This end of programme report for the Mobilising Access to Maternal Health Services in Zambia (MAMaZ) programme, looks at the MAMaZ’s original hypothesis, which was that it would be possible to have a direct impact on the first two of the ‘three maternal delays’ (the decision to seek care, and delays in reaching appropriate care) by working directly with communities to build social approval for behaviour change and capacity to establish and manage community emergency response systems. It provides an overview of the interventions that were implemented, and explains why they were appropriate and relevant to the context.
Funded by UK Aid, the programme was set up to design and test innovative approaches to address the household and community level factors that delay or prevent access to maternal and newborn health care services. Established with a large operations research component, MAMaZ aimed to generate much needed evidence on how to intervene effectively on the demand-side in order to improve maternal and newborn health outcomes.
Key innovations are described, including the establishment of an Emergency Transport Scheme, use of a highly innovative training approach for community health volunteers, and introduction of a Social Fund, which provided a community incentive to sustain the change process and keep community response systems operational. MAMaZ’s results included a 27 percent increase in skilled birth attendance rates across the programme’s six districts, a positive achievement after less than two years of implementation. Lessons learned and implications for policy makers and future programmes are highlighted. This report is an important resource for policy makers who are considering funding demand-side interventions in support of improved maternal and newborn health, and for practitioners who are interested in effective programme design.