When you see the word “7-11” for the first time, how would you
read it? July 11th? November 7th? Seven dash eleven? Or
7-Eleven?
It is a World Vision’s Health
and Nutrition (H/N) 7-11 strategy; it pursues a behavior change communication
(BCC) approach to have a positive impact on individual, community and
environment level by 360 Degrees of Support. Among the 8 Millennium Development
Goals (MDGs) that were established by the United Nations in 2000, MDG4 is to
reduce child mortality by two thirds, and MDG5 is to improve maternal health by
three quarters by 2015. The 7-11 strategy is to improve Maternal, Newborn and
Child Health (MNCH) to achieve MDG4 & 5. This year is 2014, so we have only
1 more year to achieve those goals by 2015. Unfortunately, only 9 out of the
137 countries have achieved MDG 4 & 5 so far, so World Vision launched
Child Health Now (CHN) campaign in 2009 to boost up the speed of reaching our
global goals. In align with this effort, AIM-Health [Access: Infant and
Maternal Health] Programme has been implemented in 10 Area Development
Programmes (ADPs) of five African countries: Kenya(1), Mauritania(2), Sierra
Leone(2), Tanzania(2) and Uganda(3).
In the “7-11,” “7” means the
number of intervention for the mother (adequate diet; iron/folate supplements;
tetanus toxoid immunization; malaria prevention, treatment access and
intermittent preventive treatment; birth preparedness, healthy timing and
spacing of delivery; de-worming; access to maternal health service: ANC, PNC,
SBAs, PMTCT, TB/STI screening), and “11”
means the number of intervention for children under 2 (appropriate breast-feeding; essential newborn care; hand washing with soap; appropriate complementary
feeding; adequate iron; vitamin A supplementation; ORT/zinc; prevention and
care seeking for malaria; full immunization for age; prevention and care
seeking for ARI; de-worming). So we are saying “Seven Eleven Strategy.”
When I first heard “7-11,” I suspected that why it must be “7-11.” I mean, it reminded me of the
convenient store, “7-Eleven.” There
must be so many other interventions for mothers and children, so it could also have
been “11-11,” “9-11,” or “10-10.” I
wanted to ask about the origin of this name to Erin, but I did not because the
question sounded so silly. :-) So I do not know the history how this name was
created. Probably, World Vision staff made this name as “7-11” deliberately to make it familiar and rememberable. Anyway, I
can pronounce it easily and nicely. “Seven
Eleven!” During this week, I have been reviewing World Vision’s all basic
concepts and strategies to strengthen my background about 7-11 conceptual framework.
And I tried to find the hidden meaning of 7-11, beyond just memorizing what
interventions World Vision are dealing with.
Every year, 8.8 million
children under the age of 5 die of preventable disease: pneumonia, diarrhea,
malaria and undernutrition. To me, diarrhea was temporary one night troublesome
phenomenon. How diarrhea kills children? I was so surprised. However, for
malnourished children, diarrhea is life-threatening disease because it leads to
severe dehydration. Every year, up to 500,000 women die during pregnancy or
from childbirth-related complications. 99% of cases have been occurred in
sub-Saharan Africa and South Asia.
To achieve the goal of
improving MNCH, World Vision focuses on 3 Child well-being outcomes (CWBO).
1. Mothers and children are
well-nourished.
2. Mothers and children are
protected from infection and disease.
3. Mothers and children
access essential health services.
It looks good. All of them
make sense. Everyone will be happy if we reach those outcomes. But if we think these
in a different way, we realize that mothers and children in developing
countries are not nourished well, are exposed to all kinds of infection and
disease defenselessly, and they have no access to essential health services.
If your friend is sick, you
may advise him/her, “You’d better to go
to hospital.” So, we can go to hospital, receive medical treatments from
doctors and nurses if necessary, go to pharmacy to get some medicine. You may be
hospitalized or you go back home to take some good rest. All activities seem to
be normal. (Of course, we also have to have medical insurance…) Anyway, the
point is that we take it for granted that we can go to hospital 24/7 whenever
we have an emergency and give birth to babies.
But, this normality that we
considered it as a common behavior never applies to sub-Saharan Africa. For
example, whole number of populations is 28,791 in Sherbro Island, Sierra Leone.
There is only one hospital that surgery is possible, named Bonthe Government
Hospital. In that hospital, there is only one medical doctor who can perform a
surgery. That means, 1 surgeon is taking responsibility for 28,791 populations’
health. To make it matters worse, no one wants to go and work there as a nurse or
doctor because people think living in the island is like being in prison and
feel isolated. Although there are 10 peripheral health units (PHUs) and 110
community health workers (CHWs) for Sherbro people, no one can save their lives
when they are in danger of medical emergency except a medical doctor. If
pregnant women who need immediate help but that only one medical doctor is not
available, they have to be referred to Mattru Jong Hospital located in the
mainland right away. It takes 1 hour for taking speedboat, and 1 another hour
to reach that hospital, but more seriously, they do not have money to
purchase fuel for a speedboat. Referring to the hospital is delayed for one
reason or another; even if they finally succeed in reaching the hospital, after
that is too late. Prolonged or obstructed labour caused death of a baby inside
of the womb, and mothers’ lives fall into in hazard.
We can see 7-Eleven
anywhere. Even if you do not know where it is, you can ask a passenger “Where is 7-Eleven?” and find it within
10 minutes. You are so thirsty and famished, so you buy a Coke and bread. After
quenching your thirst and hunger, and you buy some vitamin and soap to improve
quality of your life. This would be normal to you. But somewhere in Africa,
this is not normal. They even never know what 7-Eleven is. They have no
hospital, no ambulance, no water, no essential drug, no electricity, no
vitamin, no soap, and no bread. They do not even notice their children are
dying because they have never heard of the symptoms of diseases. Mothers are
also dying of anemia, tetanus, HIV/AIDs, tuberculosis, STIs, and neglected
tropical diseases. All of diseases are preventable, but they are still
suffering from those only because they have no “7-Eleven” near to their home. That is why. To me, World Vision’s “7-11” tells me that it sounds familiar
but it is something that I should not take that for granted. Food, iron/folate,
TT, malarial pill, vitamin A, medicine, soap, and hospital… All of them seemed
to be a matter of course, but they were actually life-saving tools that should
be an indispensable part of our lives. So, I would like to see that 7-11 should also be in sub-Saharan
Africa and South Asia, just like U.S. people easily see it, then everyone in
the world would enjoy life-saving benefits and take it for granted in the
near future.
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