Saving Mothers, Giving Life Birth Plan: A Cost-Effective Option for Reducing Maternal Mortality

Background: Efforts to reduce the extremely high maternal mortality rate in Zambia have recently received considerable attention. Saving Mothers, Giving Life (SMGL), launched in 2012 by the U.S. Government, is a multi-partner initiative pilot program implemented in select districts in Zambia and Uganda. With the goal of reducing maternal mortality by 50%, the program in Zambia focused on creating demand for facility-based deliveries and postpartum care using a pictorial birth plan tool, radio advertisements, and the community-based interpersonal intervention “Change Champions.”

Purpose: The USAID-funded Communications Support for Health (CSH) project assessed the effectiveness of demand-creation activities in Zambia to determine the need for improvement and scalability.  

Methods: CSH used a multi-pronged, mixed methods approach. Operations research included in-depth interviews with 54 target audience members and local implementers. An evaluation included a rapid household survey with 152 pregnant women and mothers to measure their exposure, perception, and perceived impact of SMGL. The evaluation also included in-depth interviews with 23 “Change Champions.”

Results: The operations research and evaluation discovered the birth plan to be a potentially high-impact, low-cost, scalable option. The evaluation revealed that the birth plan received a high rate of exposure (71%), recall of messages (34–54%), reported use (82%), and positive perceptions (82%). The operations research also demonstrated that the birth plan was highly useful and accepted. The research underscored the need for consistent training and collaboration among local stakeholders to support effective implementation of the birth plan.