A lifetime of good
health begins in childhood.

Every year, more than 5 million children under age 5 — and 200,000 women — die from preventable or treatable causes, most of them in low- and middle-income countries and especially in sub-Saharan Africa and central and southern Asia. For mothers, these causes can include hypertension, infections, complications around delivery and postpartum bleeding. For newborns, causes include prematurity and complications during birth. Severe infections account for nearly half of under-5 child deaths. 
 
The broader drivers for these poor outcomes are many, including lack of access to quality care, malnutrition, poor sanitation and hygiene, low levels of health literacy and education, gender inequality and discriminatory cultural practices, weak health systems and other socioeconomic factors that create health disparities.  


But, again, most maternal and child health concerns are treatable or entirely preventable. Strengthening health systems, promoting access to water, sanitation and hygiene, and improvements to nutrition can go a long way toward keeping mothers and children healthy. Immunizations alone are extremely cost-effective, yielding up to a 44-fold return on investment in lower-income countries.

 

Leveraging community health workers

We train and deploy community health workers to provide antenatal care, education on safe delivery practices, and routine immunizations directly in communities, ensuring that even the most remote or marginalized populations have access to essential maternal and child health services. 

Engaging community leaders and networks

We collaborate with local leaders, women's groups and community networks to promote the importance of antenatal care visits, immunizations and proper nutrition ֫— and to advocate for safe deliveries, whether at home with a skilled birth attendant or in a health care facility.

 

Educating new mothers

Trained community health workers provide comprehensive education to new mothers on the importance of antenatal care, immunizations, proper nutrition and safe delivery practices, supporting them with the knowledge to make informed health decisions for themselves and their children. 

Connecting mothers to essential services

We facilitate access to health care by linking new mothers with local health services, including skilled birth attendants, immunization programs and nutritional support, ensuring they receive the care necessary for a healthy pregnancy and childbirth. 

Featured Projects

The Busia Maternal Newborn & Childhood Survival Project | Uganda 
Using a community-based engagement approach, this three-year project led to a decrease in childhood illnesses, increased awareness on pregnancy, delivery, postpartum and newborn danger signs.
 
Lessons Learned from a Strengthened Partnership for Nurturing Care 2018 – 2021
With funding from the Conrad Hilton Foundation, ChildFund led a multi-country initiative to address the needs of caregivers and their young children (3 and under) affected by HIV and AIDS in sub-Saharan Africa.
 
Child Health Innovation | Honduras
This USAID-funded project implemented community-based structures and strengthened the public health system, resulting in increased caregiver understanding of young-child health and when to seek care and births assisted by qualified health workers and hospital deliveries.

If children are malnourished, especially in their earliest years, they simply can’t access the foundational learning, growing and interacting that they must to reach their full potential. Proper nutrition is crucial at all stages of life and during pregnancy, and without it, children can face a range of short- and long-term health issues, including increased risk of developmental delays, weakened immune systems and chronic conditions such as diabetes and heart disease later in life. 

Unfortunately, the world is currently off track to meet 2025 global nutrition targets. Currently, the number of stunted children under 5 years old is projected to be 128 million in 2025 (with a target of 100 million). Low birth weight rates are stagnant, making it unlikely that the 30% reduction target will be achieved.  

Malnutrition is common in many regions where ChildFund works. These communities are particularly vulnerable due to poverty, food insecurity and limited access to health care, making nutrition programming critical for improving health outcomes, fostering economic development and breaking the cycle of poverty. Yet proper nutrition programming can significantly reduce under-5 deaths and prevent diseases related to malnutrition for all children. 

ChildFund programming works to reduce malnutrition by promoting healthy infant and young-child feeding practices, training and mobilizing community health workers to provide nutrition services, and connecting families with local health services. Our nutrition programming is often conducted in tandem with early childhood development programming and builds on health and nutrition aspects found within the Nurturing Care Framework. 

Strengthening Health Systems 

By integrating nutrition interventions into existing health systems, countries can ensure sustainable, equitable access to quality nutrition care, particularly for vulnerable populations. Strengthening health systems to improve nutrition involves addressing health care infrastructure, workforce and supply chains to deliver essential nutrition services, such as micronutrient supplementation, counseling and malnutrition treatment.

Reaching the Most Marginalized Groups

Ensuring equity when delivering community-based nutrition programs requires targeting the most vulnerable and marginalized populations, including women, children and those in remote areas, to address disparities in access to nutrition services. Tailoring interventions to meet the specific needs of diverse communities helps overcome barriers and ensures that all individuals can achieve optimal nutrition and health outcomes. 

Active Community Engagement

Mobilizing and training community health workers to regularly screen, identify and treat cases of acute malnutrition ensures early intervention and increases coverage of nutrition services, particularly in hard-to-reach areas. Results from a systematic review suggest that nutritional status of children in all studies improved and this was evidenced by increases in weight, height, mid-upper arm circumference and reduced morbidity.

Promotion of Infant and Young Child Feeding (IYCF) Practices

Educating caregivers on the importance of exclusive breastfeeding for the first six months and introducing nutrient-rich complementary foods thereafter can significantly improve child nutrition and reduce malnutrition rates. The Sustainable Nutrition Education and Health (SNEH) Project in India targeted children and pregnant and lactating women in 33 villages in Madhya Pradesh, resulting in a 96% reduction in malnutrition among children under 5. Learn More

Featured Projects 

MUKTI TB Project | India
This innovative, results-based financing (RBF) initiative in Madhya Pradesh, India, included an intensive nutrition intervention, utilizing home visits, counseling, food basket distribution and assistance in obtaining government benefits to enhance the nutritional status of tuberculosis patients.

Ensuring Children’s Nutrition and Age-Appropriate Development in Mullaitivu Project (ECNAAD) | Sri Lanka
The integrated approach of this program considered the different factors that influence a child’s health and development, such as family health habits, personal and environmental hygiene, safe water and sanitation practices and food security. Results from the evaluation report showed that the percentage of children 0-5 years old who measured within the appropriate weight for their age increased from 36.61% to 91.7%.

Ensuring Health, Nutrition and Children’s Education (ENHANCE)
This multi-country project implemented in Indonesia, Sri Lanka and the Philippines reflects global efforts to strengthen and advocate for children’s access to quality nutrition, health, education and early childhood services. The endline survey found that 61% of malnourished children’s nutritional status improved.

Inadequate sexual and reproductive health (SRH) remains a critical issue in many parts of Africa, Asia and Latin America, where limited access to these services leads to high rates of maternal mortality, unintended pregnancy and sexually transmitted infections. In these regions, annually, there are more than 111 million unintended pregnancies and 35 million unsafe abortions, as well as 16 million women and 13 million newborns not receiving care for complications related to pregnancy and childbirth. Significant challenges that impact SRH access include cultural barriers, gender inequality and insufficient health care infrastructure.  

Comprehensive SRH programming empowers individuals, particularly women and girls, to make informed decisions about their bodies and futures, promoting gender equality and enhancing their participation in social, economic and political life. Contraception and family planning also help to break intergenerational poverty by supporting young people to make positive decisions on the timing and size of their families. 

By collaborating with local organizations, leaders and advocacy groups, and engaging community health workers to promote SRH awareness and address cultural and social barriers, we work to foster community support and increase the uptake of SRH services and practices. 

Systems strengthening involves resourcing health care facilities to enhance their capacity and includes training health care providers and ensuring the availability of essential SRH services and supplies, such as contraception and maternal care. Since comprehensive universal health care includes sexual and reproductive health, with SRH integrated into primary health care and improved service delivery, health systems can provide more equitable, accessible and better-quality care, reducing SRH-related morbidity and mortality.  

Ensuring equity in SRH Programming requires targeted efforts to reach marginalized and vulnerable populations, such as women, adolescents and people in rural or underserved areas, who often face the greatest barriers to accessing care. This involves tailoring services to meet the diverse needs of different communities, addressing cultural and gender norms and removing economic and geographic barriers so that everyone has equal access to comprehensive SRH services and information.  

Empowered Youth

For adolescents to fully transition to healthy young adulthood, they must have the power to make decisions about their own bodies. Peer exchange clubs and outreach initiatives to deliver SRH services in remote or underserved areas can help overcome geographic barriers and stigma while improving access to necessary care and products. Learn More:  PASSAJE Project to increase access to quality reproductive and menstrual health services | Senegal

Innovation

ChildFund has implemented several innovative digital SRH programs in Brazil, Guinea and India. These projects have used multiple modalities to reach young people via innovative apps and existing platforms such as WhatsApp to increase their knowledge on SRH and promote health seeking behaviors.

Featured Projects

Girls' Adolescent and Reproductive Rights: Information for Management and Action (GARIMA) | India  
GARIMA, which means “dignity” in Hindi, provides adolescents with age-appropriate knowledge on sexual and reproductive health and how to adopt safe and healthy SRH practices, and provides access to adolescent-friendly counseling and services. GARIMA is also an example of building our programs to scale to reach significant populations through a program model approach. Learn More: GARIMA – A Comprehensive Program Model on Adolescent Reproductive and Sexual Health Education  

Assuring the Essentials of Optimal Development for Children affected by HIV and AIDS | Kenya and Zambia 
The aim of the project was for children aged 0-5 years in communities affected by HIV and AIDS to meet their developmental milestones while being supported by responsive male and female caregivers. Learn More: Stories of Most Significant Change | Kenya and Zambia Endline Evaluation Report | Kenya and Zambia Nurturing Care Project 

There is nothing more fundamental to a child’s health and well-being than clean water. Poor sanitation and unsafe drinking water are major contributors to malnutrition and stunting in children. Inadequate water, sanitation and hygiene (WASH) infrastructure also contributes to the spread of waterborne diseases such as cholera, diarrhea and typhoid, which are leading causes of illness and death in low- and middle-income countries. According to the WHO, 1.4 million annual deaths could be prevented with safe WASH. Strengthening WASH systems in these areas is essential for improving public health, reducing disease transmission and fostering sustainable development. 

The effects of poor sanitation and lack of clean water extend beyond health: Women and girls most often bear the responsibility of collecting water and managing fuel sources needed to boil water and ensure it is clean enough to drink. Improved WASH facilities reduce the time and physical burden associated with these tasks, enhance educational opportunities for girls and improve overall gender equity. Access to clean water and proper sanitation also improves overall public health, which leads to reduced community health care costs and increased productivity. Investments in WASH programs yield significant economic returns by creating healthier communities that can fully participate in economic activities. 

ChildFund’s interventions to promote public health through enhanced access to water, sanitation and hygiene knowledge and infrastructure include improving access to water and sanitation facilities, supporting local water and sanitation committees to manage and maintain water sources, and educating children and families on the importance of safe water and healthy practices. We also work through local partners to establish robust monitoring and evaluation systems and support capacity-building for local authorities and service providers. All of this ensures the reliable and sustainable provision of WASH services, leading to better health outcomes and improved quality of life for communities.  

Local Water and Sanitation Committees

Establishing and empowering local committees to oversee the management and maintenance of water sources and sanitation facilities ensures community involvement and ownership, which can improve the sustainability and effectiveness of WASH interventions. 

Behavior Change Campaigns and Education 

Implementing targeted education programs that promote the benefits of safely managed drinking water, proper sanitation and handwashing can shift community behaviors and increase the adoption of healthy practices. This includes training on the use and maintenance of facilities and the importance of hygiene. 

Incentives and Support for Facility Upgrades

 Providing financial and technical support to households, schools and health centers for upgrading to improved sanitation facilities and safe water systems, combined with incentives for adopting hand washing practices, can enhance access and encourage consistent use of WASH services. 

Featured Projects 

Community and School WASH project in Mukuru and Kasarani Informal Settlements, Nairobi | Kenya
The goal of this program was to deliver WASH interventions to improve waste disposal, increase access to and use of safe water, improve hygiene practices in households and decrease waterborne diseases among children between 0-14 years. Learn More

WASH Project in Oromia Region | Ethiopia
This project addressed the lack of potable water in this region through restoring damaged boreholes and public water fountains, providing structure maintenance and promoting public health information on environmental sanitation. This led to improved access to safe water for the communities and public health awareness and hygiene promotion for more than 64,932 people affected by drought. Learn More

Nairobi WASH (Mazingira Bora) project | Kenya
This project provided water, sanitation and hygiene interventions aimed at improving management of waste disposal, increasing access to safe water and improving hygiene practices to decrease waterborne diseases among children ages 0-14. Use of mico-membrane filters increased from 1% to 76.20%. Children’s water access increased from 77% to 89.7%, and the rate of water systems protected from contamination increased from 38% to 41%. Learn More 

Procter & Gamble Children’s Safe Drinking Water Program (CSDW) 
This program focused on increasing access to safe and clean drinking water for people using water from unprotected sources (earth dams, sand dams, hand-dug wells) and increasing community awareness and knowledge of the use of safe and clean water; impact groups of focus included children under 5 as well as people living with HIV or AIDS in an effort to reduce morbidity cases related to the consumption of unsafe water. The project helped to increase household use of treated water by 53% (from 46% to 99%). Learn More

Malaria remains a leading or the leading cause of death for children under 5 in many countries in Africa where ChildFund operates. Tuberculosis is the second leading infectious disease killer after COVID-19 globally, above HIV and AIDS. Globally in 2022, there were an estimated 249 million malaria cases in 85 malaria endemic countries, an increase of 5 million cases compared with 2021. In 2022, TB caused an estimated 1.30 million deaths. And although there are easy, cost-effective strategies to reduce the incidence of both malaria and TB, these threats still persist, especially in low- and middle-income countries. 

Malaria and TB disproportionately affect vulnerable groups, including children under 5, pregnant women, people living with HIV, and those with weakened immune systems. Targeted programming helps protect these at-risk populations. Programming aimed at prevention and treatment can also help mitigate economic and social impacts, like reduced workforce productivity and increasing health care costs. 

Effective programming including education and awareness can lower this risk and is essential to reduce the incidence and mortality rates associated with these diseases. ChildFund promotes infectious disease prevention and control by engaging and educating communities around preventive practices, as well as testing and treatment for malaria and tuberculosis and training community health workers to reach communities in the most remote areas. 

Empowered Community Health Workers

Training and deploying local health workers to provide education, conduct testing and distribute preventive measures – like insecticide-treated bed nets – ensures that malaria and TB services reach even the most remote and underserved populations. 

Community Outreach Programs 

Conducting regular outreach in rural and hard-to-reach areas improves access to malaria and TB testing, diagnosis and treatment, reducing the disease burden by identifying and treating cases early.  

Community Engagement and Education

Involving community leaders and members in awareness campaigns and educational programs helps build trust, encourages preventive practices, and ensures that individuals seek timely testing and treatment for malaria and TB. Community participation strengthens the capacities of health systems to prevent and control tuberculosis and allows a better understanding of the disease from the patient and community perspectives. 

Featured Projects 

MUKTI TB Project | India 
This innovative, results-based financing (RBF) initiative in Madhya Pradesh, India, included an intensive nutrition intervention, including home visits, counseling, food basket distribution and assistance in obtaining government benefits to enhance the nutritional status of tuberculosis patients. Learn More

Busia Maternal Newborn & Childhood Survival (MNCH) Project | Uganda  
This intervention contributed to improved knowledge of positive pregnancy, postpartum and family health care, including the importance of early childhood immunization. Women aged 15-49 who knew at least four maternal danger signs during pregnancy increased by 13%, and mothers aware of at least four key child family health care practices (such as immunization) increased by 29%. Learn More | Evidence Snapshot