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Closing the Gap by Design: Setting up a Maternal Newborn Health Program as if People Mattered. The Peoples Institution Model Alan Talens, MD, MPH    Nancy TenBroek,  MA  Will Story , MPH EmdadHoque , MD, MPH CORE Group Spring Meeting Baltimore MD May 12,2011
STRATEGIC  THEMES Of  CRWRC Constituent Engagement Relief and Development  under  Justice Umbrella Building Country Capacity
Sub district performance assessed by using the “Proportions  of births attended by skilled birth personnel” indicator.
Netrokona District
Antenatal Care (4 or more visits) OR=2.06 [ns] OR=Undef.
Doer/Non-Doer for ANC Male  Docs Waste Of money Mothers-In law  approval Supers- tition Advantage Complete PE Husband Cooperation
Qualitative  Findings (PLA)  “Heavy work for pregnant women is good” “Less food during pregnancy is beneficial” “Less food for moms after delivery will keep them fit”
Goal  of Project to reduce mortality and improve health status among the most marginalized mothers and newborns Study Questions:  Does the PImodel lead to more equitable outcomes in  MNH compared to the status quo? How does the Peoples Institution  model reach the poor and marginalized women and children in their community?
Community Mobilization  + Community-IMCI
PEOPLES’ INSTITUTION
CHV Peoples Institution  Health Sub Team Health Facilities  TTBA Community People Child Survival Program
PRIMARY GROUPS ,[object Object]
health promotion
literacy
agriculture.,[object Object]
Quantitative Equity Analysis
Qualitative Multi-case Study Analysis Esytablishes the HOW Figure 1. Level of social Capital Level of community mobilization  Closeness of household to health provider Lay providers are involved in care and referral

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Considerations For Incorporating Health Equity in Project Design_Talens_5.12.11

  • 1. Closing the Gap by Design: Setting up a Maternal Newborn Health Program as if People Mattered. The Peoples Institution Model Alan Talens, MD, MPH Nancy TenBroek, MA Will Story , MPH EmdadHoque , MD, MPH CORE Group Spring Meeting Baltimore MD May 12,2011
  • 2. STRATEGIC THEMES Of CRWRC Constituent Engagement Relief and Development under Justice Umbrella Building Country Capacity
  • 3. Sub district performance assessed by using the “Proportions of births attended by skilled birth personnel” indicator.
  • 5. Antenatal Care (4 or more visits) OR=2.06 [ns] OR=Undef.
  • 6. Doer/Non-Doer for ANC Male Docs Waste Of money Mothers-In law approval Supers- tition Advantage Complete PE Husband Cooperation
  • 7. Qualitative Findings (PLA) “Heavy work for pregnant women is good” “Less food during pregnancy is beneficial” “Less food for moms after delivery will keep them fit”
  • 8.
  • 9. Goal of Project to reduce mortality and improve health status among the most marginalized mothers and newborns Study Questions: Does the PImodel lead to more equitable outcomes in MNH compared to the status quo? How does the Peoples Institution model reach the poor and marginalized women and children in their community?
  • 10. Community Mobilization + Community-IMCI
  • 12.
  • 13. CHV Peoples Institution Health Sub Team Health Facilities TTBA Community People Child Survival Program
  • 14.
  • 17.
  • 19.
  • 20. Qualitative Multi-case Study Analysis Esytablishes the HOW Figure 1. Level of social Capital Level of community mobilization Closeness of household to health provider Lay providers are involved in care and referral
  • 21. Conclusion 1.Active Community Mobilization and C-IMCI appear to be an Effective combination for an Equity Strategy 2.Include equity in the design from the beginning 3. Incorporating Equity in our programs in the right thing to , a moral obligation . Community Mobilization/ Governance and C-IMCI as Equity Strategies