207631 USAID's Child Survival and Health Grants Program Improves EBF, ORT, and Handwashing Practices

Monday, November 9, 2009: 1:00 PM

Jennifer Mary Yourkavitch, MPH , Maternal and Child Health Integrated Program, Macro International, Calverton, MD
James G. Ricca, MD, MPH , Maternal and Child Health Integrated Program, ICF Macro, Washington, DC
Karen P. Fogg, MPH , Maternal and Child Health Integrated Program, Macro International, Calverton, MD
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.


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.

Learning Objectives:
After the session, participants will be able to: Describe the estimated impact of hygiene and diarrhea prevention interventions (exclusive breastfeeding (EBF), ORT use, and hand washing) of recent USAID-supported NGO projects Describe the approaches used to increase coverage

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have advised community-based health projects for more than 10 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.