Program Background
The original aims of this program were to help combat the major issue of teenage pregnancy and malnutrition in Vanuatu. According to a 2009 census, at least 8% of 15-19 year old girls in the country have given birth. In addition to this, due to malnutrition, 20% of these children are stunted. In order to effectively combat this trend Save the Children aims to implement training programs to teach young mothers about micronutrient supplementation, nutrient education and infant and young child feeding counselling.
Although this was the core aim of the project, tragedy struck the region early in its lifecycle in the form of Cyclone Pam. The ensuing environmental damage impeded the initial efforts towards this goal and forced the project to include recovery efforts as well as re-establishing availability and access to primary health care services.
Key Challenges and successes
Obviously, the delivery of the intended program was affected by the aftermath of the cyclone. With instability in the local Ministry of Health and reduced support from both the central and provincial level, the project was impeded during the first half of the year.
Due to the lack of existing training materials and resources for community based Reproductive, Maternal, Newborn and Child Health (RMNCH) and nutrition training, the project decided to develop in-house training materials in collaboration with the Ministry of Health and other stakeholders. These materials will continue to be developed for use in maternal nutrition programs in the future.
The lack of up-to-date evidence-based policies and procedures, supervision and oversight of primary health care services (including medical supplies) were all challenges faced during the program implementation period. These challenges were minimised by working with communities to develop baseline data, community maps and strengthen community-planning processes.
The cyclone’s effects displaced several thousand people in the region, including Save the Children staff and communities participating in the project. This unfortunately affected the programs ability to deliver fully on its 2014-15 objectives and outcomes.
Project Impact
Despite the necessary inclusion of relief efforts following the cyclone, the awareness and training programs managed to reach over 4,000 caregivers in the Shefa, Tafea, Penama and Malampa regions.
The project also aided the supervision of 75 Village Health Worker (VHW) Aid Posts, which provide healthcare and nutrition services. Critical in-service training was delivered to these VHW Aid posts on nutrition/WASH/child protection and disability health promotion messages in all cyclone-affected areas, helping with the primary goal of educating and training caregivers in Vanuatu.
With UNICEF complementing the funding, the project was able to extend its VHW reach and achieve increased access to quality health and nutrition services.
Relief efforts from the project reconstructed and restocked four Aid Posts with essential drugs and equipment in Efate, Ekipe, Mormarte and Epau. These posts provided services for almost 5,000 people.
A further 48 Aid posts were restocked with essential medicine and equipment and provided services to almost 10,000 people affected by the cyclone
Project overview
Teenage pregnancy is a major issue in Vanuatu, with at least 8% of 15-19 year old girls having given birth (2009 census). In addition, 20% of children are stunted. Targeting nutrition until a child is two years old is a recognised cost-effective use of limited resources.
This project is part of a large scale primary health care project. This funding will provide for training to teenage girls (including teenage mothers) and teenage boys (including teenage fathers) on the following topics:
- reproductive health and family planning
- positive parenting; maternal and child health
- breastfeeding and nutrition
- hygiene
- healthy behaviours during pregnancy
- communication and facilitation skills
Project goal and objectives:
The project goal is to improve the health of children aged 0-2 years and their mothers, particularly teenage mothers, in Vanuatu.
1) To improve maternal and child health (MCH) knowledge, attitude and practice among mothers, especially teenage mothers.
Activities include awareness-raising and training specific to the needs of adolescent mothers, in areas such as reproductive health and family planning, child health and nutrition, hygiene and positive behaviour during pregnancy.
2) To increase access to, and quality of, maternal and child health services for pregnant women and mothers, especially teenage mothers, and children under 2 years.
Activities include training and mentoring support for health workers to improve the services offered for teenage mothers and fathers and to deliver teen-focused maternal and child health services. Further, community level awareness campaigns will promote MCH services, and stronger links will be fostered between health service providers at the community, health facility and provincial levels, to ensure appropriate referral and support. These improved linkages aim to increase the number of pregnant teenagers and mothers accessing appropriate MCH services in a timely manner.
3) To improve nutrition of pregnant mothers and children 0-2 years of age.
Activities include trained community health extension workers, and other trained community members, providing support to teenage mothers on breastfeeding and good nutrition practices. Further, the project will identify barriers to good nutrition practices to inform the development of appropriate and relevant training and support activities to ensure mothers have optimal nutrition during pregnancy and breastfeeding; to practice breastfeeding exclusively to 6 months; and that caregivers provide optimal nutrition to their young children, particularly from 6 – 24 months.
4) To investigate and document the issue of teenage pregnancy.
The project will undertake research to improve understanding of the contributing factors to teenage pregnancy, and to inform the development of appropriate strategies to address the issue.
Project partner & community involvement:
Key stakeholder engagement will take place at national level, with both Ministry of Health and other development partners; at provincial level with government; and with communities.
The project involves a whole-of-community approach, where leaders and members of community and church groups, as well as teenagers, are well-informed about reproductive, maternal and child health issues, and are supporting teenage mothers and their babies.
Providing health care in Vanuatu
This project will be piloted in three rural locations in Vanuatu on Efate, Santo and Ambae, working directly with three health centres, numerous health workers and at least 10 communities per location.
A key strategy for the delivery of health services in Vanuatu is the revitalisation of primary health care – community-based outreach health services to reach those most in need. Over the last 12 years, Save the Children have worked together with the Ministry of Health to deliver a Village Health Worker (VHW) program; training and supporting volunteer community health workers in basic primary health care.
The Health Babies, Healthy Teens project will work in co-ordination with the VHW program, as well as other provincial health outreach services, to better deliver quality health services.