Encouraging Positive Practices for Improving Child Survival (EPPICS)

Interpersonal communication is central to this project. For instance, community health volunteers receive training to encourage community members - in particular, husbands and mother-in-laws - to include wives in household decisions and choose healthier birthing practices. This approach was designed to address what organisers identified as a hurdle to maternal health: persuading decision-makers at the household and community levels to encourage women to give birth in health centres for safer deliveries. Volunteers also reach out to key leaders who potentially have the power to sway public opinion, including village chiefs, religious leaders, elders, and magazias (queen mothers), who are respected female leaders.

The project also helps form mothers' groups to promote antenatal services, institutional deliveries, and exclusive breast-feeding. Furthermore, recognising that many women give birth with traditional birth attendants, the project is encouraging these attendants to link pregnant women to health facilities so that mothers can benefit from prenatal and other referral services.

The EPPICS project reaches additional community members through use of "Community Giant Scoreboards". These large signs serve as visual tools that are meant to rally residents by publicly tracking community performance against key maternal and child health indicators. Community health volunteers update the scores monthly, using green or red sticks to indicate positive or negative progress. The scoreboards are intended to mobilise community members to engage in healthy practices to improve performance results. The scoreboards also serve as an educational tool by presenting images of desirable and undesirable health practices.

Maternal and Neonatal Health

Maternal and infant mortality and morbidity remain high in this district, largely due to traditional practices that can put mothers and newborns at risk.

According to CRS, a comparison of survey results from October to December 2012 to the same period in 2013 showed that the number of mothers who registered for antenatal care increased from a baseline of 52% to 97%. Those who attended at least 4 antenatal visits increased from 47.7% to 71.2%, and intermittent preventive treatment against malaria (IPT2+) increased from 59% to 77.8%. Institutional deliveries increased from a 43% baseline to 79.3%, and exclusive breastfeeding increased from a baseline of 46% to 89%. In addition, postnatal care improved from 32% at baseline to 84.5%. "The project also helped to establish a formal link between communities and district health information systems. These initial results promise to make a sustainable impact in improving maternal and neonatal outcomes in communities served."