meeting on Ending AIDS.
Vice President of SC US Global Health,
Robert Clay, meets with Myanmar’s Minister of Health, Dr. Myint Htwe on June 10, 2016 during the High Level Meeting on Ending AIDS.

launched their Super Fast-Track framework for ending AIDS among children, adolescents, and young women. Titled “Start Free, Stay Free, AIDS-Free,” the initiative will build upon current progress made towards the previous Fast-Track framework to end the global AIDS epidemic. The new Super Fast-Track framework sets ambitious targets to:

  • eliminate new HIV infections among children;
  • find and ensure access to treatment for all children living with HIV; and
  • prevent new HIV infections among adolescents and young women.

The link to several press releases at the event can be found here.

The Time is Now: Delivering on the SDG Agenda

 

TheGlobalGoals_Logo_and_Icons

There’s no way around feelings of euphoria today.

 

World Leaders at the United Nations are ringing in a new set of Sustainable Development Goals (SDGs) that promise to end extreme poverty and the scourge of hunger and preventable deaths of infants and children around the world.

 

At the same time, the Pope is calling for solidarity with the most deprived and those displaced by conflict and climate change.

 

Over the coming days, millions of people globally – from youth in Ghana to Shakira — are taking part in the “world’s largest” prayers, lessons, and ceremonies to light the way for the SDGs. It’s one of those rare moments in which governments, faith institutions, everyday citizens and popular idols unite around a common cause to forge a historic moment.

 

Three years of debate among UN diplomats and millions of citizens voicing their priorities has culminated in the approval today by 193 nations of new Sustainable Development Goals, to replace the Millennium Development Goals established in 2000. Negotiations on the SDG agenda have been among the most collaborative in UN history. It is truly a global vision for a better world.

 

Furthermore, the SDGs comprise a holistic agenda – 17 goals rather than 8 – with ending extreme poverty at its core supported by a healthy planet in a peaceful world.

 

The goals are bold and ambitious. The trick will be maintaining the momentum once the speeches end, the crowds disperse, and the cameras turn their focus elsewhere.

 

It will take a collective effort to achieve this, but the most defining players will be governments who will bring political will and resources to deliver a better future for their people.

 

Here are six actions that all governments can take to make the SDGs real for their countries:

 

1) Create national action plans to implement the SDGs. Each government should take the SDGs back home, consult widely with local actors, and make policy and programmatic decisions to put the goals into practice in their country. The entire SDG agenda of 17 goals and 169 targets may not be applicable to every country but there are a core set – namely, the “unfinished business of the MDGs”– like health, education and poverty, which do apply to every country and can be acted upon starting today.

 

2) Commit financing to the SDGs. Countries should align their budgets to achieve these outcomes. For the United States, this may mean more investments to reduce deaths caused by obesity, heart disease, or automobile accidents, while for poor countries global health dollars could be invested in community health workers to reduce deaths associated with childbirth and malnutrition.

 

3) Assign a high-level government lead on the SDGs. To ensure rigorous monitoring and accountability, it is important to put in place a focal point on the SDGs who can reach across ministries and carry political weight to ensure action and coordination.

 

4) Communicate a clear commitment to the SDGs. Heads of state can take these goals home and share them with Parliament or Congress and speak to citizens, private companies, and others to contribute financing, technical know-how, and new ideas and innovations to deliver on the SDGs. Citizens should also play a role holding governments’ “feet to the fire” to be accountable for achieving this agenda over the next 15 years.

 

5) Prioritize action to “leave no one behind.” Many times on large agendas such as this one, people try to attain the easy solutions and quick wins. This time, however, the world pledged to achieve progress for the poorest and most vulnerable groups first. This requires investments in gathering and disaggregating data to ensure that all groups benefit from progress and no one is being “left behind,” such as girls living in poverty.

 

6) Publish an annual whole of government report on the SDGs and participate fully in the global follow up and review process. Every country should create progress reports on the SDGs and encourage citizen participation to leverage all resources and people-power in fulfilling the 2030 agenda. This will demand that we work together to strengthen our systems for evaluation and learning in order to scale projects that work and end those that don’t.

 

With the new SDGs, we can build a world in which no child lives in poverty, and where each child has a fair start and is healthy, educated, and safe. But progress toward meeting these goals in each country will depend on more government investment, open and transparent country institutions, participation by a diverse cross-section of civil society, and effective partnerships between government, civil society, private sector, and donors.

 

In 2030 we will judge success by what has been delivered, rather than by our declarations today. Let’s use this historic moment to pave the way for concrete action for children around the world.

For Babies In Big Cities, It’s Survival Of The Richest

The following blog first appeared on The Huffington Post

I will never forget the moment when I looked out the car window at a bustling, steamy intersection in the heart of Manila, and locked eyes with a young woman. She was holding a tiny baby while begging in the street.

 

I glanced down at my six-month-old son, sleeping contentedly in my arms inside our air-conditioned car. The enormous inequalities between my world and hers struck me as never before. The child in my arms was about the same age and no smarter, cuter, or better than hers. Yet due to mere circumstance of birth, I knew my son would have many more opportunities in life, while this mother and her child would struggle to survive each day to the next.

 

It’s been 20 years since that fleeting moment, but the vision of the mother and her child has stuck with me. It drove me to change careers and join Save the Children, where we work tirelessly to ensure that every mother and child has a fair chance in life.

 

These days, more and more mothers in urban areas are seeking better opportunities for their children. That’s why Save the Children’s new report, State of the World’s Mothers 2015: The Urban Disadvantage — released with support from Johnson & Johnson — focuses on the health and survival of moms and babies in cities. The findings reveal a harrowing reality: for babies in the big city, their survival comes down to their family’s wealth.

 

I have been back to Manila many times. I am happy to report that, along with other urban centers in the Philippines, it is an example of how cities can narrow survival gaps between the rich and the poor by increasing access to basic maternal, newborn and child services, and making care more affordable and accessible to the poorest urban families.

 

A child’s chance of dying before his fifth birthday has been steadily declining over the years among the poorest 20 percent of urban families in the Philippines. From when I first visited that country in the mid ‘90s until today, child mortality rates among the urban poor have been cut by more than half and the urban child survival gap has narrowed by 50 percent between wealthy and poor kids.

 

Sadly, the Philippines is one of just a few countries with such dramatic improvements for poor urban children. In too many countries, urban child survival inequality is worsening, even as those nations have been successful in reducing overall child mortality rates.

 

In my travels throughout the developing world, I’ve never had to look very far to see evidence of these differences. For example, in New Delhi, India – a city with one of the largest health care coverage gaps between rich and poor – it is not unusual to see a gleaming hospital steps away from a sprawling slum, and to have babies literally dying on the doorstep.

 

But it’s not just in the developing world where our report found stark disparities between the haves and have nots. In our nation’s capital, Washington, D.C., a baby born in the lowest-income district, where half of all children live in poverty, is at least10 times as likely as a baby born in the richest part of the city to die before his first birthday. And while Washington, D.C. has cut its infant mortality rate by more than half over the past 15 years, the rate at which babies are dying in the District of Columbia is the highest among the 25 wealthiest capital cities surveyed around the world.

 

We all have a lot more work to do to ensure that every mother has the same opportunities for her baby, whether she lives in Manila, Washington, D.C. or anywhere else in the world.

 

Find out more about Save the Children’s new report atwww.savethechildren.org/mothers.

Where Health and Education Meet, Children Win

The following blog first appeared on The World Bank.

 

Every mom wants a healthy baby. And in the early days of a child’s life, parents and doctors understandably focus on how the baby’s physical development—is she gaining weight? Is he developing reflexes? Are they hitting all of the milestones of a healthy and thriving child?

 

But along with careful screenings for physical development, there is an excellent opportunity to tap into those same resources and networks to promote early cognitive, socio-emotional, and language development. This helps children everywhere have a strong start in life, ensuring that they are able to learn as they grow and fulfill their potential throughout childhood.

 

Save the Children works with partners around the world to integrate early childhood development interventions into programs in innovative ways—figuring out what works in local contexts and building an evidence base with governments to effectively support children and parents in the early years.

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In El Salvador, for example, we worked jointly with the Ministry of Health and National Academy of Pediatricians to design a screening tool to measure development in children under five. This empowers doctors and health workers to screen for development alongside health check-ups. Now when parents take their children to “healthy child control’’ checkups, children receive a comprehensive developmental evaluation so that the medical staff can identify risks early and advise on age-appropriate activities. By encouraging parents to exclusively breastfeed for the first six months or mimic the babbling sounds that their two to four-month old baby makes, these health experts are putting parents and young children on the path to success.

 

Medical staff in communities throughout El Salvador have been trained on this screening tool, and among 100 health centers evaluated, Save the Children found that not only are medical staff using the screening tool, but 95% are using it properly. The program has been brought to schools nationwide, and the Ministry of Health expects to reach hundreds of thousands of children, from birth to age five, in the early years of implementation.

 

Non-state actors like Save the Children can work with governments to find innovative approaches that meet the specific needs of the local population, and government commitment can turn this approach into scalable, sustainable change for children. This type of partnership is a win-win: When all parties are willing to look at a problem from new angles, real and lasting solutions can help children in those critically important first few years of life.

 

Thanks to our early experience and success, Save the Children was invited to be part of the El Salvadoran government’s team to design the new national early childhood development curriculum. We are now, along with other organizations, supporting the national roll-out of the curriculum and providing feedback to the government on community and center-level implementation.

 

Early childhood development is not limited to health, and it begins long before a child enters the classroom. Now, thanks to the leadership of the El Salvadoran government, the partnership of NGOs like Save the Children, and the support of health workers, parents and communities, children across the country are getting a stronger start in life—and the chance to build a better future for themselves.

The World’s Ebola Crisis: Disastrous for Mothers and Daughters

In the course of a regular day with my 13 year-old daughter, I check in on how her day went and tell her I love her.  It’s pretty standard stuff for moms.  And as President and CEO of Save the Children, I’ve seen how children’s health, happiness and safety are paramount to mothers in every corner of the globe. That’s why last week, when I called my daughter from Liberia, I stayed on the phone a little longer than usual—so grateful to hear her voice and know she was safe and well.

 

The conditions in Liberia, where Save the Children is responding to the Ebola epidemic, are some of the worst I’ve ever seen.  Children are always among the most vulnerable in a crisis and this is no exception—2.5 million children under five are living in the hardest-hit areas across the region, and 75% of all children infected in the current epidemic have died. Even those who are not infected themselves risk losing their parents to this terrible disease and often end up alone and ostracized by their communities. Fear, like the virus, is spreading rapidly.

 

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Martheline with her three younger siblings, who she is now caring for in the wake of their mother’s death from Ebola.

I met a young girl named Martheline, who is about my own daughter’s age. When her mother became ill with the Ebola virus, there was no money for a doctor and no way to access local services. Martheline nursed her mother at home, and then mourned her when she passed away.  Having lost her father several years before, Martheline was left to care for her three younger siblings—while a fearful community left them to fend for themselves. Even though they were not infected by the virus, every day has become a struggle for survival.

 

This crisis is also taking a toll on the incredible progress the world has made to reduce maternal, newborn and child deaths in Liberia and around the world. Already weak health systems are collapsing under the strain of the outbreak and many health facilities are closed—meaning that children are missing out on vaccinations and basic health care, putting them at great risk for preventable childhood diseases, and more women are giving birth at home in dangerous conditions. The effects of this virus are devastating and far-reaching.

 

The people I met in Liberia are no different than those I’ve met anywhere else in the world. They want the chance to be self-sufficient. They want to be able to support their families. They want to live with dignity and pride.

 

The most important thing we can do now is to focus on giving those affected by Ebola the chance to live safe, healthy lives once again. That’s why Save the Children is joining forces with those in the region to halt the spread of Ebola. In Liberia, we’re building Community Care Centers to provide community-based care closer to home, training health workers, and providing medical equipment and protective kits to families. We’re also working with orphans and other vulnerable children to ensure they are protected in this time of crisis by providing survivor kits to meet their basic needs and reuniting them with extended family whenever possible.

 

I know it can be easy to feel hopeless in the face of such devastating death and disease. But the global health community has already proven that by working together and partnering with people on the ground, progress is possible. Together, we eradicated smallpox. We are well on our way to do the same with polio, yellow fever and measles. 17,000 fewer children die each day than in 1990. There are millions of children alive today because we believed in the power of local health systems and we believed in the power of working together.

 

We must act now to support mothers, daughters, families and communities in Liberia, Guinea and Sierra Leone. Martheline didn’t just lose her mother to Ebola—she lost her childhood to the virus. It’s up to us to make sure she doesn’t lose her future too.

 

Donate today to help Save the Children build and manage Community Care Centers for Ebola patients and their families and distribute Survivor Kits to meet orphaned children’s basic needs.