Maternal Health Project

Maternal Health Alliance Project

PROJECT GOAL: The overall goal of the Maternal Health Alliance Project (MHAP) in Malawi is to identify broadly applicable strategies, approaches and methodologies for systematically improving implementation of evidence-based reproductive, maternal and newborn health (RMNH) interventions.

CARE'S INTERVENTION IN MALAWI: CARE’s experience has shown that participatory governance is a key strategy to addressing important barriers to health, including socio-cultural barriers as well as coverage, quality, and equity in service delivery. Our approach to participatory governance brings together community members, service providers, and local government to identify service utilization and provision challenges, and to mutually generate solutions, and work in partnership to implement and track the effectiveness of those solutions in an ongoing process of quality improvement. This collaborative and participatory approach generates buy-in and motivation, leading to improved implementation and outcomes, as well as accountability and sustainability. To facilitate this process MHAP uses the Community Score Card (CSC), an internationally recognized participatory governance tool developed by CARE Malawi.

CARE'S EVALUATION PLAN: CARE is using a cluster-randomized control design to evaluate the effectiveness of the CSC in Malawi. Health centers (and their surrounding catchment areas) are randomly assigned to treatment or comparison conditions. The evaluation includes 10 intervention and 10 comparison clusters. The evaluation consists of a women’s survey, a health worker survey and a medical chart review at baseline (2012) and endline (2015).

Outcomes of interest include the following:
  • Women’s and communities’ empowerment to participate in quality improvement efforts, as well as, access and utilize RMNH services
  • Health workers’ empowerment and their responsiveness, effectiveness, and accountability to communities’ needs
  • RMNH coverage, quality and equity

Raising the Score

Check out a collaborative storytelling project—Raising the Score-- that documents the impact of CARE’s Community Score Card in improving maternal health service in Malawi. View the trailer here:

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And a graphic video that explains the CSC process here:



Maternal Health Alliance 2014 Update

Growing MHAP's Family Tree to Amplify Impact

Evidence of Impact: Stories from the field

MHAP Photos

Official Launch of Muuni Wauchembere Wabwino

What partners are saying about MHAP

Example MHAP Score Card


The Community Score Card Wiki

CARE Community Score Card Toolkit

CSC Overview

Community Score Card.ppt

Community Score Card Implementation Guidance Notes

Guidance for pairing Community Score Card with Social Analysis and Action


CARE Malawi Host Dissemination Event featuring the Minister of Health
Januray 2016
Malawi's Minister of Health, Dr. Peter Kumpalume, confirms that Malawi has managed to meet World Health Organization (WHO) standards on reducing child mortality rate during an in country dissemination event hosted by CARE Malawi. Highlights from the dissemination event were also featured on of one of the most popular online news sites in Malawi, Nyasa Times, creating awareness for a boarder audience! Please click on the link above to read the highlights from the event, as well as the Minister of Health's comments.

CARE Malawi engages stakeholders to improve Reproductive Health Services
August 2015

New CORE Group publication featuring CARE CSC approach
July 2014

CARE Hosts Woodrow Wilson Event on Social Accountability
May 2014

Community Hails CARE Malawi
Malawi Nyasa Times

CARE, Malawi Government Launch Muuni Wauchembere Wabino
October 2013

CARE Launches New Community of Practice
September 2013

Sara Gullo
Senior Technical Advisor
Sexual, Reproductive and Maternal Health