Step 5: Increase Awareness Among Women and Their Families

Mobilizing families and communities increases demand for services, a vital step in improving care for mothers and newborns. When women and their caregivers understand potential dangers and are prepared, it leads to better outcomes.

Identify women’s, families’ and communities’ understanding of the problem and barriers to action: In countries where PPH is a major killer, especially at home births, the problem is often well-known, but recognizing when bleeding is too much and accessing life-saving care are barriers. Often barriers to PPH prevention and management are larger economic, geographical or cultural issues. National behavior change communication or community mobilization strategies will likely address most barriers, but those specific to PPH prevention seeking behaviors need to be explored and integrated.

Develop tools, materials and activities to address barriers and mobilize communities: Communication messages, materials and activities focused on behavior change for PPH prevention and management can be developed and integrated into existing maternal and newborn health campaigns, reaching pregnant women and their families.

 In addition, in most countries where misoprostol was distributed for PPH prevention at home births, behavior change communication activities are planned to help name or brand and position the packet of tablets (such as “Immediate Response to Hemorrhage [perdarahan atasi segara]” in Indonesia; “Tablet against PPH [Golee Zed-e- Khoon Reyzee Bad Az Wiladat]” in Afghanistan; and “Mother’s Protection Tablet [matri suraksha chakki]” in Nepal).

    Link communities and facilities to improve access and demand for care: To ensure the continuum of care for PPH prevention and management, referral systems need to be in place to ensure women can get to life-saving care when needed. Linking communities to nearby providers and facilities helps improve communication, care-seeking and referrals.

    Mobilize CHWs and communities for PPH: Many countries have found CHWs invaluable in promoting birth preparedness and complication readiness—some expanding their role to deliver services and commodities, make referrals and monitor outcomes. They can also assist in mobilizing communities for birth preparedness/complication readiness (such as the successful Desa Siaga campaign in Indonesia) to arrange transport, funds and blood donors in emergencies.

    Program Pitfalls and Lessons Learned: Behavior Change Communication

     Because communities often do not recognize maternal complications as a problem, conducting formative research helps to determine communities’ understanding of the major killers of women and newborns, and enlisting leaders and influential people helps to develop solutions.

     Targeting behaviors, including key essential newborn care practices and care-seeking, can achieve significant improvements.