Health & Nutrition

Crucial Investments for Stability, Economic Growth

Health and nutrition programs are a keystone of ACDI/VOCA’s mission-driven work to enhance people’s knowledge, opportunities and choices. At ACDI/VOCA, we believe that the health and nutrition of individuals and families is crucial to ensuring food security, creating sustainable livelihoods and empowering people to seize opportunities for better lives.

Consider these facts:

• Today more than 1 billion people are chronically undernourished and food insecure.
• Poorly nourished and food-insecure people not only live with daily hunger and preventable and treatable illnesses, but they also suffer a myriad of long-term consequences.
• Undernourishment compromises immune systems, which leads to a higher incidence of illness and disease that in turn contribute to lower productivity and life expectancies.
• Poor nutrition undermines economic growth. According to UNICEF, 195 million children younger than 5 are chronically malnourished. Chronic undernourishment in children creates a vicious cycle of compromised physical and cognitive development that reduces their economic productivity when they become adults, miring people in poverty that, in turn, leads to chronic undernourishment and poor health in the next generation.

ACDI/VOCA customizes our health and nutrition approaches and methodologies to specific country and regional environments to create the greatest impact and ensure sustainability. Our work builds on local strengths and cultural values in a holistic and context-driven way as part of our integrated, multi-sector programming. We also have found that household- and community-driven approaches for health improvements in fragile or disrupted environments contribute to stabilization efforts and collective action.

Health and Nutrition for the Most Vulnerable

Many of our programs are in conflict, post-conflict or other fragile states where we are tasked with meeting people’s most basic food and health care needs. These needs are greatest among the most vulnerable populations, including young children and pregnant and lactating women.

In Haiti, ACDI/VOCA uses the preventing malnutrition in children under 2 approach (PM2A) developed by USAID’s Food and Nutrition Technical Assistance II Project (FANTA-2). Our staff focuses on providing food rations to pregnant and lactating women and children 6-23 months of age. The rations are combined with a suite of health care and education services including ante and postnatal care, treatment of childhood illness, immunization, growth monitoring and promotion, and care groups to reduce all types of malnutrition in implementation areas.

ACDI/VOCA’s programming in the Philippines’ Autonomous Region of Muslim Mindanao (ARMM) also focuses on vulnerable women and children. The region’s hundreds of islands and islets make access to health care difficult. ACDI/VOCA addresses this challenge through our “Floating Clinic”—a boat equipped with an onboard health clinic that delivers mother- and child-centric health services and professionals to hard-to-reach islands.

From Meeting Acute Health Needs to Making Long-term Gains

Whether working in an emergency setting or one of chronic hunger and poverty, ACDI/VOCA’s programs always keep the long-view in sight: sustained health and economic growth for communities and people.

ACDI/VOCA health and nutrition programs use training, technical assistance and public information campaigns to promote positive health and behavior change environments so that even once a program ends, people will consume more nutritious foods and practice better health and hygiene habits to maintain their health.

For example, our staff in Haiti teaches smallholder farmers—many who are part of our PM2A program—new farming techniques which help them revitalize their farm plots to feed their families and earn money. In addition, we have trained hundreds of health staff in Haiti and formed care groups and water and sanitation committees, which will be active long after the program ends.

In Uganda, ACDI/VOCA teaches “Farming as a Business” skills to transition HIV-positive farmers, who need nutritious diets to stay healthy and maintain their medication, from food aid and subsistence farming to profitable enterprises.

To achieve long-term improved health services and delivery in the Philippines, our program works closely with regional and provincial governments, health boards, and other officials on public health plans and policies. In its first year, the project facilitated the development of provincial investment plans for health in each province. In the second year, the project established a contraceptive self-reliance policy.

Gender and Cultural Approaches Optimize Health, Nutrition Programs

ACDI/VOCA’s health programming reflects sensitivity to local gender, intra-household resource dynamics and cultural traditions and practices. These considerations are essential to design activities that result in improved health and nutrition for everyone in the household.

Take gender approaches as an example. Health and nutrition programs traditionally single out women as recipients because of their caretaker and food preparer roles (and sometimes, primary farmers). However, in several communities the social norms that determine these gender roles for women may limit their ability to change behavior and community practices.

Using gender analysis and assessments, ACDI/VOCA devises integrated strategies to address asymmetric intra-household dynamics and to build programs that provide a strong foundation for food security and household-level health and nutrition. We train both women and men on the importance of nutrition, maternal and child health, hygiene, family planning and livelihoods so they will mutually support decisions and household resource allocation.

In Uganda ACDI/VOCA required men to attend the health and nutrition training before they could receive additional agriculture production training. As a result, participating men adopted the new behaviors they learned, which resulted in improved nutrition, health and hygiene practices within their own households—as well as the broader community.

ACDI/VOCA similarly has facilitated positive inroads through applying cultural approaches. In the Philippines, project staff employed the “Islamic Approach to Health Care” based on the essential aspects of Islamic society—solidarity, cooperation, self-sufficiency and perfection—to encourage people to adopt healthy living behaviors and counter cultural stigmas opposed to pregnancy spacing and modern health practices.

Sustainable Health, Nutrition Programs Build Local Capacity

Ultimately, our health and nutrition programs promote long-term sustainability and growth by investing in local partners and the people we serve through efforts that build local capacity.

ACDI/VOCA works with local and regional government bodies to improve their technical capacities and outreach services to improve people’s access to and quality of health services. For example, in Haiti, the Philippines and Uganda, ACDI/VOCA partners with governments to improve people’s access to health insurance; develop laws, regulations and guidelines for health initiatives; train health care workers; support public health promotion activities; and improve linkages between communities and local health units.

ACDI/VOCA also facilitates the construction and rehabilitation of health infrastructure through community-driven development approaches under which local communities participate in decision making. Initiatives include constructing hospitals and clinics and supplying needed health equipment–from emergency room equipment to training materials for rural health workers to motorboats to access remote island communities to training in the design and manufacture of prosthetics.

In Kazakhstan, Kyrgyzstan, Iraq and Serbia, ACDI/VOCA brought together local communities through voluntary boards to establish community health goals and action plans to directly improve the lives of local citizens. Using participatory processes, communities identified priority health needs and were fully engaged throughout the planning and implementation of the health projects (e.g., constructing and rehabilitating health units, supplying equipment, training health workers, introducing reproductive health curriculum in schools, and supporting manufacturers of prosthetics).