Removing Barriers for Sustained Reduction of Maternal and Newborn Mortality in Rural Zambia

Save the Children Federation, Inc
Organization Location: 
Westport, CT USA

This integrated innovation engages elected rural ward councilors in rural Zambia to remove local barriers to use of key antenatal, intra-partum, and postnatal care services and practices in a poor, under-served constituency. Locally-elected representatives, though rarely convoked to improve maternal-newborn care (MNC) directly, constitute a promising, but untested, entry point to save lives by strengthening leadership skills and democratic processes. The innovation is potentially a transformative breakthrough because democracies not on track to meet MDGs 4 and 5 have systems that could employ these tools and processes. Ward councilors work with Area Development Committees and local business leaders to establish priorities and accountability mechanisms that ensure mothers are aware, motivated, and able to access MNC. Wards that document 50+% increased use of services and practices at the end of 12 months receive awards from funds contributed by private-sector partners. We apply the Community Action Cycle (CAC), a socio-behavioral change technology proven to reduce neonatal mortality in Nepal and India; link to an existing Save the Children-government partnership; harness private sector acumen; leverage Save the Children expertise in child participation for corporate social responsibility; and engage the media. Partnering representative democracy with private enterprise ensures sustainability and scalability. Thus: (1) ward councilors and business leaders craft incentive schemes and generate award funds; (2) trained ward councilors apply MNC-focused CAC technology with Area Development Committees; (3) journalists/media report initiatives and spotlight local constituency and business champions; and (4) partners monitor and rigorously evaluate, using formative research, proof-of-principle milestones, and proven community-capacity indicators.