Mobilization of Organized Communities for Surveillance of Healthy Practices During Pregnancy and Childbirth

Presenter: Veronica Triana, Management Sciences for Health

Background:  In Peru, gaps persist in prenatal care (91.9%) and institutional delivery (72.0%) in rural areas compared to national averages (96.9 % and 89.2%, respectively) (2014 DHS). In its 2011 baseline, the Healthy Communities and Municipalities II (HCM II) project, funded by the United States Agency for International Development (USAID) identified that in the rural communities in which it works, care in pregnancy and delivery were not sufficiently valued by women and their families, and that the community’s role in promoting a healthy, safe and voluntary motherhood was fragile.

Methodology:  In that context, HCM II prioritized capacity development with families for maternal health, with the support of a social network of community leaders (Community Neighborhood Board, or JVC in Spanish) who monitor maternal and child health practices through household visits, as well progress towards becoming healthy families. This process was developed using the four phases of health promotion: (i) awareness and organization: with the support of the JVC, families take on the challenge of becoming a “healthy family”; (ii) planning: families analyze their maternal health practices and make commitments to change; (iii) implementation: families adopt healthy practices, with key monitoring visits by the JVC, and education and follow-up with health personnel and local government; and (iv) self-evaluation: families and JVCs identify changes in behavior, environments and living standards that favor maternal health.

Results:  This intervention enabled an improvement in demand for prenatal care from 68.2% to 79.5%, and hospital births from 88.2% to 96.4% (both p < 0.01), as per the 2011 baseline and the 2014 mid-term evaluation.

Conclusion:  The empowered role of the JVC in monitoring with families, with support and participation of health workers and local government, is improving public knowledge of key maternal health issues, as well as improved social cohesion and coordination for its promotion.