Community Practices and Mobilization

Community education about healthful practices that results in behavior change can safeguard health and improve fetal and maternal well-being in pregnancy. Healthful practices include child spacing, infection prevention, good nutrition, and avoidance of harmful practices, such as unsupervised intake of herbs or modern pharmaceuticals to induce abortion or labor. Childbirth education of mothers and family members is vital in maintaining optimum health prior to birth. While healthy women can die in childbirth, those who are malnourished or infected have an increased risk, as do their newborns. Behavior change communication using various reinforcing messages through multiple channels targeting both men and women is most effective for promoting healthy behaviors to improve pregnancy outcome.

Most maternal and newborn deaths occur in the community, not in hospitals or clinics. As a result of poverty, geography, and culture, about half of the women in USAID-assisted countries give birth at home without a skilled attendant. Qualitative research informs us that there is a host of factors that affect a woman’s use of services at the time of birth. These include cost; proximity; transport; compassionate, efficient and effective care; and respect and provision for non-harmful traditional cultural practices.

Improved services as a stand-alone strategy will not sufficiently reduce maternal mortality. Rapid, increased utilization of lifesaving care must be generated. By organizing transport and setting up emergency funds, communities can be mobilized to increase use of services by assisting individual women to reach services at the time of an emergency. Influential community members can be helpful in advocating for and monitoring services being provided. These may include provision of 24-hour services, adequate sanitation, provision for privacy, and monitoring of the referral system. Community involvement is essential for accountability in provision of services for the community.

Where institutional delivery is not the norm, a well-functioning referral system is essential to get women the lifesaving care they need in the event of an obstetric complication. The community health center can provide safe delivery care and basic EOC for complications. At times, it is appropriate that the health center be bypassed for prompt provision of comprehensive obstetric care when sophisticated medical management, major surgery, or blood transfusion is warranted. USAID supports strengthening of referral systems.

USAID implements a multi-pronged approach to maternal health, which supports integrated programs to serve women and children in the stages of pre-pregnancy, pregnancy, delivery, and early childhood.

Learn more about the Maternal and Newborn Health Strategy.