Child Survival and Health Grants Program
Although impressive progress has been made since 1990 in preventing child and maternal deaths, much remains to be accomplished. Every day in 2015, 17,000 more children will live and 650 more mothers will survive childbirth than in the past. However, another 17,000 children and 800 mothers continue to die each day around the globe.*
In 2012, the world rallied around the Child Survival Call to Action to end preventable child deaths within a generation, which was later expanded to include maternal mortality. The USAID-led 2014 and 2015 Acting on the Call events and reports demonstrate progress and recommit to doing what is needed to meet these targets.
Effective partnerships between governments, non-governmental actors (civil society, private sector), and communities are critical to accelerate country progress toward ending preventable child and maternal deaths. A growing body of evidence demonstrates that low-cost, community-based approaches can support healthy household behaviors, improve maternal, newborn, and child health outcomes, and reduce newborn and child mortality even in the world’s poorest communities.* Examples are found in community health worker (CHW) programs where CHWs are supported both by the health system and by community health promotion groups, such as participatory women’s groups and Care Groups.*
For almost three decades, USAID’s Child Survival and Health Grants Program (CSHGP) strengthened the capacity and leveraged the resources of international non-governmental organizations (NGOs), governments, and civil society to respond to shifting policies and strategies in 65 countries. Collectively, they served over 147 million children under the age of five and almost 74 million women of reproductive age in marginalized communities. Using the lives saved tool (LiST), CSHGP partners demonstrated that community-based programs can help achieve EPCMD goals.*
Between 2008-2012, the program awarded grants to 19 citizen-supported international NGOs to work alongside Ministries of Health, academia, and a range of local partners in 23 countries. Their objective was to develop, test, and facilitate the expansion of innovative and promising community-oriented solutions to improve the coverage of life-saving interventions across a continuum of care for mothers, children, and newborns.
A range of knowledge products featured below – as well as the collective findings from a cohort of Child Survival and Health Grants – leverage the CSHGP’s robust implementation science platform, and reinforce the importance of community engagement in health and local systems to achieve health outcomes, particularly as countries transition from the Millennium Development Goals to the Sustainable Development Goals. The evidence, experience, and lessons of the CSHGP are relevant not only to the policies and programs in USAID’s 24 priority countries, but also in MCSP and other global and bilateral mechanisms aimed at strengthening community health platforms. The CSHGP’s findings are part of the greater effort to accelerate progress for maternal and child health worldwide. Focus on community engagement, knowledge, and resources should be expanded and integrated into strategies for health systems strengthening, accountability, and learning to accelerate progress toward EPCMD.*
*Sources:
Acting on the Call: Ending Preventable Child and Maternal Deaths. USAID Global Health Bureau, Washington, DC, June 2015.
Ricca, Jim, et al. “Community-based intervention packages facilitated by NGOs demonstrate plausible evidence for child mortality impact.” Health Policy and Planning. 2013
Edward A, et al. “Examining the evidence of under-five mortality reduction in a community-based programme in Gaza, Mozambique.” Trans R Soc Trop Med Hyg. 2007
Local Systems: A Framework for Supporting Sustained Development. USAID, April 2014
Afghanistan
World Vision, 2008-2013
Mobile Technology Strengthens Behavior Change Communication and Referrals by Community Health Workers for Maternal, Newborn, and Child Health in Rural Afghanistan
Bangladesh
World Renew, 2010-2014
People’s Institutions for Improved Maternal and Newborn Health in Bangladesh
World Renew Bangladesh FE Brief
The Healthy Child and Mother Project Final Evaluation: Reducing mortality and improving health status among mothers and newborns through building public and private partnerships in Bangladesh
Benin
Center for Human Services, 2010-2014
Community Partnerships for Quality of Care in Benin
Partnership for the Community Management of Child Health /Partenariat Pour la Prise en Charge Communautaire de la Sante Infantile (PRISE-C)
Can the Addition of a Quality Improvement Collaborative Improve Performance and Retention of Community Health Workers in Benin? A quality improvement collaborative together with financial incentives improves performance but not retention when compared with financial incentives alone.
A Community Collaborative Approach to Improving Community Health Worker Performance and Retention in Benin
Burundi
Concern Worldwide, 2010-2014
Shifting the management of a community volunteer system (Care Groups) from NGO staff to Ministry of Health staff in Burundi: Care Groups supervised by community health workers produced similar improvements in child health and nutrition outcomes as those supervised by NGOs
Testing the Effectiveness and Sustainability of an Integrated Care Group Model as Compared to the Traditional Care Group Model
Related peer-reviewed publication
Cambodia
International Relief & Development, 2010-2014
Evidence-Based Interventions for Maternal, Newborn and Child Health (MNCH) in Cambodia
Report of the End of Project Evaluation of the Evidence-Based Interventions for Improved Nutrition to Reinforce Infant, Child and Maternal Health in Cambodia Project: An Innovative Project for Lasting Behavioral Change and Improvement in Child and Maternal Health and Nutrition
Ghana
Catholic Relief Services, 2011-2015
Evaluation of Encouraging Positive Practices for Improving Child Survival, East Mamprusi, Ghana, West Africa
Guatemala
Curamericas, 2011-2015
Community-Based, Impact-Oriented Child Survival in Huehuetenango, Guatemala
Honduras
ChildFund International, 2009-2013
Community-Based Maternal, Neonatal, and Child Health Innovation in Francisco Morazán Sur, Honduras
Indonesia
Mercy Corps, 2010-2014
Nurturing the Mother-Child Dyad, West Jakarta, Indonesia: Lessons Learned Through a Study on Mobile Data Collection
Nurturing the Mother-Child Dyad in Indonesia
Nurturing the Mother-Child Dyad in an Urban Setting: Final Evaluation of the Hati Kami Project in Jakarta, Indonesia
Mozambique
World Relief, 2009-2014
Testing a Community-Based Tuberculosis (TB) Care Model in Mozambique
World Relief Mozambique FE Brief
Final evaluation of the Vurhonga Community-based Tuberculosis Directly Observed Treatment Short course (TB DOTS) Project, Mozambique: An effort to increase the tuberculosis control performance through a Care Group Volunteer network
Nepal
Helen Keller International, 2008-2012
A Multisectoral Response to Malnutrition Improves Food Production and Nutrition Practices Among Women and Children in Nepal
Nicaragua
Catholic Relief Services, 2008-2012
An Innovative Approach to Involving Men in Maternal and Newborn Health Care: Program Experiences in the Department of Matagalpa, Nicaragua
Niger
Concern Worldwide, 2009-2014
Community Engagement for Child Health in Niger
Lahiya Yara Child Survival Project Final Evaluation Report: Strengthening Community Health Systems in Tahoua District, Niger
Semi-literate Volunteer Mothers Deliver Life-saving Care to Children in Niger’s Tahoua Region: A community case management model extends access to Ministry of Health treatments for childhood malaria, diarrhea, and respiratory illnesses.
Can Low-literacy Mothers Deliver Essential and Life-saving Care to Young Children in Rural Niger?
Pakistan
Aga Khan Foundation, 2011-2013
Women’s Use of Community Midwifery Services in an Isolated District in Pakistan
Emerging role of traditional birth attendants in mountainous terrain: a qualitative exploratory study from Chitral District, Pakistan
Role of community based savings groups (CBSGs) enhancing the utilization of community midwives in Chitral district of Pakistan
Peru
Future Generations, 2010-2014
Training Community Leaders for MNCH in Peru
Final Evaluation Report on “Health in the Hands of Women: A Test of Teaching Methods” Project in Peru
Health in the Hands of Women: Testing Teaching Methods in Rural Peru: An innovative method for teaching female community health workers, “Sharing Histories,” helps significantly reduce chronic malnutrition among literate mothers’ children.
Health in the Hands of Women: A Test of Teaching Methods
Rwanda
CARE, 2010-2014
Kuraneza: A “Good Growth” Project in Rwanda
An Evaluation of the Kuraneza Project: Good Growth for Children in Rwanda
World Relief, 2011-2015
Innovating for Child Health: An Evaluation of an Integrated Care Group Model in Rwanda
South Sudan
World Vision, 2010-2014
Lessons Learned about Integrated Community Case Management (iCCM) Implementation in South Sudan (World Vision) and Zambia (Save the Children)
WV S. Sudan & SC Zambia iCCM Learning Paper
Transforming Maternal and Child Health in South Sudan
Maternal and Child Health Transformation Project in Warrap State, South Sudan
Timor-Leste
Health Alliance International, 2011-2015
Mobile Moms/Liga Inan: Improving Quality and Access to Maternal Care in Timor-Leste
Zambia
Save the Children, 2009-2014
Lessons Learned about Integrated Community Case Management (iCCM) Implementation in South Sudan (World Vision) and Zambia (Save the Children)
WV S. Sudan & SC Zambia iCCM Learning Paper
Community Systems for Child Health in Rural Zambia
Lufwanyama Integrated Neonatal and Child Health Project in Zambia (LINCHPIN): Final Evaluation; Building Community Systems to Improve the Health of Newborns and Children in Rural Zambia
Related peer-reviewed publications