Demonstrating Child Survival Successes at the Community Level

This research brief from the Health Communication Capacity Collaborative (HC3) at Johns Hopkins Bloomberg School of Public Health Center for Communication Programs in collaboration with Management Sciences for Health, NetHope, Population Services International, Ogilvy PR, and Internews explores the strategy of community-level approaches which "emphasise the community, rather than the individual, as the point of engagement." The brief suggests that this approach is more sustainable and that when there is local participation in design and implementation, local ownership is enhanced. "Community approaches focus on group processes (e.g. participation, consensus building, community dialogue)" and often use "public events as a way of reaching and involving community members on a broad scale (e.g. community theatre, sporting events.)"

The intervention itself has been for frontline health workers (FHWs) using a train the trainer model and has included:

1. A targeted training course;
2. Pictorial checklists to guide prevention, care, and referral; and
3. Reusable medical equipment and commodities.

In order to evaluate the effectiveness of this approach, trainers were given a questionnaire to assess their knowledge, and the FHWs were assessed with "objective structured clinical examinations (OSCEs; administered pertaining, immediate post-training, several months follow-up)…" and focus group discussions on the impact of the trainings on FHW practices and perceptions.

Results included a greater likelihood of FHW referring patients to a health facility post-training and a greater reported use of cleaned and boiled delivery equipment after each use (reproductive health), no maternal deaths 30 days after the training, and an improved survival rate of newborns born not breathing (all received additional resuscitation).

An article regarding the training of frontline maternal, newborn, and child health workers in South Sudan informed this brief.