1. MCHIP/Egypt: Community-based SBC and
GenderInterventions forMaternal, Newborn
and Child Health
Angie Brasington, Community Health and Social Change
Advisor, MCHIP/Save the Children
o n be half o f MCHIP/Eg ypt te am , e spe cially:
Dr. IssamEl Adawi, Chief of Party
Samah Said Helmy, Gender Advisor

2. MCHIP/Egypt Context
 2-year funding to address
high rates of malnutrition
and newborn mortality
 Atmosphere of political
turmoil, rise in religious
conservatism.
 Unable to work with Ministry
of Health (post revolution)
 Deep experience working
with local Community
Development Associations
(CDAs)
BUT, CDAs from the neediest
places had limited experience,
especially in MNCH-focused
programming.
Start-up - November 2011
Community-based
Implementation starts –
November 2012
CB-implementation ends –
Nov/Dec 2013
Endline survey – Jan/Feb 2014

3. 1 Umbrella CDA / District
5-10 Local CDAs / Umbrella CDA
12 CHWs / Local CDA
(Total ~1,200 CHWs)
6 Governorates
12 Districts
(2 per Governorate)
Egypt
120 Villages
(1 Village /CDA =
~15-20,000 pop)
Target Population = 2,041,725
Pregnant Women = 57,168
U2 = 112,295
Newborn = 51,043
Maternal
Nutrition and
Birth
Preparedness
Newborn
Health
Child Spacing
Infant and
Young Child
Nutrition
MCHIP
Technical
Support
SBC and referral by
CDA-trained and
supported Female
CHWs
Capacity Strengthening
of CDAs
Technical Focus
Transformativegender-focusedstrategies
Core Approach Geographic Coverage

4. CHWs provide IPC focused on the 1,000 day period.
Home visits and group antenatal and birth preparation
classes for all pregnant women
PPhome-visits for counseling and referral
Community GMPfor 6- 23 month olds (bi-monthly), followed
by nutrition-focused home visits and classes.
Dialogue sessions with men and women on the influence of
gender and social norms on key health practices – Fam ily
So lidarity Mo dule s
4
MCHIP’s key CB-MNCHInterventions

5. FamilySolidarity- new & appealing
 Sessions interwove popular media -
Egyptian movies & songs, sayings and
mottos that reflect culture
 Critical incidents sparked reflection on
local customs and discussion about
connection between gender, human
rights and health
 Health messages and gender concepts
interlinked social roles and health,
including violence against girls and
women.
5

6. Hot Topics
Participants liked
discussing:
Islam and gender
Gender and leadership
Women’s dress codes -
changes over time and how
dress reflects one’s identity.
Shifts in gender and social
norms over time.
6

7. Roll out process
1. MCHIP trained and supported CDA board members and
staff to conduct Gender Analysis that informed their
program strategies and Family Solidarity Modules (Nov 2012)
2. Gender Advisor developed FSMs (Dec 2012)
3. MCHIP supported CDAs to train CHW trainers on FSM
content and facilitation skills (Jan – March 2013)
4. CDAs trained and supported CHWs to conduct FSMs,
focusing on engaging mothers, fathers and grandmothers
of children under two (April – Nov 2013)
7

8. 81.9
55.7
70.9
65.2
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
100.0
Endline Endline Endline Endline
Intervention Comparison Intervention Comparison
Upper Egypt Lower Egypt
Husbands went to doctor with their wives for ANC
41.9
22.9
44.9
38.3
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
100.0
Endline Endline Endline Endline
Intervention Comparison Intervention Comparison
Upper Egypt Lower Egypt
Men received advice on Spacing
Results fromendline survey
UpperEgypt LowerEgypt
Men participated in group sessions 31.8 19.3

9. Results fromendline survey
52.3
45.8
30.6 28.6
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
100.0
Endline Endline Endline Endline
Intervention Comparison Intervention Comparison
Upper Egypt Lower Egypt
Knowledge of atleast three newborn danger signs

10. 38.5
16.4 17.9 15.1
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
100.0
Upper Lower Upper Lower
Men who participated Men who did not participate
Knowledge to breasfeed more during diarrhea
40.1
12.9
20.9
16.9
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
100.0
Upper Lower Upper Lower
Men who participated Men who did not participate
Joint decision on purchase and selling of animals
Results fromendline survey

11. Learning
 CHWs found Family Solidarity content relevant
to their outreach work and their own lives
 Implementation strategies varied based on
levels of religious conservatism
 Family Solidarity delivered mid-cycle, + and –
 Some sessions conducted jointly, but mainly
conducted for women and men separately.
11

12. Learning
 Build trust in communities -- he alth as a no n-
co ntro ve rsiale ntry po int – then start FSMs
 Be flexible and rely on local organizations to
refine process and activity plans
 Work closely with Village Health Committees
 Invite participation of religious leaders – and be
prepared for their inputs
 Train and support male and female facilitators
 Develop women’s leadership skills
12

13. 13
ThankYou