Written by This £249,843 projectwill improve knowledge of best practice MNH care in the community, change behaviour and reduce newbornand maternal death rates. This intervention is highly cost effective according to World Bank and WHO criteria – the cost effectiveness of the RCT this project is based on was US $220 to $393 per year of life lost averted. (Fottrell et al, 2013). Poverty at the community level will be reduced because the project design focuses specifically on the prevention of MNH problems (through hygiene, infant feeding, social supportetc) and the underlying causes of mortality which affect women, men, boys and girls (e.g. social isolation, poor nutrition, dangerous traditional practices, delays in seeking care). The community level solutions are virtually cost-free for the target groups, once they have taken them on board. We will work within existing community structures which will contribute to a high potential for sustainability. Our successful experience of working in partnership on similar projects suggests it is low risk, including the potential for corrupt activities.In addition this project delivers value for money in the following ways:
- Economy – we will minimise the cost of inputs by: working with incentivised women’s group facilitators instead of paid facilitators; minimising start up costs – PCPis familiar with the approach, having delivered such an intervention before and has already streamlined its management team. Existing staff are familiar with this project methodology and have strong relationships in Bogra already, and we will use and adapt pre-existing M&E systems.We will adapt existing training and meeting manuals and other materials so set up costs will be low and quotes for all capital purchases will be obtained before purchase.
- Efficiency – we will maximise the number of communities reached by: working with community volunteers (women’s groups members) while also providing the required coverage to achieve results; working with existing systems;locating the project within the communities; working with traditional leaders to develop and implement the project ensuring buy-in and community ownership; monitoring the women’s groups’ strategies and disseminating learning and best practice from the project using appropriate methods. Improving the MOH’s referral systems and raising staff/management awareness will also improve efficiency.
Effectiveness – The impact on MNH and death rates is highly cost effective (as above). The health system strengthening and advocacy elements of the project empower the communities to use the community MNH data to demand better quality services and hold decision makers to account.