Promoting Healthy Behaviors among Egyptian Mothers: A Quasi-Experimental Study of a Health Communication Package Delivered by Community Organizations.

Decisions made at the household level, for example, to seek antenatal care or breastfeed, can have a direct impact on the health of mothers and newborns. The SMART Community-based Initiatives program in Egypt worked with community development associations to encourage better household decision-making by training community health workers to disseminate information and encourage healthy practices during home visits, group sessions, and community activities with pregnant women, mothers of young children, and their families. A quasi-experimental design was used to evaluate the program, with household surveys conducted before and after the intervention in intervention and comparison areas. Survey questions asked about women's knowledge and behaviors related to maternal and newborn care and child nutrition and, at the endline, exposure to SMART activities. Exposure to program activities was high in intervention areas of Upper Egypt: 91% of respondents reported receiving home visits and 84% attended group sessions. In Lower Egypt, these figures were 58% and 48%, respectively. Knowledge of danger signs related to pregnancy, delivery, and newborn illness increased significantly more in intervention than comparison areas in both regions (with one exception in Lower Egypt), after controlling for child's age and woman's education; this pattern also occurred for two of five behaviors (antenatal care visits and consumption of iron-folate tablets). Findings suggest that there may have been a significant dose-response relationship between exposure to SMART activities and certain knowledge and behavioral indicators, especially in Upper Egypt. The findings demonstrate the ability of civil society organizations with minimal health programming experience to increase knowledge and promote healthy behaviors among pregnant women and new mothers. The SMART approach offers a promising strategy to fill gaps in health education and counseling and strengthen community support for behavior change.

Best practices for a successful MNCH partnership that an external evaluation could never find: experiences from the Maternal and Child Health Integrated Program.

Partnerships for maternal, newborn, and child health (MNCH) are increasingly prevalent, yet little has been published about the possible reasons for their success or failure. In this commentary, we assess the presence of four principles for a successful collaborative partnership-clear goals, clear roles, trust, and commitment-within the Maternal and Child Health Integrated Program (MCHIP), an MNCH partnership among eight implementing organizations that was funded by USAID from 2008 to 2014. MCHIP made substantial strides in developing clear goals and partner roles, and despite external constraints, to develop the trust and commitment needed to work in an interdependent manner. Future collaborative MNCH partnerships should pursue a shared understanding of these four principles as early and often as possible to ensure success.