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Title Reaching Children s Potential Demonstration Program Introduction Insufficient food nutrition health care parental knowledge hygiene sanitation clean drinking water and appropriate technologies create life and death situations for mothers and children every day in communities throughout the world The all too often result is stunted children Stunting a recognized global crisis significantly impairs cognition making it difficult for children to learn and thus robs them of their future Worldwide nearly 24 of all children under five are stunted but in rural Tanzania upwards to 40 of children are afflicted WHO declares that stunting is preventable if addressed early but is largely irreversible if not addressed before age two Global Volunteers Reaching Children s Potential Demonstration Program RCP is a child focused parent driven family centered and community led comprehensive approach that dramatically improves child and maternal health by addressing the root causes of stunting and helps children reach their full potential RCP is both replicable and scalable and all components are implemented with the catalytic assistance and support of local staff and volunteers WHO s brief video Stunting in a Nutshell offers additional insights Rationale Why address stunting WHO and the World Bank identify stunting as a major global problem and implores that it be addressed immediately for four specific reasons 1 Stunting affects more than 149 million children globally WHO UNICEF World Bank 2019 2 Stunting has severe short and long term health and economic consequences 3 There is international agreement on its definition and can be measured consistently across settings 4 Stunting can be prevented if addressed during a critical window the first 1 000 days of life Stunting s impact on individuals and communities shows up in almost every aspect of life and stage of development Stunted children struggle to learn both early on and as they grow Stunting perpetuates the cycle of poverty from generation to generation Stunting can indicate increased risk of long term chronic diseases later in life Stunting steals trillions of dollars from the global economy Stunting robs children of their future Stunting is a complex issue however insufficient nutrition repeated infection and inadequate psychosocial stimulation are the primary contributors to childhood stunting WHO s brief video Causes of Stunting offers additional insights Stunting is a simple metric a child is defined as stunted when height for age is more than two standard deviations below the WHO Child Growth Standards median but it poses a horrendous threat to human development This simple measure height for age discloses a lot about a child s potential It can indicate serious cognitive and physical challenges forecast future educational and

economic success and predict future health and ability to thrive WHO s brief video Consequences of Stunting offers additional insights Tanzania In 2009 stunting rates in Tanzania were 42 and in 2016 they improved to 34 However in rural communities stunting can reach 40 of all children Baseline data collected and analyzed by a research group from St John Fisher College s Pharmacy doctoral program reported that 37 9 of the children under 2 years old in the initial RCP villages were stunted slightly higher than the Tanzanian national and regional rate and 24 2 of those children fell in the severely stunted category more than 10 higher than the national average The WHO 2025 goal is to reduce the number of stunted children by 40 To achieve that WHO recommends scale up prevention that includes education and care during pregnancy support for maternal nutrition exclusive breast feeding through the first six months and education improved healthcare and pre and post natal care for moms Based on current trends Tanzania will fail to come close to WHO s goal Project Description RCP invests in children s nutrition health education and psychosocial care from conception through the 18th birthday focusing on the first 1 000 days of life the critical stage where a child s growth and development is most sensitive to environmentally modifiable factors related to the underlying causes of stunting Families with a woman of childbearing age and or those with children under 2 are invited to enroll and participate as members in RCP Their dues are their most valuable asset time To remain as active members they must attend at least 80 percent of all workshops offered and be present during at least 80 percent of all home visits In return parents work hand in hand with local staff and outside volunteers and are provided daily nutritious meal packets and supplemental micronutrients until they become food selfsufficient interactive workshops on nutrition health hygiene childcare child development disease prevention and income generation relevant household technologies including hand washing stations container gardens chicken coops fuel efficient stoves and bed nets access to quality prenatal postnatal and infant and adult care through Global Volunteers health clinic and opportunities to join local cooperatives and parenting clubs The combination of these tactics addresses a whole child strategy during the first 1 000 days and beyond Parents are offered a comprehensive set of tools and resources to help themselves and their children RCP s whole child approach is unique in several ways First RCP addresses the entire range of factors known as underlying causes of stunting hunger malnutrition maternal care child development infectious disease psychosocial care income generation and education from a variety of angles using an innovative combination of methods RCP implements all WHO s Framework for Action Second RCP relies on the catalytic support and expertise from volunteer professionals to fill in resource gaps and allow local people to engage directly with outside experts Third RCP interventions are designed to interconnect so that pertinent information is delivered relevant technologies are provided and psychosocial support is offered and all are reinforced and woven together throughout the program A prime example is the use of flipcharts during regular home visits Staff and volunteers use colorful flipcharts that highlight the workshops learning objectives and help families

practice exercises and specific technology skills Through discussion and ongoing flipchart training home visits provide a safe place to ask questions that might not be offered in a larger setting and the occasion to expand understanding about food nutrition health sanitation clean water and income generation This one on one reinforcement of materials and personal support in the intimate setting of the family home helps solidify foundational knowledge that inspires change The data shows the RCP program is making the difference After the first two years of the RCP program July 2017 through July 2019 children showed statistically significant reductions in stunting In particular a research group from Saint John Fisher College pharmacy doctoral program Lull Dudla Kuder 2020 in process of publication reported these findings Stunting decreased by seven percentage points from 37 4 to 30 in children enrolled in the RCP program for at least 18 months This equates to a 20 percent reduction Of all children who were stunted when first enrolled in the RCP program 62 percent were no longer stunted after 18 months This is especially important because the severity of stunting normally increases substantially as children get older escalating from 23 percent at three months to 62 percent at 24 months Of all children who were severely stunted when they were first enrolled in the program 39 were not stunted after 18 months On average all children enrolled in the RCP program for at least 18 months improved from being nearly severely stunted 2 62 SD to being not stunted 1 75 SD On average those children who were stunted at enrollment and were in the RCP program for at least 18 months improved from being severely stunted 4 08 SD to being not stunted 1 86 SD RCP is changing lives and paving the path for village children to reach their full potential But RCP had a great impact a statistically significant impact on multiple measures An impact that is changing lives and paving the path for children in rural Tanzania to reach their full potential Budget Current overall annual budget for RCP is 841 000 per year to completely support five villages Global Volunteers is currently looking to move into expansion and scale up phase Summary Global Volunteers is ready to expand and scale this unique multidimensional approach to addressing the root causes of stunting to ensure every child can reach their potential and become contributing members of society Systems and collaborative relationships are in place Families and community leaders are providing positive feedback and leadership Preliminary data analysis and reports are promising RCP is having a great impact a statistically significant impact on multiple measures This impact is changing lives and paving the path for children in rural Tanzania to reach their full potential

The need in the Iringa Region and beyond is great Global Volunteers and the ELCT are poised and ready to scale and take this to the next level Organization Since 1984 Global Volunteers a US based 501 c 3 human and economic development organization has engaged 36 000 short term volunteers on long term community projects focusing on women and children For 30 years we have worked in partnership with the Evangelical Lutheran Church in Tanzania ELCT in communities on a wide range of projects In 2012 Global Volunteers piloted the RCP program in St Lucia Through the leadership of local women and from RCP moms we learned what worked and what didn t In 2014 Tanzania President Jakaya Kikwete invited Global Volunteers and the ELCT to help end stunting by adapting RCP to local needs We initiated the RCP program in Ukwega Ward Iringa Region in July 2017 RCP now supports five villages and 570 families with local staff who assist with parent workshops conduct regular home visits and collect data food producing and hygiene technologies a modern health clinic and other facilities including a greenhouse food storage facility water catchment system lodging for volunteers and staff and a large workshop room Global Volunteers strong relationships and long history in the region support collaborations with local and regional governments ministry of health and service faith based organizations Global Volunteers is led by professionals in development health law business international relations education IT HR and communications We employ local staff with backgrounds in community development health care nutrition water energy cooperatives and records management