1. Callister, Lynn Clark PhD, RN, FAAN

Article Content

The Millennium Villages Project was a visionary 10-year global project with 14 rural sites in 10 sub-Saharan African countries (Ethiopia, Ghana, Kenya, Malawi, Mali, Nigeria, Rwanda, Senegal, Tanzania, and Uganda) with matching comparative sites to minimize confounding variables. Outcomes of interest were measured related to the Millennium Development Goals (MDGs). The focus here is on interventions in the health category that included constructing new health facilities, increasing the use of community health workers, strengthening ambulance referral, eliminating healthcare fees, adding enhanced electronic health information systems including use of mobile phones, promoting immunizations, modern family planning, skilled birth attendants; treating more effectively HIV/AIDS and tuberculosis, and the distribution of bednets with rapid diagnosis of and treatment of malaria (Mitchell et al., 2018). There were significant positive findings for the intervention sites (the Millennium Villages) when compared with the control group in the area of health measures including: (1) proportion of children younger than 5 who were moderately/severely underweight or stunted, wasted, or had anemia (2) infant and under 5 mortality rates, (3) proportion of infants who were immunized against measles or exclusively breastfed for at least 6 months, (4) proportion of births attended with skilled healthcare providers, (5) proportion of women who were anemic, (6) proportion of women using modern contraceptives, (7) proportion of women having at least four prenatal visits, and (8) proportion of childbearing women tested for HIV/AIDS or who were tested for malaria and/or slept under a bednet.


Looking beyond statistical data, the stories of the lives of women and children who were part of the Millennium Villages are heartwarming. This includes the stories of the midwives in Ruhiira, Uganda, who were provided with improved technology and enhanced education. In this village, the improvement in maternal health was a high priority. During the first 3 years, there were no maternal deaths among women giving birth with midwives attending them. One mother said, "My labor was so obstructed. If the Millennium Promise was not here, I know I would have died without a child. But instead I am alive and have a beautiful baby girl." Another woman living in the Millenium Village in central Mali spoke of the blessing of having clean water from the village well instead of walking far distances to obtain water with the uncertainty as to whether or not that water source would make her children sick. Village residents partnered with an American pipe manufacturer who donated more than 300 miles of pipes, with the Millenium Promise drilling boreholes, installing the pumps, and building water towers in the village. One woman who learned that she was HIV positive during her first pregnancy and whose husband also had HIV/AIDs spoke of the comprehensive counseling and prenatal care she received in her village of Ruhiira in Uganda said, "At first my husband and I weren't sure if it was wise to try for a baby after discovering that we were both HIV-positive, but the Sister [midwife Sister Fortunate] told us that with the right precautions, we didn't need to feel fear" (


Although the project has some design limitations (Bendavid, 2018), this visionary program is a significant attempt to keep the promises made to women and children to improve their health and well-being. According to the lead investigator, Dr. Jeffrey D. Sachs (2018), there were significant impacts on 30 out of 40 MDG targets. Now we face the challenge of meeting the Sustainable Development Goals. This project provides evidence that global partnerships and creative packages of interventions can make significant differences in the lives of millions of women and children. Replication with revised study protocols in low-resource countries in other continents of the world is recommended. A description of the protocol used for this project is available at




Bendavid E. (2018). The fog of development: Evaluating the Millennium Villages Project. The Lancet. Global Health, 6(5), e470-e471. doi:10.1016/S2214-109X(18)30196-7 [Context Link]


Mitchell S., Gelman A., Ross R., Chen J., Bari S., Huynh U. K., ..., Sachs J. D. (2018). The Millennium Villages Project: A retrospective, observational, endline evaluation. The Lancet. Global Health, 6(5), e500-e513. doi:10.1016/S2214-109X(18)30065-2 [Context Link]


Sachs J. D. (2018). Lessons from the Millennium Villages Project: A personal perspective. The Lancet. Global Health, 6(5), e472-e474. doi:10.1016/S2214-109X(18)30199-2 [Context Link]