“CHOICES” for Children: Child Health Outcomes Improved through Community Empowered Solutions

01 July 2014 to 30 June 2019
Area: Bakan district, Pursat Province
Primary beneficiaries: 6,000 Households (Approximately 12,400 people)
Secondary beneficiaries: 14,100 Household members
Budget: TOTAL USD $2,324,545
Donors: DFAT Australia and ADRA Australia

The “CHOICES” for Children project targets families from 60 underserved rural communities of Bakan district. The project supports communities to better address the risks to child nutrition and wellbeing. CHOICES helps parents and child caregivers to make improved informed decisions about feeding practices, improving household hygiene/drinking water and sanitation, as well as empowering food insecure families to have more sustained household livelihoods. It works in a holistic manner emphasizing the need for local ownership and self-initiation in the change process and focuses on interventions that specifically support children who are the most vulnerable in their villages in the rapidly changing development context.

The project uses a community empowerment model to address identified risks and support opportunities related to labour and migration decisions, key nutrition and child health, and livelihood opportunities for the very poor segments of local villages. It is recognized that many of the target families, including prime emphasis on households that meet the criteria of the government “IDPoor” category 1 and 2, migrate for significant periods during the year seeking work thus programs to be able to reach them while back home. Families who live near each other join Reflect Circle (RC) group activities in their own community that help increase their capacity to understand and analyze livelihood options and the impacts/risks of these on their families. Activities also strengthen literacy, numeracy, public interaction and other communication skills needed for negotiation and maintaining rights. Group facilitators accommodate schedules of various community groups and seek to draw traditionally marginalized households including those who migrate for parts of the year when they are available.

The CHOICES project addresses poor child nutrition practices through awareness including education in groups and village wide campaigns. Height-weight-age based growth monitoring is conducted in collaboration with government health providers and identifies malnourished children from 0-5 years. Nutrition rehabilitation and education sessions are conducted with parents and caregivers to accelerate physical growth as well as an awareness raising platform for identification of nutritious locally available food options using the Positive Deviant HEARTH program methods. Positive feeding practices during migration or when children are under the supervision of other caretakers will also be addressed. The project also promotes the use of fortified nutritional supplements and foods where available. This includes supporting the Ministry of Health in rolling out regular distribution of SPRINKLES children’s vitamin and micronutrient supplements as well as promoting nutritionally fortified and concentrated foods available from local producers. Household hygiene and sanitation’s impact on child health is addressed through promotion and support of sanitary latrines and access to safe water.

The CHOICES project responds to locally identified livelihood improvement opportunities during migration for vulnerable households including both production and marketing. Animal production for fish and chicken raising is provided for poor households. Improved care methods are provided and linked to the local Village Animal Health Workers, including marketing services. Training and support is provided for home vegetable gardens and rice production for poor and vulnerable households who have sufficient rice land. Marketing and networking for rice and vegetables is trained to help increase incomes. Wells and ponds and installed to support crop and animal raising.

Identification of various livelihood skills by interest group members leads to custom training such as food production, sewing, local handicrafts and tool production, small equipment repair and maintenance, construction techniques etc.. Skills are used both locally as well as by family members who migrate for labor during parts of the agriculture cycle to boost household incomes. Ongoing activities promote broader knowledge for members, particularly women, in key agriculture areas and address household decision making practices. Planning, financial management and marketing are learned with cross visits to successful model farmers and businesses arranged. Women’s vocational literacy and numeracy skills are built to provide long term access to information and improved record keeping and additional community driven economic based initiatives will also be supported. At least one community saving/loan group is formed in each village to support choices and options.

Family and child risks for labor migration outside of their community are specifically assessed through group learning with ways identified to reduce risks to health and ensure quality incomes. Training in how to avoid human trafficking and labor and rights abuses emphasizes safeguarding children through highlighting the impact of caregiver attitudes and behaviors. It identifies ways to make sure children have access to proper foods/health care, education, and social support throughout the year. This includes group involvement from women and men in separate activities as well as in joint male and female group meetings. The project community facilitators also reach out to single parents and the disabled as well as family members unable to attend regular group meetings or events. The project activities ensure opportunities for child health care behaviors and livelihood are not compromised by household member gender or disability including HIV status.