Community-led evidence-based action for newborns (CLEAN) at scale through participatory women's groups (PWGs), health workers and clean delivery kits (CDKs): saving lives at birth in rural Bangladesh.
In poor communities, Participatory Women's Groups (PWGs) that focus on maternal and newborn health can dramatically reduce newborn deaths and catalyze improvements in the demand, delivery and quality of maternity services. Trials in Nepal, India, Malawi and Bangladesh showed that engaging PWGs in participatory learning and action reduced newborn deaths by up to one third. Coverage is important. In Bangladesh, with one group per 1500 population, newborn mortality fell by 7%; when scaled to 1 group in 300, mortality fell by 34%. PWGs have inbuilt sustainability: in Nepal and Malawi, women's groups continued to meet and pursue their activities, without external financial input, after the projects were over. Using pooled data from 3 south Asian sites, clean delivery kit (CDK) use was associated with a relative 48% reduction in NMR. We wish to scale PWGs and CDKs across three rural districts of Bangladesh covering over six million population. One PWG will be mobilized per 500 people. We shall work with district authorities, government community health workers and volunteers, other organizations working with self-help groups like BRAC, and existing community groups. We shall ensure that the mobilization of women's groups complements other local programs (e.g. home visits), enhances use of CDKs, and builds capacity for participatory learning and action methods across NGOs and government. We shall monitor mortality outcomes in key scale-up sentinel sites and assess how the PWGs interact to improve quality of health services locally.