Mother Care and Child Survival in Underserved Regions of Mali, Mozambique and Pakistan

The project reached 683,087 direct and indirect beneficiaries, including 136,477 women of reproductive age, 136,477 men, 102,750 girls and 103,916 boys. Some notable achievements: the recruitment and training of over 3,000 new and existing community health workers, including matrones, relais, traditional birth attendants, traditional healers, community health workers, community midwives and lady health workers; training, coaching, mentorship and support for these community health workers across all three countries; support to 169 health facilities, including 100 rural maternities in Mali, 32 public health facilities in Mozambique, 24 public health facilities in Pakistan and 13 AKHS-P health facilities in Pakistan including minor repairs, renovations and provision of equipment and supplies to the facilities along with training of health workers on MNCH and nutrition practices to improve the quality of health services.
MCCS also increased access to MNCH services in target districts by addressing the key barriers faced by women and their families to utilization of services, such as transportation, communication and knowledge and awareness. To facilitate communication from the community to facility level, the project procured and distributed 375 mobile devices to community and facility health workers along with monthly credit. In all three countries, the provision of credit was handed over to either community health committees, health workers/facilities or to local government. The project also piloted emergency transportation solutions, such as bicycle and motorcycle ambulances in Mali and Mozambique and community transporters in Pakistan. By the end of the project, 41 communities in Mozambique and the catchment populations of 45 VHCs are benefitting from these transportation plans. In Mali, the motorcycle ambulance delivery has been delayed due to the security situation and will be in the 6 targeted communities in early 2016. The project also established, revitalized and trained 436 community and facility health management committees across Mali, Mozambique and Pakistan through training on gender equality, maternal and child health and nutrition practices and community engagement strategies. These committees have implemented over 10,000 communication events such as CHW lectures, group events, advocacy events, health awareness events and theatre group presentations since the start of MCCS.
MCCS also trained over 400 health facility staff on recommended nutrition practices. This has resulted in screening of over 100,000 children under for malnutrition followed by appropriate counselling and referral to higher level health facilities for treatment. Over 10,000 community sessions on the preparation of nutritious foods using local, seasonal ingredients were carried out and the project supported the establishment of over 2,700 home gardens in Mozambique. These events contributed to improved diversity in diets and allowed community members to benefit from the healthier nutrition practices.
Gender considerations were integrated through project interventions to ensure women and men have equal access to services and opportunities. The project provided training and sensitization on the importance of gender equality and advocates for participation from both men and women in health and MNCH activities, health committees and outreach events. In Mozambique, the project team also worked with local leaders to ensure women were recruited and selected as CHC members and CHWs, resulting in increases from 31% female membership of CHCs in Y1 to 47% in Y3. In Pakistan, the project worked to increase female leadership and participation in the various groups and committees – there is 39% female participation in facility health management committees and 60% female participation in village health committees. In addition, women were encouraged to take on leadership positions in 8 village health committees and 16 facility health management committees. In Mali, women’s participation in COSAs increased from 37% in year one to 45% by the end of the project, an important achievement in the context of Mopti.

Results achieved as of December 2015 include: (i) over 3,000 community health workers (including 45 community midwives) and 490 staff in health facilities trained in the delivery of quality basic maternal, newborn and child health services in 12 districts in the Mopti Region of Mali, the province of Cabo Delgado in Mozambique, and the province of Gilgit-Baltistan in Pakistan; (ii) 169 first-level health facilities, including 100 rural maternities in Mali, 32 public health facilities in Mozambique, 24 public health facilities in Pakistan and 13 AKHS-P health facilities in Pakistan, have received minor repairs and renovations to improve the quality of MNCH services provided to women and children; (iii) established, revitalized and trained 436 community and facility health management committees across Mali, Mozambique and Pakistan through training on gender equality, maternal and child health and nutrition practices and community engagement strategies; iv) over 400 facility-based health workers and 4,418 people from village health committees and other community groups to promote effective nutrition practices and address nutrition problems; (v) creating kitchen gardens in 2,739 households in Mozambique, and providing over 10,000 community-level education sessions on the production and preparation of nutritious; and, (vi) screening over 100,000 women and children under five years of age for nutrition problems, with appropriate counselling and referrals, as needed.

These results are contributing to improving the health of women and children in the project areas due to better nutrition and better access to quality maternal, newborn and child health services.