Care Groups significantly reduce child mortality in Mozambique

Food for the Hungry/Mozambique's (FH/M) Expanded Impact Child Survival project in Mozambique is covering 10 districts in Sofala Province. This program is based on FH's Title II health program, which has outpaced all other Title II PVOs in Mozambique in terms of reductions in child malnutrition and speed of behavioral change. The analysis described at the 2004 APHA conference was extended to include measurement of child mortality changes. FH's health and nutrition interventions are implemented via Care Groups, a multiplier model where thousands of mothers are taught in groups to promote behavior change with nine of their neighbors. An assessment of mortality was conducted using pregnancy histories conducted by interview teams with members of the National Institute of Statistics, personnel from the provincial/district health systems and NGOs. The survey instruments used in the Demographic Health Survey (DHS) 2003 and standard Verbal Autopsy instruments were adapted for the study. From 1998 to 2001, FH/M decreased the proportion of children 6-23 months who had moderate/severe stunting by 40% (from 50.4% to 30.3%, p<0.05, n=2,337). The current study found a 62% reduction in the under-five mortality rate. The cost-per-beneficiary was $4.50. Other studies on this model (as applied by World Relief) have found similar reductions in the under-five mortality rate and evidence of high sustainability of results. Title II health programs – using effective methods such as Care Groups – should be mobilized to help achieve MDG4, since they can achieve significant improvements in child survival in addition to their impact on childhood malnutrition.