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IN UKWEGA WARD,RURAL TANZANIAReaching Children’s Potential ProgramImpact Report

2017 2019 2021 2023 202540% 30% 20% 10% 0% 98% less likely to be stuntedif stunted at baselineOver a four-year period, families enrolled in Global Volunteers'Reaching Children’s Potential (RCP) Program experienced a 57%reduction in stunting prevalence in their children 24 months andyounger.218 months after baseline evaluation, compared to children in acontrol village, RCP children were:1Stunting Prevalence - Ukwega Ward, Tanzania61% less likely tobe stuntedChanging the Arc of Children’s LivesStunting Prevalence – RCP Villages and Control Village

3EXECUTIVE SUMMARYChildhood stunting, one of the most significant impediments to humandevelopment, affects 22% of children under five worldwide, and upto 50% in some rural communities.Caused by insufficient nutrition, protection from disease, and childstimulation, stunting is preventable, but only during the first 1,000days of life.From 2017-2021, Tanzanian families participating in Global Volunteers’Reaching Children’s Potential (RCP) Program experienced a 57%reduction in stunting among their children 24 months and younger,an extraordinary result, especially when compared with other stuntingreduction programs.RCP is a child-focused, parent-driven, community-led comprehensiveapproach based on three goals: Eradicating Hunger, ImprovingHealth, and Enhancing Cognition.Everyone benefits when children can reach their full potential – thechildren, their parents, their communities, and all who inhabit ourplanet.Global Volunteers engages short-term volunteer professionals andstudents who offer their skills, knowledge, and financial resourcesthat make the RCP Program successful.The RCP Program is replicable and scalable.Parents, with the catalytic assistance from staff and volunteers, caneliminate stunting in their children.If 1% of the developed-world adult population volunteered annuallyover five years, and for the approximate cost of the 45 aircraftcarriers currently deployed worldwide, stunting could be eliminated.Since 1984, Global Volunteers has engaged 38,000 volunteers inhundreds of communities in 36 countries on six continents.

Between August 2017 and July 2018, Global Volunteers’ Tanzanian staffcollected baseline data on the prevalence of stunting in three rural villagesin the Ukwega Ward. Of the 187 children aged 24 months and youngerwhose families were enrolled in the RCP Program, 37.4% were stunted.This finding is comparable to stunting prevalence in the wider SouthernHighlands of Tanzania, which impacted an estimated 45% of childrenunder five.An Unparalleled Reduction in Stunting: A 2021 analysis of 167 children24 months and younger from the same villages enrolled in the RCPProgram indicated stunting prevalence of 16%, a 57% reduction in fouryears. Because 89% of families with children 24 months and youngerparticipated in the RCP Program in 2021, the calculated stuntingprevalence is representative of stunting in the full population.The RCP Program Reduces Likelihood of Stunting: A comparison ofstunting prevalence in RCP villages and Kisinga, a control village, foundthat children enrolled in the RCP Program were 61% less likely to bestunted after 18 months than children in Kisinga. Similarly, children in theRCP Program who were stunted when entering the program were 98%less likely to be stunted after 18 months than children in Kisinga who werestunted at the beginning of the study.ANALYSIS111213 1415Global Volunteers works under the direction of local leaders. From left to right: CCM DistrictChairperson Killian Myenzi, District Commissioner Asia Abdala, Bishop Dr. Owdenberg Mdegella,Joseph Kakunda, MP, and Dr. Benjamin Makafu - August 2018 officials.166

COMPARATIVE STUDIESSubstantial progress has been made to eliminate stunting.Worldwide20 years(2000-2020)34%Africa20 years(2000-2020)27%Tanzania11 years(2005–2016)22%57%RCP4 years(2017–2021)A review of stunting reduction programs with designs andinterventions similar to the Reaching Children’s Potential Programrevealed diverse estimates of post-program reductions in stuntingprevalence.57%23%21%31%19%26%27% 3 4 5 6 7Program DurationReduction in Stunting PrevalenceReaching Children’s Potential, TanzaniaAmalima, ZimbabweMwanzo Bora, TanzaniaStunting Prevention &Reduction, Rwanda NOURISH, Cambodia"Good Start in LifeProgram, PeruSHOUHARDO II, Bangladesh6050 40 30 20 171819Decrease in StuntingComparison – Decrease in Stunting Prevalence2223*24212526820*Programs marked with an asterisk reference stunting prevalence among children 2 and younger.

PROGRAM DESCRIPTIONThe RCP Program is a child-focused, parent-driven, community-led,comprehensive approach that invests in child and maternal nutrition,health, and education. Beginning with pregnancy and continuing throughthe 18th birthday, it focuses on the first 1,000 days of life – the onlywindow to prevent the lifelong cognitive, physical, and economicdetrimental impacts of stunting. All program components areimplemented and directed by local people with the catalytic support oflocal staff and external short-term volunteers. Sustainable, replicable, andscalable, the RCP Program offers hope for children, families, andcommunities worldwide.The program is conducted in collaboration with the Evangelical LutheranChurch in Tanzania, Global Volunteers' partner for 35 years.279

School and Household GardensChild NutritionMicronutrient SupplementationImproved StovesEradicate Hunger1.2.3.4.Improve Health5. Health, Nutrition, andHygiene Education6. Systematic Deworming7. HIV and AIDS Education8. Malaria and Dengue FeverPreventionEnhance Cognition9. General Education10. Promoting Girls’ Education11. Psychosocial Support12. Potable Water and Sanitary Latrines12 ESSENTIAL SERVICESThe RCP Program’s goals are to eradicate Hunger, improve Health, andenhance Cognition so children may realize their full potential. Based onthe United Nations Essential Package, Global Volunteers fashioned the“12 Essential Services” which identify the interventions that ensurechildren’s health and well-being. Parents are provided the tools to deliverthe 12 Essential Services to their children.292810

PRESUPPOSITIONSEveryone benefits when all children reach theirfull potential.Ensuring child and maternal health and nutritionduring the first 1,000 days of life is the least costlyand most effective strategy to enable children toreach their potential.The prevalence of childhood stunting is aneffective gauge of how well a community/countryis providing for child and maternal health andnutrition.When parents, particularly mothers, are providedrelevant knowledge, appropriate householdtechnologies, and psychosocial support, they willprevent their children from being stunted.Preventing stunting requires a comprehensivesustainable program that addresses householdfood, nutrition, health education, hygiene,healthcare, general education, mental health,water, sanitation, and jobs.1.Five presuppositions underlie Global Volunteers’ RCPProgram: 2.3.4.5.12

RCP PROGRAM COMPONENTS Comprehensive in scope, the RCP Program enables parents tosupport their children through:14

THE PEOPLE RESPONSIBLETanzanian village parents have significantly raised the expectation forwhat’s possible. The RCP Program was initiated in three remote villagessituated in the mountains in Kilolo District, Iringa Region. Primarily fromthe Hehe tribe, these are a rightly proud and hardworking people. Mostparents have some primary school education, and nearly all aresubsistence farmers. They are lovely people – kind, welcoming, andfriendly – with the tremendous desire to learn and to improve the lives oftheir childrenThese villages, Ipalamwa, Lulindi, and Mkalanga, are at the top of themountain, a two-hour drive to the closest major city on challenging roads.With a combined village population of approximately 4,000, most peoplelive in difficult circumstances lacking social services, sufficient nutritiousfood, adequate transportation, and economic opportunities.While community leaders and government agencies continue to helpmake this effort a success, it is the parents, particularly mothers with thecatalytic assistance from staff and short-term volunteers, who areprimarily responsible for reducing stunting in their children. They are theones who learn, adopt new technologies, and change behavior so theirchildren can thrive.16

Sesiana Duma and Tidali Nossa have lived in Ipalamwa all their lives. Theyboth completed primary school and now, like most of their neighbors, arefarmers who work every day growing corn, beans, vegetables, andavocados. They have three children. Immanuel was 3 ½ and his sister,Livael, was eight months when they enrolled in the RCP Program in July2017. Faith was born in September 2019.Sesiana says, “Life has never been the same since the RCP Program. Theway we raised our last two children is very different from how we raisedthe first one. Our first-born was very weak when he was a baby, differentfrom Livaeli and Faith, who have grown with the RCP Program. It’s beenvery easy and smooth to raise the last two with the instructions that weare given at the RCP Center.”“The most important thing I’ve learned is breastfeeding your babyexclusively for six months and slowly establish solid food. Faith was bornvery tiny, but I breastfed her faithfully exclusively for six months. She isnow very healthy and big.FAMILY STORY - A CASE STUDY17

“I delivered Faith at the Ipalamwa General Clinic. The services are justamazing. The way I was treated made me feel less pain compared to otherpregnancies. And truly I tell you I don’t know even how I delivered thebaby; I just find that I have the baby.”Sesiana says she also learned “that handwashing with clean water andsoap is very important to anyone’s health. The workshop gave us light onhow we should properly wash our hands.” But one of the challenges is“the soap is always eaten by the goat,” so they put the soap away whenthey go to the fields. She reports that she greatly enjoys regular homevisits. “Seeing the caregiver at my home I feel encouraged and valued andI feel like I have someone helpful that I can share a lot stuff.”Tidali says that it is their “wish that our children go further educationally”because neither he nor Sesiana could go beyond primary school.Sesiana reports, “Our children are now healthier, happy all the time, andactive compared to how they were before.” 18

Children. Children benefit from enhanced cognition, healthier bodies, anda greater ability to learn.Mothers. Moms benefit from psychosocial support offered by volunteersand staff during home visits. Their presence encourages mothers tocontinue doing the work necessary to improve their children’s lives.Families. RCP families gain increased knowledge, additional food andnutrition, and household food production technologies that offer thepossibility of food self-sufficiency and healthier, smarter children.Communities. Communities benefit when more children attend schooldue to nutritious school feeding programs; students learn more;graduates earn more; and local cooperatives produce and sell productslocally.The Planet. All of us benefit when we eliminate stunting and enhancelearning. Children can realize their full potential, become full contributingmembers of society, and break the cycle of poverty. More education andless poverty will result in greater technological breakthroughs, increasedglobal economic activity, meaningful lives for more people, and fewercauses for war – a safer, healthier place for all.BENEFITS OF RCP’SCOMPREHENSIVE APPROACH20

VOLUNTEERSConduct parent educational workshops on health, nutrition, and earlychildhood development topics.Accompany staff on home visits, offering professional expertise,reinforcing workshop lessons, and encouraging moms to continue thehard work that makes their children’s lives better.Implement household hygiene and food production technologies.Teach health and science in secondary schools, conversational Englishin primary schools, and English alphabet and numbers in preschools.Work alongside local people planting EarthBoxes, constructingchicken coops, building fuel-efficient vented stoves, repairingcommunity buildings, and painting schools.Assist the women’s co-ops by improving the quality of their products,teaching about successful business practices, and obtaininginternational markets.Offer families psychosocial support to help parents make thenecessary behavioral changes required by the RCP Program.Deliver patient care at the Ipalamwa General Clinic.Participate on the RCP Advisory Committee.Provide or leverage 95% of all RCP Program funding.Many governments and NGOs lack sufficient resources to implement theinterventions necessary to prevent stunting. This is especially widespreadin Africa where in some rural areas the prevalence of stunted childrenexceeds 50%.Global Volunteers engages short-term volunteers to fill the gap. They helpfamilies deliver essential services that every child needs to realize theirpotential. Volunteers offer their skills, knowledge, and funding that makethe RCP Program successful. Volunteers:Everyone can do this. Volunteers change everything! They are anunlimited resource that assist parents and community organizationsdeliver the essential services that prevent stunting.22

ELCTIRDAt the recommendation ofMark Van Wyk & Susanne Forsyth PARTNERS AND DONORSGlobal Volunteers is honored to have many donors and partners, largeand small. Most individual donors have served in Tanzania on GlobalVolunteers service programs; more than 120 contribute between $10 and$600 monthly. Many corporate, academic, and faith-based organizationscollaborate in Global Volunteers worldwide efforts to conduct and expandthe RCP Program.24United Republic of TanzaniaGovernment AgenciesEvangelical Lutheran Church in TanzaniaGround Water Systems, IncRRTL Architects

In 2014, Tanzania President Jakaya Kikwete (right) invited Global Volunteers cofounder and CEOBud Philbrook (left) to conduct the RCP Program in Tanzania, after Bishop Owdenburg Mdegella(center) introduced the idea and the two men to each other.REPLICABLE & SCALABLEThe RCP Program is replicable and scalable because it primarily dependsupon (a) the desire and commitment of local people to improve theirchildren’s lives, and (b) volunteers who desire to share their knowledge,skills, financial resources, and compassion.Local people, especially moms, want to improve their children’s lives.Started in a single village, the RCP Program has expanded to five. Leadersthroughout the Iringa Region have asked Global Volunteers to conduct theRCP Program in their communities, as have community leaders in othercountries.With 38 years’ experience engaging short-term volunteers, we know thathundreds of thousands of people desire to make the world better andenrich their lives through service. The RCP Program allows them to fulfillthose desires. Individuals, families, universities, corporations, and faith-based organizations have personally, or through their students, faculty,employees, and members, served the RCP Program.25

22%OF THEWORLD'SCHILDRENUNDER 5 ARESTUNTED1%IT ONLY REQUIRESto volunteer 1 to 2 weeks a year for 5 years to provide parents theknowledge, household technologies, and encouragement they need.O F A D U L T S I N T H E D E V E L O P E D W O R L DStunting prevention begins with applying parental knowledge abouthealthy pregnancies, child development, required nutrition, anddisease prevention, and implementing appropriate household foodproduction and health-enhancing technologies.FOR THE APPROXIMATE COST OF THE45every infant and toddler on earth, and children yet to be born, couldreach their potential.SHORT-TERM VOLUNTEERSSTUNTING CAN BE ELIMINATEDEvery child on earth could reach their potential. A I R C R A F T C A R R I E R SC U R R E N T L YD E P L O Y E DW O R L D W I D E26

RCP villages involvedin this study Women cooperativesWorkshopsconducted Volunteers served inUkwega WardWomen and childrenprovided twonutritious meals dailySchool children fedtwo nutritiousmeals dailyAverage annualclinic patient visitsBY THE NUMBERS Professional medicalstaff at IpalamwaGeneral ClinicEarthBoxesplanted

Families to receivechicken coops andstoves in 2022RCP Tanzania staffFamilies enrolled inthe RCP ProgramRise Against Hunger and locallyprocured meals distributedBabies born atIpalamwa GeneralClinic28Householdhandwashing stationsinstalled

The Ipalamwa General Clinic administers vaccinations.Volunteer professionals and students present virtual workshops whenvolunteers are not on the ground.The women’s cooperatives produce liquid hand soap and sew masks.Donors continue to generously support the RCP Program financially.Built stoves and chicken coops alongside community members.Conducted workshops on mental health and wellness topics. Over 100local people participated.Encouraged staff and community members to get vaccinated and takepreventative measures against contracting Covid-19.The coronavirus has adversely affected the ability to fully engagevolunteers; however, Global Volunteers and the RCP Program haveadapted and persevered.The first volunteer team returned to Tanzania in August 2021. Thesevolunteers:Several teams of volunteers are scheduled to serve throughout 2022,2023, and beyond. The future of the RCP Program is bright.COVID-1929

THE NEXT CHAPTER: EVEN GREATER SUCCESSOnly 20 of the 48 parent workshop topics were presented.Some families did not have EarthBoxes, and none had chicken coopsor fuel-efficient vented stoves.The opportunity for pregnant women to stay close by the clinic prior todelivery was not available until 2020.Just two household water harvesting stations were installed.The RCP Program has made remarkable strides in reducing stunting andhelping children reach their potential. However, due to insufficient fundingduring the first four years of the program, just 50% of the interventionswere employed.If stunting can be reduced by 57% with only half of the interventionsemployed, stunting will be eliminated when the complete RCP Programis conducted. When parents have the knowledge included in all theworkshops, families are food self-sufficient, households capture and storerainwater, healthcare is available to all, every student has access to qualityeducation, and each household has two hand-washing stations, allchildren will be able to reach their potential.30

The Tanzania RCP Demonstration Program isled by local people. Further, we follow theguidelines required of rigorous experimentation,including collecting appropriate baseline data,protecting individuals’ privacy, comparing villagesthat are part of the RCP Program with similarvillages that are not yet offered the interventions,and producing statistically significant results.

GLOBAL VOLUNTEERS 1. Go only where invited 2. Do what asked to do 3. Serve under the direction of local leaders 4. Work hand-in-hand with local people 5. Support sustainable community-based projectsVolunteers are “servant-learners,” working with and learning fromlocal people.Featured on CNN, CBS Early Show, NBC Today Show, ABCEvening News, the Oprah Winfrey Show, People Magazine,Newsweek, Woman’s Day, The Christian Science Monitor, TheNew York Times, The L.A. Times, The Boston Globe, Wall StreetJournal, and China Daily.In consultative status with the United Nations ECOSOC. Focused oncommunity-driven development.38,000 short-termvolunteers serving onlong-term developmentprojects.Founded in 1984 as a private, nonprofit, human and economicdevelopment INGO based in St. Paul, Minnesota – USA.To create, nurture, and sustain thewell-being of the world’s childrenand their community, that theymight realize the full promise oftheir human potential.To wage peace and promotejustice through mutualinternational understanding.200+ communities in36 countries on sixcontinents.GOALMISSIONPRESUPPOSITIONS32

Lull, M & Taskoviski, S. (2021). Growth in RCP versus non-RCP children over 18 months. Manuscript in preparation. UNICEF. (2021, April). Malnutrition. https://data.unicef.org/topic/nutrition/malnutrition/ World Health Organization. (2014). Global nutrition target 2025: Stunting policy brief.https://www.who.int/publications/i/item/WHO-NMH-NHD-14.3 Dewey, K.G. & Begum, K. (2011). Long‐term consequences of stunting in early life. Maternal and Child Nutrition,7(3),5-18. doi: 10.1111/j.1740-8709.2011.00349.x Soliman, A., De Sanctis, V., Alaaraj,N., Ahmed, S., Alyafei, F., Hamed, N. & Soliman, N. (2021). Early and long-termconsequences of nutritional stunting: From childhood to adulthood. Acta Biomedica, 92(1). doi:10.23750/abm.v92i1.11346 World Bank. (2006). Repositioning nutrition as central to development: A strategy for large scale action.https://openknowledge.worldbank.org/handle/10986/7409 Branca, F. & Ferrari, M. (2002). Impact of micronutrient deficiencies on growth: the stunting syndrome. Annal ofNutrition and Metabolism, 46 (Suppl 1),8-17. doi: 10.1159/000066397 Soliman, A., De Sanctis, V., Alaaraj,N., Ahmed, S., Alyafei, F., Hamed, N. & Soliman, N. (2021). Early and long-termconsequences of nutritional stunting: From childhood to adulthood. Acta Biomedica, 92(1). doi:10.23750/abm.v92i1.11346 Center on the Developing Child Harvard University. (2007). Inbrief: The science of early childhood development.https://developingchild.harvard.edu/resources/inbrief-science-of-ecd/ de Onis, M. & Branca, F. (2016). Childhood stunting: a global perspective. Maternal & Child Nutrition, 12 (Suppl. 1),pp. 12–26. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5084763/#mcn12231-sec-0008title Dudla, C., Kern, C., Bell, D., & Lull, M.E. (2021). Impact of the reaching children’s potential demonstration program on childhood growth in Ukwega Ward, Tanzania. Under peer review. Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC), Ministry of Health(MoH), National Bureau of Statistics (NBS), Office of the Chief, Government Statistician (OCGS), and ICF. (2016).Tanzania demographic and health survey and malaria indicator survey (TDHS-MIS).https://dhsprogram.com/pubs/pdf/fr321/fr321.pdf Stunting prevalence can increase as children get older. Although calculations of stunting prevalence generally include children five and under, the RCP program focuseson pregnant women and children under two when children are most at risk for permanent negative impacts. This result was confirmed by an independent analysis conducted by lead researcher, Dr. Melinda Lull at St. JohnFisher College Wegman School of Pharmacy. Lull, M & Taskoviski, S. (2021). Growth in RCP versus non-RCP children over 18 months. Manuscript in preparation. United Nations. (2021). The sustainable development goals report. https://unstats.un.org/sdgs/report/2021/The-Sustainable-Development-Goals-Report-2021.pdf Ibid Headey, D.D., Heckert, J., Ndiaye, B., Brero, M., Assey, V., & Palloni, G. (2019). Accounting for the rapid reductionof child stunting in Tanzania over 2005-2016. International Food Policy Research Institute. Discussion Paper No.01874. https://www.ifpri.org/publication/accounting-rapid-reduction-child-stunting-tanzania-over-2005-2016 Programs that estimate stunting prevalence among children 2 years old and younger are marked with anasterisk. All other programs estimate under prevalence among children 5 and younger. Save the Children. (2019). NOURISH project endline survey report. https://resourcecentre.savethechildren.net/pdf/NOURISH+Project+Endline+Survey+Report+April+2019+Final.pdf/ Lechtig, A., Cornale, G., Ugaz, M.E., & Arias, L. (2009). Decreasing stunting, anemia, and vitamin A deficiency inPeru: Results of the Good Start in Life Program. Food Nutrition Bulletin, 30(1),37-48. doi:10.1177/156482650903000104 World Bank. (2021). Rwanda stunting prevention and reduction project (P164845): Implementation and results report. https://documents1.worldbank.org/curated/en/162771633217142770/pdf/Disclosable-Version-of-the-ISR-Rwanda-Stunting-Prevention-and-Reduction-Project-P164845-Sequence-No-07.pdf Tango International. (2015). SHOUHARDO II final quantitative performance evaluation: SHOUHARDO II multi-yearassistance program (MYAP). https://www.usaid.gov/sites/default/files/documents/1866/SHOUHARDO%20II%20Draft%20Quantitative%20Evaluation.pdf Africare. (2018). The impact of social and behavior change interventions in the Mwanzo Bora nutrition program(MBNP): Program assessment brief. https://pdf.usaid.gov/pdf_docs/PA00T5SQ.pdf Cultivating New Frontiers in Agriculture. (n.d.). Amalima. https://www.cnfa.org/program/amalima/ World Health Organization. (2014). Global nutrition target 2025: Stunting policy brief. https://www.who.int/publications/i/item/WHO-NMH-NHD-14.3 World Food Program and UNICEF (n.d.). The essential package.http://www.un.org/esa/socdev/poverty/PovertyForum/Documents/The%20Essential%20Package.pdf Global Volunteers. (2011). The essential services prospectus. https://globalvolunteers.org/essential-services/prospectus/ end notes213456789101112131415161718192021223423242526272829

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