El Salvador and Bangladesh: Two models of building coalitions to improve maternal and newborn health programmes

Enfants du Monde (EdM), in collaboration with partner organizations, based its maternal and newborn health (MNH) programmes in Bangladesh and El Salvador on the WHO framework for working with Individuals, Families and Communities (IFC). A fundamental requisite of this framework is a participatory planning process that ensures intersectoral and inter-agency collaboration; however, collaboration and partnerships have materialized in very different ways. In El Salvador the IFC framework is integrated into the national strategy with the Ministry of Health (MoH) assuming a lead coordinating role supported by PAHO, WHO and EdM. A national level committee has been formed with MoH and a coalition of non-governmental organizations (NGO). At local level, the IFC committees are led by health centre directors and include all other groups. This approach has created an environment conducive to scaling-up. Challenges have included the time it takes actors functioning at different levels to learn how to dialogue and work together. In contrast, the experience in Bangladesh has followed a different trajectory with a local NGO leading implementation in cooperation with other local NGOs and the district MoH, and only limited collaboration at the national level. This approach has allowed for building a strong network among NGOs and strengthening NGO-government relations at district level. However, the potential for scaling-up is limited without cooperation with the national MoH. Each model has strengths and weaknesses, but in both cases it is clear that developing coalitions with various and intersectoral organizations bringing their expertise to reach common goals reinforces health programs.