Special Considerations


An equity approach targets the poorest with key interventions to achieve greater impact. Interventions often don’t reach mothers and infants who are at the most risk. NGOs can conduct equity assessments to learn more about equity in their programming areas. Collecting appropriate information about the wealth of different segments of a population will enable analysis of key indicator coverage in different subpopulations and can inform planning and implementation to ensure the most vulnerable are reached effectively.


Mobile Health, or mHealth, is the use of mobile devices, such as mobile phones, patient monitoring devices, tablets, and personal digital assistants, to improve health outcomes, health care services, and health research. The ubiquity of mobile devices in both developed and developing countries presents an opportunity to improve health outcomes through the innovative delivery of health services and information. Following are some possible applications of mHealth:

  • Education and Awareness: Messaging in support of public health and behavioral change campaigns
  • Diagnostic and Treatment Support: Using point-of-care devices
  • Disease and Epidemic Outbreak Tracking: Monitoring of disease incidence, outbreaks, and public health emergencies
  • Supply Chain Management: Tracking supplies to improve stock-outs and combat counterfeiting
  • Remote Data Collection: Collecting patient data in real time
  • Remote Monitoring: Ensuring appointment or medication regime adherence
  • Healthcare Worker Communication and Training: Connecting health workers with sources of information

Key Resources for mHealth in MNC Programs:

  • mHealth Alliance is a diverse group that advances mHealth through research, advocacy, and support for the development of interoperable solutions and sustainable deployment models and hosts Health Unbound (HUB), an online knowledge resource center and interactive network for the global mHealth community.
  • Dimagi is a social enterprise that makes open source software to improve healthcare in developing countries and for the underserved.
  • CDC, 2011. The Health Communicator’s Social Media Toolkit

Another Resource for m-Health: Berg M, et al., 2009.  Every Child Counts: The Use of SMS in Kenya to Support the Community-Based Management of Acute Malnutrition and Malaria in Children Under Five


Advocacy is an important component of an SBC strategy, and it can play a key role in MNC programming. National-level MNC programs can be strengthened through increased political commitment and leadership on the part of government officials and public administrators. Even programs that are primarily community-oriented have a role to play.

Convincing policymakers to take action requires evidence-based information, strategic thinking, strong advocacy skills, and persistence. In addition, increased advocacy efforts are needed among all audiences with the potential to influence leaders and society (e.g., CBOs, NGOs, religious and traditional leaders, the media, women’s groups, and youth), as well as the public, to increase demand.

Looking at the benefits of MNC through a broader development lens, advocacy efforts need to encompass a range of activities that will help maintain high visibility and ensure that MNC is a central development intervention. Following are some examples of potential activities to achieve this goal:

  • Ensure MNC is incorporated into national- and district-level strategies and budgets.
  • Build the evidence base, and document proof of success.
  • Maximize advocacy opportunities.
  • Create and maintain coalitions of MNC champions.

Key Resource for Advocacy: The White Ribbon Alliance


A woman’s status and decision-making power in the community and her family will influence her health and health care-seeking behavior and, thus, have an influence on her pregnancy. A woman’s decision to seek or not seek health care for herself and her family is influenced by her status and gender, as well as the opportunities and barriers that exist in her community. Gender-based violence is a particular concern.

Key Resource: UNICEF Training of Trainers on Gender-Based Violence: Focusing on Sexual Exploitation and Abuse

Engaging Men

Traditional MNC programs focus almost exclusively on women, failing to recognize that men play a significant role in maternal and newborn health decision making. In 1994, the Program of Action from the International Conference on Population and Development in Cairo highlighted the importance of involving men in reproductive health, recognizing that “‘male responsibilities and participation’ are critical aspects for improving reproductive health outcomes and achieving gender equality, equity, and empowering women” (USAID, 2003. p. 7).[i]

Research has shown that men are willing to change their attitudes, beliefs, and behaviors relating to reproductive health when they are given the information and support to do so.[ii] Involving men in MNC can occur as supportive partners or as agents of change around community norms. The appropriate information and education on the benefits of appropriate and quality MNC can encourage a man to support his partner during pregnancy, childbirth, and the postnatal period.


More than one billion young people are entering their reproductive years, with another two billion to follow, yet many young people lack basic information about services for reproductive and sexual health and access to those services.

The majority of adolescent pregnancy occurs within marriage, and girls under 18 who become pregnant are twice as likely to die of pregnancy-related complications as young women ages 20–24, and girls younger than age 15 may be five times as likely to die. Judgmental attitudes, locations of health centers, and inconvenient hours of services often make it difficult for youth to get the health services they need.

Youth-friendly reproductive health and prevention and management of STIs-HIV are central components of health services for youth. These services also should include age-appropriate education and counseling on responsible sexual behavior, FP, STI-HIV prevention, and pregnancy care, as well as counseling on gender-based violence and sexual abuse and referrals for help for both young men and women.

The active involvement of youth as partners in the planning and implementation programs can help ensure that the program is relevant to their needs, increases ownership, and takes advantage of young people’s expertise and energy in developing strategies and messages for effectively reaching their peers.

[i] USAID, 2003. Reaching men to improve reproductive health for all: implementation guide. http://ccp.jhu.edu/sites/default/files/Reaching%20Men%20to%20Improve%20ReprodHealth%20for%20ALL.pdf

[ii] Barker, G., et al. Engaging Men and Boys in Changing Gender-Based Inequity in Health: Evidence From Programme Interventions Geneva: World Health Organization, 2007.