In the mountainous regions of Lesotho, stunting and chronic malnutrition can affect up to 51 percent of children. To help reverse this trend, CRS introduced keyhole gardens, raised bed plots that produce harvestable crops within 3 months of completion.

Their compact size means they can be built where farmland is scarce: in urban areas, at schools, and even at refugee camps. Because they are located near the home, keyhole gardens are a good source of food for elderly and chronically ill people, and for families caring for vulnerable children.

Highly adaptable, keyhole gardens are suited for arid and semi-arid zones, and yield harvests during periods of biting frost. Their design allows for moisture retention, and they keep the soil warm. Constructed with locally available resources, these gardens reduce the need for costly materials purchased on the market.

Year-round production means families can rely on well-rounded diets, even in the lean season. During peak times, some households have sold their surplus at a profit of up to $8.44 per month at the time of sale. For these households, which typically receive an average income of $46.22 a month, this profit represented an 18 percent increase in monthly income.

A CRS-sponsored learning event in Lesotho in 2011 worked to adapt keyhole gardens to local conditions in 16 sub-Saharan African countries, Afghanistan, and Haiti. A follow-up event in 2012 revealed that the methodology was versatile and adaptive to different environments. In Burundi, keyhole gardeners used local timber products to construct the garden walls. In Haiti, keyhole gardens resulted in greater vegetable yields. In the water-scarce regions of Madagascar, the gardens improved access to vegetables.

Today, poor families worldwide are reaping the benefits of keyhole and other homestead gardening practices. Timor Leste, Syria, and Turkey have begun adopting the practice.

Families arrive in droves for Community Health Day—held in villages across Malawi—to access a range of services, from growth monitoring and deworming to birth registration and school enrollment assistance. These services are provided in collaboration with the Ministry of Health and other providers to support healthy families. On-site health workers treat people with minor ailments and refer undernourished children, hypertensive adults, and other complicated cases for further services. Individuals found to be HIV-positive receive on-site counseling and a referral to a health facility for testing to confirm the diagnosis and to assess whether they are eligible for antiretroviral therapy.

Speeches and dramas keep people entertained as they wait their turn for services. Such health days are one CRS approach to ensuring that children and their caregivers receive vital health services and information. To date, more than 95,937 Malawians have benefitted from health days, and 41.5 percent of attendees have been children under age 15 years.

In just 1 year, similar events in Kenya have reached more than 7,050 through the Conrad N. Hilton Foundation funded THRIVE program. The Kenya program also uses these health days as a platform to keep children’s immunizations up to date and to follow-up on birth registration—a critical document to ensure that children are guaranteed their legal rights as citizens. As a result of this program, more than 2,853 Kenyan children have acquired their birth certificates.

Health days provide a platform for improving access to vital health, nutrition, and other social services to rural communities. Information collected during health days helps to inform Ministry of Health officials and other entities of gaps in service delivery so they can address those gaps through other means, such as scaled-up mosquito net distribution.