Supporting a Brighter Future for Children in Marshall Islands

MAJURO, Marshall Islands, Jan 16, 2019 - Dr. Mary Jane Gancio, a pediatrician at Marshall Islands’ largest hospital in the capital, Majuro, is meeting her newest patient: a two-week-old who has been brought in for her first check-up. With the child on a small examining table, Mary Jane checks the height and weight of the newborn; indicators that are of great importance in Marshall Islands, a country that faces the immense challenge of childhood stunting.

Dr. Gancio works long hours and says she sometimes finds the sheer number of patients overwhelming.

“These are children that need help, so even though I’m alone and feel tired and stressed out, you still have to come in and do something and see these children,” Dr. Gancio said.

In a community just outside Majuro, Joanna, a 20-year old single mother, is receiving a visit from Jonita Alik, a member of Women United Together Marshall Islands (WUTMI), a local organization that works in Marshallese communities to identify vulnerable mothers and ensure they get advice on the right stimulation and nutrition to help their babies thrive – a critical early intervention to address stunting in the small atoll nation.

Even with the efforts of WUTMI and Marshall Islands’ health services, the country still faces serious hurdles in addressing stunting. Inadequate access to effective maternal and child health services; a lack of early learning opportunities; and critically, a limited availability of affordable nutritious diets, especially for children in vulnerable families, are all significant problems.

Study shows over a third of children in Marshall Islands are stunted

The scope of these challenges were detailed in a 2017 joint study from the Marshall Islands government and the United Nations Children’s Fund (UNICEF), which showed that 35% or over a third of Marshallese children under 5 surveyed were stunted from poor nutrition. Even by the Pacific Island region’s standards – in which most countries face significant issues of poor nutrition with high prices of imported goods – these numbers are alarmingly high.

Stunting and malnutrition can irreversibly damage development and learning. The resulting cognitive and linguistic delays accumulate early and continue, impairing earning and prosperity over a lifetime.

_{Dr. Mary Jane Gancio, a pediatrician at Marshall Islands’ largest hospital in the capital, Majuro,  leads a breastfeeding workshop for new mothers at Majuro Hospital. (World Bank/Patrick Rose)}

Project to provide children best start in first 1,000 days of life

The World Bank-led Early Childhood Development Project, launched in April 2019, is an effort to address these challenges head on. The US$13 million project is funded through the International Development Association (IDA), in partnership with the government of the Republic of the Marshall Islands and UNICEF.

The project is supporting work to improve reproductive, maternal, newborn and child health and nutrition services, with a focus on the first 1,000 days of life. It will also promote primary school readiness by providing financial support and counselling to parents, support public information campaigns on early childhood education and nutrition, and increase access to early learning services through piloting preschool classroom programs in schools in Majuro and Ebeye.

The project came following a direct request from former President of Marshall Islands, the Hon. Hilda Heine. Herself a former teacher, principal, and Minister for Education, Ms. Heine recognizes the importance of strong foundations for children to thrive, survive and learn into the future.

“Over the years we’ve been struggling with efforts to make sure children are healthy – and the study by UNICEF shows this. But, while we knew there were issues, we didn’t realize the extent of the problems,” said President Heine.

Heine saw the study as an opportunity and used it to make a direct case to the World Bank about the need for an early childhood development project.

“To have a bright future our citizens must be healthy and educated. We can invest in great facilities and good teachers but if investment in our children’s health and nutrition is not there, we can’t progress as a nation. As an educator, I know how important it is to invest in our children,” Heine said.

_{Marshall Islands mother Joanna (right) receives support on nutrition and early learning advice from Jonita Alik (left) of Women United Together Marshall Islands (WUTMI), a local organization that works in Marshallese communities. (World Bank/Patrick Rose)}

Human capital a regional priority

In January 2020, the government of Marshall Islands has established a new committee that is working across the health and education sectors to drive key policy and program issues. The country’s first national Early Childhood Development Forum is set to be held early this year to finalize the country’s ECD strategy.

The project represents one part of the World Bank’s human capital focus, that is being driven throughout the Pacific Islands and around the world. In May, 2019, the World Bank held the first Human Capital in the Pacific Summit, bringing Finance Ministers from across the Pacific Islands to discuss future commitments to securing brighter, healthier futures for children across the region.

The World Bank’s partners through the region are also pushing a greater focus on human capital and childhood development. In October, 2019, UNICEF followed the Human Capital Summit with an Early Childhood Development Forum, which saw the creation of a Pacific Regional Council for Early Childhood Development.