Global Health Key Programs
Delivering Adolescent Sexual & Reproductive Health in Sierra Leone
In Sierra Leone, teenage pregnancy rates are estimated at 21%, with 45% of 19-year-olds having started childbearing and 20% of all deaths among girls and young women are pregnancy related (DHS, 2020). We address some of these challenges through a diverse range of programs that prioritize meaningful adolescent engagement and partnership. We engage adolescents in the design, implementation, evaluation, learning, and partnering with youth-led organizations. We also work within communities through health workers and champions, at the district and national levels, to improve access to quality adolescent-friendly, gender transformative sexual, reproductive and child health services, and reduce adolescent pregnancy.
Connect
Connect (2019-2023), a 4.5-year project funded by the Bill & Melinda Gates Foundation, enhances large-scale health and development projects to improve health outcomes among young first-time parents (FTPs). Connect integrates postpartum family planning (PPFP) for FTPs into the community-based nutrition Lishe Endelevu project in Tanzania; in Bangladesh, Connect enhances the MaMoni Maternal and Newborn Survival Project to improve coverage, timing, and quality of postnatal care, inclusive of PPFP, for FTMs. By leveraging existing projects with light-touch facility- and community-level approaches, Connect effectively and efficiently supports this population.
Growing Up GREAT!
Growing Up GREAT!, implemented under the USAID-funded Passages Project (2015-2021), is a scalable, multi-level intervention designed to improve sexual and reproductive health (SRH) and gender equity among very young adolescents (VYA) and the important adults in their lives. It supports VYAs and their caregivers, teachers, health providers, and communities to question and break down social barriers that prevent access to health information and services. Growing Up GREAT! was piloted in the Democratic Republic of the Congo in 2017-2018. An evaluation by the Global Early Adolescent Study found that the intervention improved SRH knowledge and VYA relationships with caregivers, and also shifted key SRH attitudes and behaviors.
Healthy Transitions for Nepali Youth
In 2019, Save the Children launched the Healthy Transitions for Nepali Youth Project (HTNYP) in four districts of Karnali Pradesh Province in the hill region of Nepal to support unmarried and married adolescent girls and young women (AGYW) aged 15–24 years as they transition to marriage and parenthood. HTNYP engages young women, their husbands when applicable, their parents or in-laws, and the community in interventions to improve reproductive, maternal, and newborn health (RMNH) knowledge and practices, as well as increase gender equality in household decision making. HTNYP also supports quality improvement of RMNH services to ensure they are available and responsive to the needs of youth. Evidence from the first cohort of AGYW who participated in HTNYP demonstrates that reaching them using a robust socio-ecological approach has potential for short- and long-term positive outcomes for RMNH behaviors. Our findings show that women’s attitudes towards RMNH care-seeking behavior, as well as their knowledge, significantly increased for several key indicators. Details from the evaluation may be found on the Healthy Newborn Network.
USAID Kulawa & Tipping Point
USAID Kulawa (2020-2025) is the USAID Resilience in the Sahel Enhanced II (RISE II) Health Services Delivery activity in Niger, which works to improve access to and use of quality health services, strengthening ownership and management by communities, local government, and service providers. Kulawa—meaning “care” in Hausa—strives to close the equity gap in maternal, newborn, and child health (MNCH), family planning/reproductive health (FP/RH), and nutrition service access and use, with a special focus on youth. USAID Kulawa will also provide an implementation platform for Tipping Point, a 4.5-year research study funded by the Bill & Melinda Gates Foundation and led by the University of California San Diego. Tipping Point will use a three-arm study to explore whether a social network-based intervention is more effective and more scalable than traditional approaches to improving family planning uptake among married adolescents and youth 15-24. Save the Children will implement Tipping Point’s innovative social network-informed intervention as part of Kulawa’s youth and family planning interventions.
USAID Kulawa
USAID Kulawa (2020-2025) aims to increase utilization of quality child health, family planning, and nutrition services in 17 districts across three regions of Niger. USAID Kulawa—meaning “care” in Hausa—seeks to improve access to quality health services and strengthen ownership and management of health services by communities, in partnership with citizens, government, and service providers. In 2022, 246,897 children under-five were treated for diarrhea. In addition, a total of 193,070 children were immunized against measles before their first birthday. To strengthen health coverage and reach zero dose and under-immunized children, the project supported outreach and mobile clinic activities to reach 18,030 children with immunization services in 2022.
CORE Polio Ethiopia and Nigeria
In Ethiopia, Niger, and Nigeria, the USAID-funded CORE Polio projects aim to contribute to the eradication of polio, strengthen routine immunization in key areas and ultimately reduce the rates of child deaths and disease caused by vaccine preventative diseases (VPDs). Each project aims to build partnerships between international, national, and sub-national organizations involved in polio and support organizations in their efforts to strengthen national and regional routine immunization systems. These projects also support organizations’ efforts to detect and report cases of polio, as well as other infectious diseases, and support timely documentation and use of information to continuously improve the quality of polio eradication (and other related health) activities.
Zapim II
Save the Children is a partner to the Abt Associates-led Zimbabwe Assistance Program in Malaria (ZAPIM) II (2021-2026), which aims to enhance coverage of malaria control and elimination measures. Focus areas include case management and malaria during pregnancy; provision and distribution of long-lasting insecticidal nets; social and behavioral change communication; operations research; and comprehensive monitoring and evaluation. Save the Children is leading the social behavior change and community-level activities including community action cycle and case management. We work in 12 districts of three provinces and have trained 447 volunteer health workers (VHWs) and refresher trained an additional 1,022. We improve quality of care by supporting 527 peer supervisors who provide more immediate supervision to VHWs.
Global: USAID MOMENTUM Country and Global Leadership project
Save the Children is a core partner in the Jhpiego-led MOMENTUM Country and Global Leadership Project (2020-2026), providing leadership on child health, newborn health, nutrition, community health, adolescent health, and water, sanitation, and hygiene (WASH). Our work includes promotion of effective integration across these areas. Current areas of focus include: improving the quality of facility-delivered health care for children, including small or sick newborns; strengthening the delivery of services that are part of the Integrated Management of Childhood Illnesses (IMCI); addressing inequities in access to care by strengthening community health services for children, especially the effective management of pneumonia, diarrhea, malaria, and malnutrition; and working at all policy levels – global, national, and sub-national - to bring renewed focus to those children most at-risk from these still-too-common childhood killers. To date, child health activities have been part of the project’s work in Ghana, Indonesia, Kenya, Madagascar, Malawi, Nigeria, Sierra Leone, Uganda, and Zambia.
Reducing Infectious Disease in Children under Age 5 in Kenya
This Pfizer Foundation-funded three-year project (2020-2022) increased sustainable immunization among populations with low coverage in Kenya. Our collaborative efforts with the MoH improved access to and use of high-quality immunization services among semi-nomadic and nomadic pastoralists in Mandera and Wajir counties, and in the Kibera urban slum of Nairobi County. The project facilitated full immunization coverage for 93,879 children and we reached 200,554 community members with relevant messages on health, nutrition, and child vaccination. Immunization coverage increased in the project area by 26 percentage points (from 62% at baseline in 2020 to 88% at endline in 2022), contributed to a decrease in the incidence of vaccine preventable disease outbreak among children, including childhood pneumococcal disease, rotavirus, and diarrhea, and a reduction in overall under-five mortality.
By project end, we strengthened MoH and public health systems in Nairobi, Mandera and Wajir counties to ensure that routine and supplementary immunization activities are carried out efficiently by the government and that strategies are in place to reach unvaccinated children in the hard-to-access areas. Additionally, we also extended our support to the Kenya MoH for the transition from Gavi (the Vaccine Alliance) support to a self-reliance national immunization program in near future. Results from a cost-efficiency analysis of this project in Kenya revealed the approximate cost for a fully immunized child as $21 US dollars, while the per capita cost for communicating health messages to community members and health care worker training was $10 US dollars, and UNICEF estimated approximately $32 US dollars as vaccine delivery cost (=total cost – cost of vaccine and supply) per fully vaccinated child with standard schedule for children < 24 months).
Save the Children has supported HIV and TB programs through the Global Fund to Fight AIDS, Tuberculosis and Malaria’s country and regional grants since 2009. From 2021-2023, we will support six Global Fund countries: Bangladesh, Bhutan, Cote d’Ivoire, Mali, Myanmar, and Nepal. Our programs target key populations including orphans and vulnerable children, youth at risk, pregnant mothers and their children. We focus on providing prevention services/treatment, counseling, case management, improved quality of care, strengthened diagnostic technology, improved governance and accountability of programs, strengthened disease surveillance, and treatment options.
Bangladesh | HIV
Save the Children, in a leading role in the national HIV and AIDS response in Bangladesh, has managed five HIV grants of the Global Fund in two capacities – management agency (2004-2009) and principal recipient (2009-2023). The present grant (2021-2023) provides high-impact and cost-effective interventions for key populations to prevent the spread of HIV and minimize the impact of AIDS on individuals, families, and communities affected by the epidemic. In collaboration with the Government of Bangladesh, our program covers 18 districts. In partnership with five local partners, they provide HIV prevention services, increase access to testing and treatment, and strengthen the national HIV and AIDS response through supporting a functional health information system, improved reporting, and enhanced capacity of healthcare personnel. Since 2021, we have expanded our program to reach 14,035 people who inject drugs, representing a 48% increase in coverage from the previous grant period and 30,000 female sex workers (62% increase in coverage).
Global Fund HIV Program Fact Sheet - Bangladesh 2021-2023
Bhutan | HIV
The Sustainability of HIV Services for Key Populations in Asia Program (SKPA)-2 (2022 - 2025) is implemented through the Save the Children Country Office in Bhutan. The SKPA-2 Program partners with governments, key populations, and their communities to increase the financial sustainability of community-focused programs, strengthen the use of real-time high-quality data to inform programmatic design, bridge HIV service delivery gaps, and work on strengthening systems that support community ownership and action. One of the main achievements of this program is the successful implementation of the HIV self-testing demonstration project. The scale-up of this innovative approach is expected to enhance access and uptake of HIV testing that can potentially contribute towards closing the current case detection gap.
Global Fund HIV Program: Bhutan Fact Sheet 2021-2023
Côte d’Ivoire | Malaria
Save the Children has been the principal recipient of the Global Fund malaria grant in Côte d’Ivoire since 2016. Through this grant, Save the Children and our five sub-recipients support the National Malaria Strategy Plan 2021-2025, which prioritizes the need to scale up an integrated and optimized package of community-based activities to optimize the efforts of the Ivorian government to combat malaria. The project aims to achieve effective control of malaria in Côte d’Ivoire by 2025 via three objectives (i) - Reduce malaria incidence by at least 75% compared to 2015; (ii) - Reduce the mortality due to malaria by at least 75% compared to 2015; and (iii) - strengthen the program's management, coordination and partnership capacities to provide high-impact interventions. To date, the project has successfully trained an estimated 8,500 community health workers, 2,044 women groups, 271 staff, 1,248 nurses, and 1,147 midwives across 53 health districts and 16 health regions.
Global Fund Malaria Program Fact Sheet - Côte d’Ivoire 2021-2023
Mali | HIV & TB
Save the Children in Mali implements HIV programs in partnership with the Global Fund through a service agreement to reduce illness and death from both HIV and AIDS and TB among vulnerable populations in the health district of Mopti, one of the most conflict-affected regions in central Mali. Our work focuses on strengthening the health system to provide quality health services to program participants and reducing the burden of HIV and tuberculosis epidemics through effective diagnosis and treatment services. To date, the project has supported 28 health facilities and 52 community health worker sites, treating 185 cases of tuberculosis of all forms and 186 people living with HIV with ART, and tested 14,009 pregnant women to increase the percentage of people living with HIV who know their HIV status.
Myanmar | HIV, TB, and Malaria
Save the Children has been the co-principal recipient of three grants under the Global Fund in Myanmar since 2011. Our HIV programs operate across 117 of 330 townships in the country. We provide comprehensive HIV prevention, diagnosis, and treatment services for key populations, integrated HIV and TB services, promote human rights, and strengthen community systems to create an enabling environment free of discrimination for at-risk and vulnerable populations. Our TB program is active across 182 townships and includes active TB case finding efforts, diagnosis, and treatment through community and facility-based interventions, as well as collaboration with the private sector. Through our malaria program, we provide long-lasting insecticidal nets to vulnerable populations and case management services spanning from early diagnosis through treatment in 132 townships. Additionally, we support capacity building through training on malaria surveillance for service providers and intensified case detection in high-risk areas. In addition to these programs, we received funding to implement COVID-19 interventions, including provision of personal protective equipment to health care providers and communities, effective surveillance, diagnosis, and treatment, community mobilization activities to increase awareness, as well as capacity strengthening of the healthcare workforce across all areas.
Global Fund HIV Program: Myanmar Fact Sheet 2021-2023
Nepal | HIV, TB, and Malaria
In Nepal, Save the Children’s Global Fund programs target HIV, TB, and malaria. Our HIV program contributes to the goals to achieve HIV testing, treatment, and viral suppression rates of 95%--95%--95% by 2025 and increase equitable access to HIV services. Our TB program aims to reduce TB incidence through increased disease prevention, case detection, and diagnosis, TB and HIV co-infection management, and drug-resistant TB management. Additionally, we support Nepal’s long-term National Malaria Elimination Strategy (2014-2025) with the vision of a “malaria-free Nepal by 2025” through our Malaria program. This grant aims to further reduce malaria transmission, improve the quality of and access to early diagnosis and effective treatment, and strengthen programmatic, technical, and managerial capacities towards malaria elimination. Through this effective and sustained programming, Nepal is on track to achieve a malaria-free Nepal by 2025.
Global Fund HIV Program Fact Sheet - Nepal 2021-2023
Global Fund TB Program Fact Sheet - Nepal 2021-2023
Global Fund Malaria Program Fact Sheet - Nepal 2021-2023
Nomadic Health Project
The Nomadic Health Project (2018-2022) is led Save the Children in partnership with the London School of Hygiene and Tropical Medicine, with funding from the Bill & Melinda Gates Foundation. This 4-year project seeks to develop an approach to increase the use of quality family planning services among nomadic and semi-nomadic populations in Kenya and around the world. It aims to do this by engaging regional stakeholders to share lessons on effective, scalable approaches informed by an effective and scalable community health model.
USAID Kulawa
USAID Kulawa (2020-2025) is a multi-sectoral 5-year project funded by USAID that aims to increase utilization of quality child health, family planning and nutrition services in 17 districts across three regions of Niger. USAID Kulawa—meaning “care” in Hausa—seeks to improve access to quality health services and strengthen ownership and management of health services by communities, in partnership with citizens, local government, and service providers. The project aims to reach 1.4 million women of reproductive age, 1.1 million children under five, and 2.6 million youth. USAID Kulawa seeks to build off of the successes of RISE I (a former USAID project) and incorporate key lessons learned to achieve greater impacts on health and nutrition outcomes and enhance the sustainability of institutions and interventions at all levels.
USAID MaMoni Maternal and Newborn are Strengthening Project
The USAID-funded MaMoni Maternal and Newborn Care Strengthening (MaMoni MNCSP) Project (2018-2023) works to substantially improve health outcomes for mothers and newborns in Bangladesh. The project is implemented by a consortium led by Save the Children in 17 districts and an island in Bangladesh, covering a population of ~34.8 million people. MaMoni MNCSP supports the government of Bangladesh to achieve its goal to reduce the maternal and neonatal mortality rate by 2022. To achieve this, it works to increase equitable access to and use of quality, integrated maternal and newborn care (MNC) and postpartum family planning (PPFP) services, especially for the poor and marginalized who are more susceptible to maternal and neonatal deaths. Additionally, MaMoni MNCSP facilitates health system improvements and policy changes for sustained impact at scale.
In response to the COVID-19 pandemic, the project is also working with the Government of Bangladesh to strengthen the health system response to community transmission of COVID-19, minimize health risks to individuals, and avoid adverse health outcomes.
USAID Maternal and Child Health and Nutrition Activity
The USAID Maternal and Child Health and Nutrition (USAID MCHN) Activity (2020-2024) is a five-year program designed to improve maternal, newborn and child health (MNCH) and nutrition outcomes in Uganda. The activity also supports improved delivery of MNCH and nutrition services in Kampala City through strengthening service delivery systems, focusing on the urban poor in public and private sectors.
USAID MNCH closely collaborates with the Government of Uganda at the national and subnational levels, private-sector entities, other USAID projects and development partners. The project is implemented by a consortium led by FHI 360 that includes EnCompass LLC, Makerere University School for Public Health, Save the Children and the Uganda Healthcare Federation.
Save the Children leads in the provision of technical assistance for newborn care, child health, quality of care and maternal and perinatal death surveillance and response (MPDSR). In addition, we lead in the testing and implementation of the MNCH and nutrition services for urban Kampala, to develop a model of service delivery in urban settings focusing on the urban poor, both in public and private sectors.
Healthy Newborn Network
Save the Children continues to manage the Healthy Newborn Network (HNN) (2010-present), an online community dedicated to addressing critical knowledge gaps in newborn health. A legacy of the Saving Newborn Lives Projects (2000-2020), HNN brings together partner organizations and individuals working in newborn health to share key resources, data, experiences, and lessons and helps increase global commitment to advance newborn health. HNN also provides a platform for stakeholders to engage in discussions and working group activities on the vast range of newborn and maternal health topics.
MaMoni
USAID’s MaMoni Maternal and Newborn Care Strengthening Project (MaMoni MNCSP) (2018-2023) supports and contributes to the goals of the Bangladesh Ministry of Health and Family Welfare (MOH&FW) to reduce maternal and newborn deaths by increasing equitable utilization of quality maternal and newborn care (MNC) services in Bangladesh. Additionally, the project facilitates health system improvements and policy changes for sustained impact at scale. MaMoni MNCSP is implemented by a consortium led by Save the Children in 17 districts in Bangladesh, covering a population of approximately 35 million people. In response to the COVID-19 pandemic, the project has also received additional funding to work with the government to strengthen the health system response to community transmission of COVID-19, minimize health risks to individuals, and avoid adverse health outcomes.
MOMENTUM Country and Global Leadership
MOMENTUM Country and Global Leadership (2019-2024) is part of a suite of innovative awards, funded by USAID, which Save the Children implements with several other organizations. The overall aim of this program is to holistically improve family planning and maternal, newborn, and child health in partner countries around the world. The project focuses on technical and capacity development assistance to ministries of health and other country partners to improve outcomes. MOMENTUM Country and Global Leadership builds upon existing evidence and best practices and catalyzes innovations that enable government-led partnerships to deliver high-quality, evidence-based interventions that accelerate reductions in maternal, newborn, and child mortality and illness at scale. The project also contributes to global technical leadership, learning, and USAID’s policy dialogue to achieve global maternal, newborn, and child health, voluntary family planning, and reproductive health (MNCH/FP/RH) goals by supporting globally endorsed initiatives, strategies, frameworks, guidelines, and action plans.
USAID Kulawa
USAID Kulawa (2020-2025) is the USAID Resilience in the Sahel Enhanced II (RISE II) Health Services Delivery activity in Niger, which works to improve access to and use of quality health services, strengthening ownership and management by communities, local government, and service providers. USAID Kulawa—meaning “care” in Hausa—strives to close the equity gap (the difference in abilities to access services) in maternal, newborn, and child health (MNCH), family planning/reproductive health (FP/RH), and nutrition service access and use. USAID Kulawa builds on prior efforts to improve the health of people in Niger.
Yezab Nega is a mother of six and a farmer who lives in the Southern Gonder region in Ethiopia. She no longer has to worry about her child’s nutritional needs due to her involvement in GTN’s nutritional village program.
Growth Through Nutrition (GTN)
The USAID- and Feed the Future-funded Growth through Nutrition (GtN) (2016–2022) project in Ethiopia is a multi-sector, integrated nutrition program that aims to reduce stunting/chronic undernutrition by 20% and reach 28,000 poor/vulnerable households with nutrition and livelihood support in 120 districts (‘Woredas’) in six regions of Ethiopia.
Working with the Government of Ethiopia, the project focuses on first 1,000 days households to build and expand on the success and achievements of USAID’s flagship multi-sector nutrition project in Ethiopia, Empowering New Generations to Improve Nutrition and Economic Opportunities (ENGINE).
Save the Children leads a consortium of partners to implement GTN in order to:
- Strengthen Government of Ethiopia capacity to develop and institutionalize national nutrition programs and policies.
- Increase access to diverse, safe, and quality food for rural communities.
- Improve nutrition and health care services.
- Implement comprehensive social and behavior change communications (SBCC) to promote optimal nutrition, water, sanitation, and hygiene (WASH), and agriculture behaviors.
- Increase access to safe water.
- Leverage the private sector to increase access to products needed for improved uptake of WASH practices.
- Support gender and a robust nutrition learning agenda.
Family Planning and Post-abortion Care (PAC) 2021 Global Award
Save the Children aspires to ensure that all women and girls in crises are respected and supported in their reproductive health choices, and have access to the Minimum Initial Service Package (MISP) for reproductive health through our humanitarian health programming, with an emphasis on family planning (FP), post-abortion care (PAC) and comprehensive abortion care (CAC). Over more than eight years, support from a large anonymous donor for the Family Planning and Post-abortion Care Global Award (2014-2021) helped us strengthen our capacity and cement our commitment to reach more women and girls with MISP services in acute and protracted emergencies.
During the COVID-19 pandemic crisis, we will continue to drive progress institutionalizing the MISP in our humanitarian and emergency operations in Somalia, Syria, and Yemen. This will include increased attention to strengthening adolescent sexual and reproductive health and management of sexually transmitted illness elements of the MISP in each country. Drawing on our global institutional experience, we will also support subnational Ministries of Health to strengthen CAC services in compliance with national and U.S. government policy. Save the Children will utilize the MISP platform to discuss CAC with the national partner and the sub-national Ministries of Health in the three countries. We will build on the work that has been done for institutionalization of CAC and will focus on working with the local sub-national Ministries of Health in advocating for inclusion of MISP in their protocols and strategies.
Adolescent sexual reproductive health will be particularly addressed as an important part in advocating for MISP. During 2021, we will support national non-governmental organizations (NGOs), community-based organizations (CBOs) and/or subnational Ministry of Health counterparts to increasingly assume Save the Children’s current functions. We are confident our 2021 efforts will meaningfully contribute to strengthening national partner technical and operational expertise needed to secure sustained sources of funding and independently support delivery of the MISP in each country, and hope that this critically important localization work can continue in 2022-2023.
Global OFDA Infant and Young Child Feeding (IYCF) Nutrition Award
During emergencies, through our Global OFDA IYCF Nutrition Award (2019-2022) we provide early actions to protect and promote recommended IYCF behaviors and support mothers/caregivers to meet their own basic needs and the needs of children in their care (e.g., see IYCF Tools in the Context of COVID-19). This includes providing skilled counseling and psychosocial support, setting up safe spaces such as mother-baby areas or IYCF corners, and establishing IYCF support groups. We also focus on protecting mothers and children from inappropriate distribution of breastmilk substitute, while ensuring that the needs of the non-breastfed infant are met through an appropriate program.
USAID Ready Initiative
Save the Children leads the USAID-funded READY initiative (2018-2022), a consortium of operational and academic partners strengthening and augmenting the capacity of nongovernmental organizations (NGOs) worldwide to respond to large-scale infectious outbreaks of epidemic or pandemic potential, including COVID-19. READY conducts focused activities to support and strengthen outbreak coordination, build NGO operational capacity to respond to major outbreaks, and develop technical readiness across humanitarian sectors using an integrated and community-centered approach. Register for READY’s email list for more information.
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