There is a high likelihood of successful continuation. OurMNH work elsewhere in Bangladesh has generated positive results and is gaining interest from others – e.g.PCP is in discussions with Helen Keller International and BRAC re potential collaboration and scale up. Our support for theupazila health complex at the sub-district level and MCWC, general hospital and medical college hospital, linking communities and health staff at the community clinics, will contribute to the likelihood of project gains being maintained. The advocacy element of the project will enable PCP and the communities to advocate at the local level for continued improvements for services and community MNH support using locally generated data and case studies. Women’s group members elsewhere have been elected on to community clinic committees and to stand on the local union parishad (rural administration) and are influencing local MNH issues on the basis of what they have gained from PCPs women’s groups and it is likely this will happen during this project.The model proposed is based on a methodology that has already been replicated and tested for scale up, achieving significant results in Bangladesh (Nahar et al 2012), India and Malawi. PCP itself has implemented the approach at scale in Bangladesh with a significant effect on newborn mortality rates (Fottrell et al, 2013). . The model is highly attractive for replication and scale up elsewhere due to its demonstrated cost-effectiveness (ibid) and potential for saving maternal and newborn lives. When extrapolated to rural areas ofthe 75 countries where more than 95% of all maternal and child deaths occur, the overall impact of the women’s group’s intervention compares well to others and could save an estimated 283,000 newborn deaths and 41,100 maternal deaths each year (Prost et al, 2013).
SCALING-UP AND REPLICABILITY
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