Community-based Maternal and Newborn Care
Community-based MNC strategies bring MNC information and services to the communities and create or strengthen linkages between communities and health facilities. Traditionally, strategies have focused on improving awareness, demand, access, availability, and acceptability of healthy behaviors and services through these activities:
- Promotion of prevention, early recognition, referral, and treatment of complications
- Technical competence, supportive systems, and supplies for normal deliveries and obstetrical emergencies
- Quality education and training for community-based MNC
- Effective quality assurance systems for facility- and community-level services
Community-level activities effectively can increase access to MNC services in underserved rural and urban areas and also increase interest and demand for them and in the following cases:
- When demand for MNC is high, but access to services is low
- When demand for, access to, and use of MNC is low
- When demand for and use of MNC services is low, but access to services is high, and there is an interest in increasing demand
- Where the health infrastructure is weak; community-based programs use a variety of community-based channels, particularly CHWs, and in some cases, trained TBAs or community midwives
Community-based programs involve a significant level of community ownership. Key steps to encourage community ownership include working with leaders, stakeholders, and community members to identify challenges and priorities for improving MNC, and subsequently involving them in identifying and implementing strategies and activities to address any concerns. These groups include women of reproductive age, partners, in-laws, traditional and religious leaders, politicians, health representatives, CHWs, representatives of special interest groups, community organizations, and local NGOs. This involvement creates a program that is responsive to the community’s needs. Community members will then be more likely to recognize and accept the program’s benefits. This participation also fosters community ownership and responsibility for the program’s success and contributes both to behavior change and to sustainability.
Community-level activities should be linked to the government’s health system to avoid duplicating, replacing, or ignoring the system. A program must choose its activities based on MOH policy, community needs, and resources. Programs need to ensure that quality MNC services are available at the referral health facilities and address identified health facility strengthening needs in their project plan or through partners’ plans.