USAID's Child Survival and Health Grants Program Improves EBF, ORT, and Handwashing Practices

Background & purpose:

USAID's Child Survival and Health Grants Program (CSHGP) currently supports 41 NGOs implementing 54 projects in 27 countries. Typical projects run 4-5 years with an average of 40,000 child beneficiaries in one district. Projects use a variety of integrated community-oriented strategies for household behavior change and improved service delivery. This presentation will quantify coverage changes achieved by CSHGP grantees for EBF, ORT use and hand washing, and will estimate the child mortality impact of improvements. We describe successful behavior change strategies.

Methods & data used:

Data were collected at baseline and final for standard indicators through population surveys (KPC). These data were analyzed with the LiST tool to estimate child mortality impact (see 2006 APHA presentation). Information on strategies was abstracted from project documents.

Major Results:

The median absolute improvement in ORT use was 47.6% (range 0.3% - 67.9%); EBF 27.8% (range -1.1% - 87%); and hand washing 27.7% (range -12.2% - 90.4%). Estimated overall reduction in child mortality was 23% and 40% of that is attributable to these interventions. Successful behavior change strategies generally were based on regular, one-to-one, interpersonal contacts.

Recommendation:

To achieve MDG 4, further study is urgently needed to build the evidence for these community-oriented behavior change strategies. This will help build consensus among donors and host country governments for scale-up.