| Strategy 1: Promote community engagement and empowerment for improved maternal and newborn health |
| Approach 1.1: Implement community-based communication and education messages on safe motherhood via mass media and community events | Displayed posters with SMGL messages in public places to promote safe motherhood Held talk shows on local radio stations with technical experts and local leaders (political and religious local leaders, local safe motherhood champions) Supported local drama groups to perform skits and traditional songs on safe motherhood, raise awareness of danger signs in pregnancy, and promote facility delivery
| Broadcasted targeted radio messages, including spots directed specifically to encourage men to actively support their pregnant partners in seeking care Conducted drama performances to increase knowledge about and demand for delivery services and access to care Created and screened a documentary film “Journey to Becoming a Parent”
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| Approach 1.2: Build stronger partnerships between communities and facilities | Ensured that all SMGL-supported facilities have VHTs trained in accordance to the national training curriculum Mobilized health facility staff, including district coordinators, to supervise the implementation of activities performed by VHTs
| Ensured all SMGL-supported facilities had trained SMAGs Mobilized health facility staff, including district coordinators, to supervise the implementation of activities performed by SMAGs
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| Approach 1.3: Engage communities in monitoring and evaluation and accountability | Trained VHTs to conduct RAMOS data collection in 2012, 2013, and 2017 Trained VHTs to conduct maternal and perinatal death surveillance in their communities
| Ensured that SMAGs reported to health facilities on community events (pregnancies, home births, maternal deaths, and stillbirths)
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| Strategy 2: Increase birth preparedness, demand for facility delivery, and use of preventive health care services |
Approach 2.1: Assist with community activities aimed to increase:
Birth preparedness and knowledge of pregnancy danger signs Use of ANC and PNC services Awareness and use of facility-based delivery services
| Trained VHTs in every village to provide health education on birth preparedness and pregnancy danger signs Trained VHTs to encourage women to start ANC early, attend at least 4 ANC visits, deliver in a health facility, and use PNC services Supported VHTs to escort women to deliver in a health facility Trained health facility workers to conduct community dialogue meetings, including meetings that sensitized TBAs about danger signs of obstetric complications, and engaged them in emergency facility referrals
| Trained SMAGs to provide health education on birth preparedness and pregnancy danger signs Trained SMAGs to encourage women to start ANC early, attend at least 4 ANC visits, deliver in a health facility, and use postnatal care services Supported SMAGs to escort women to delivery in a health facility
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Approach 2.2: Extend the delivery system of preventive services:
ANC visits HIV counseling and testing Postpartum home care for mothers and newborns Postpartum family planning
| Trained VHTs to perform follow-up postnatal visits for mothers and newborns, identify women and newborns with danger signs, and conduct referrals to health facilities when danger signs are identified Organized clinic community outreach to provide ANC, health education, HIV counseling and testing, immunizations, and male involvement education sessions Selected religious, political, and cultural leaders became champions for promoting utilization of maternal and newborn health services Trained “Mama Ambassadors” to set up community dialogue meetings, give health education talks, distribute health commodities, and provide support to midwives
| Trained SMAGs to conduct follow-up postnatal visits for mothers and newborns, identify women and newborns with danger signs, and conduct referrals to health facilities when danger signs are identified Distributed birth plans to help pregnant women plan for social support, transport, nutrition, ANC, and PNC Selected religious, political, and cultural leaders became champions for promoting utilization of maternal and newborn health services Trained community “Change Champions” to promote safe motherhood and HIV prevention practices
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| Strategy 3: Decrease financial and logistic barriers to accessing facility delivery care |
| Approach 3.1: Market and distribute CDKs | | |
| Approach 3.2: Market and distribute vouchers to subsidize access to facility delivery care services, ANC, and PNC | VHTs promoted and distributed transport vouchers; health facility workers from private facilities marketed and distributed private vouchers The “Boda for mothers” voucher program to transport women by motorcycle for delivery or obstetric emergencies in 3 districts. During Phase 2, “Boda for mothers” was extended to cover transport for 4 ANC visits and 1 postpartum visit, in addition to transport for delivery care Marie Stopes subsidized vouchers for care in private facilities in all districts (“private vouchers”) (Phase 1 only)
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| Approach 3.3: Promote community-based loans to increase utilization of facility delivery care services | | |