Women’s Groups to Improve Maternal and Child Health Outcomes: Different Evidence Paradigms Toward Impact at Scale

doi:10.9745/GHSP-D-15-00251

The Care Group model, with relatively intensive international NGO implementation at moderate scale, appears successful in a wide variety of settings, as assessed by high-quality evaluation with rich program learning. Another women’s group approach—Participatory Women’s Groups—has also been implemented across various settings but at smaller scale and assessed using rigorous RCT methodology under controlled—but less naturalistic—conditions with generally, although not uniformly, positive results. Neither approach, as implemented to date, is directly applicable to large-scale integration into current public programs. Our challenge is to distill the elements of success across these approaches that empower women with knowledge, motivation, and increased self-efficacy—and to apply them in real-world programs at scale.

See related articles by Perry (Care Groups I) and Perry (Care Groups II).

CARE GROUPS VS. PARTICIPATORY WOMEN'S GROUPS

There is a long history of community-level health education and participatory problem solving in global health. From the late 1990s, two such approaches—Care Groups and Participatory Women’s Groups—have been developed and implemented across a variety of settings and have shown promise.

In this issue of GHSP, we have included two papers documenting program experience to date with Care Groups focusing on maternal and child health.¹^,² This model involves use of paid facilitators who, during periodic meetings, deliver focused sets of health messages to Care Group members, who are female community volunteers. These community volunteers, in turn, share the messages with neighboring households.

Similar to Care Groups, Participatory Women’s Groups make use of paid facilitators who meet with female community volunteers (Table). But rather than simply passing on specific health messages, the primary emphasis is on participatory learning and action bearing on factors contributing to poor maternal and newborn outcomes in their community. This model was first piloted in the Warmi project in Bolivia,³ which showed reduction in perinatal mortality. Based on this experience, the …

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