The authors declare that they have no competing interests.
CMG supervised the analysis of study data and prepared the first draft of the manuscript. EV conducted the analysis of study data and contributed to manuscript development. JR contributed to the development of the study methodology and contributed to manuscript development. JP provided statistical support during the analysis of study data and contributed to manuscript development. YT provided technical support on the use of the LiST tool and contributed to manuscript development. HP conceptualized the analysis and contributed to manuscript development. All authors approved the final version of the manuscript.
Globally, less than half of Countdown Countries will achieve the Millennium Development Goal of reducing the under-5 mortality rate (U5MR) by two-thirds by 2015. There is growing interest in community-based delivery mechanisms to help accelerate progress. One promising approach is the use of a form of participatory mothers’ groups, called Care Groups, for expanding coverage of key child survival interventions, an essential feature for achieving mortality impact.
In this study we evaluate the effectiveness of Care Group projects conducted in 5 countries in Africa and Asia in comparison to other United States Agency for International Development-funded child survival projects in terms of increasing coverage of key child survival interventions and reducing U5MR (estimated using the Lives Saved Tool, or LiST). Ten Care Group and nine non-Care Group projects were matched by country and year of program implementation.
In Care Group project areas, coverage increases were more than double those in non-Care Group project areas for key child survival interventions (p = 0.0007). The mean annual percent change in U5MR modelled in LiST for the Care Group and non-Care Group projects was −4.80 % and −3.14 %, respectively (p = 0.09).
Our findings suggest that Care Groups may provide a promising approach to significantly increase key child survival interventions and increase reductions in U5MR. Evaluations of child survival programs should be a top priority in global health to build a greater evidence base for effective approaches for program delivery.