Enhancing Nutrition Services to Improve Maternal and Child Health (ENRICH)

Bangladesh|Thakurgaon District

Thakurgaon is a district in northwest Bangladesh, bordering India. A largely agricultural area, it has struggled economically for years, hampered in part by long distances to the market and investment sources of the capital, Dhaka.

Community surveys show that 39 percent of children under age 5 are stunted. Low birthweights are chronic, at 25 percent of live births. 1000 Day Journey will target health interventions for women and children under age two. We'll work closely with local government officials to strengthen services in ways that are sustainable, and promote gender inclusive practices that empower women as agents of change.

Kenya|Elgeyo Marakwet County

The fertile and visually striking Rift Valley forms the eastern boundary of Elgeyo Marakwet County in western Kenya. It's an area where Homo erectus fossils date back almost 2 million years! But life today is a struggle when it comes to child and maternal health.

Child malnutrition exceeds the country average with 36 percent of children under the age of five stunted, and 19.5 percent underweight. World Vision knows the needs in the area. Since 2013, we've worked with government to establish 10 Community Health Units and train 200 Health Volunteers. 1000 Day Journey will build on these successes to strengthen all 25 Health Units in the area. A focus will be the empowerment of women to use their influence – ensuring health policies are followed through.

Myanmar|Thabuang Township

Thabuang Township is located in the massive Ayeyarwaddy River delta at the Andaman Sea. The area is extremely remote – the township's 400 villages are accessible only by boat during the May to September rainy season.

According to a 2015 survey, maternal mortality is 237 deaths per 100,000 live births. Child malnutrition is also high with 41 percent of children under age five exhibiting stunting. Interestingly, due in part to the Burmese culture, gender-disaggregated data shows little difference between men and women in health status. But women's voices are not well represented in decisions made about healthcare. 1000 Day Journey will help build women's leadership capacity in remote villages.

Tanzania|Singida and Shinyanga Regions

World Vision has experience supporting families in central Tanzania through a previous government grant. 1000 Day Journey will take the successes of that program to communities not yet reached in Singida and new communities in Shinyanga. The program will focus on training front-line health workers, distributing micronutrient powders, and the introductions of bio-fortified crops.

Cultural practices such as early marriage, gender-based violence and the devaluing of girls will be addressed. One approach to be used is Channels of Hope, a World Vision signature program that facilitates dialogue between women and men, leading to new knowledge and changed behavior in gender relations. The approach is often centered in local churches and mosques to maximize impact.