1000 Day Journey is a new women and children’s health program operating in four countries.
At nearly 160 million inhabitants and a landmass just twice the size of New Brunswick, Bangladesh is a densely populated country. An abundance of cheap labour has fueled rapid growth, with Bangladesh aspiring to be a middle income country by 2021.
But many are left behind. Almost two in five children under age five are stunted, a consequence of poor nutrition early in life that affects a child’s ability to develop and learn. Also critical in Bangladesh is gender inequality. Women’s wages are as low as $1 a day, 66% of adolescent girls are in early marriages, and more girls are underweight compared to boys.
Thakurgaon District – 1000 Day Journey focus area
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.
Thinking of Kenya might draw to mind images of game parks, long distance runners, or the bustle of the capital city and regional hub, Nairobi. But breaking into our consciousness are new images, as drought ravages half the country and the number of food-insecure Kenyans has recently doubled to 2.7 million people.
In rural Kenya, women bear the sole responsibility for maternal and child health. Mothers-in-law often have greater influence on feeding practices than young mothers. Yet it is men who manage the resources and decisions around health. And something is not working: among the five 1000 Day Journey countries, Kenya has the highest maternal mortality rates, at 510 per 100,000 live births (compared to just 7 in Canada).
Elgeyo Marakwet County – 1000 Day Journey focus area
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 (also known as Burma) is one of the poorest countries in Southeast Asia, after years political and economic mismanagement along with international isolation. There is more hope today since former political prisoner and human rights activist, Aung San Kyi, won a political majority in 2015. With this country opening up to the rest of the world, World Vision has recently started operating in Myanmar.
History has left the country’s general state of health is in poor shape. Even today, Myanmar’s government spends less than 3 percent of the country’s Gross Domestic Product on healthcare, less than any other country in the world. Canada spends 11 percent of its GDP on healthcare.
Thabuang Township – 1000 Day Journey focus area
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.
The people in Tanzania are among the poorest in our five program countries. Still, the country has made progress in reducing under-five mortality rates – from 165 deaths per 1,000 live births in 1990 to 49 today. But poverty and malnutrition are deeply related, and 1 in every 3 Tanzanian children today is stunted.
The Tanzanian government recently launched a major health program in rural regions to maintain past gains and address stubborn issues like stunting. Officials recognize that gender discrimination and cultural norms are barriers to women and girls accessing health services and nutritious diets. They also note that the capacity of rural health systems is critically limited. Singida and Shinyanga Regions – 1000 Day Journey focus area
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.