This document summarizes a presentation on establishing a maternal and newborn health program that prioritizes equitable access. It discusses using a "Peoples Institution" model centered around community mobilization and participation. Key elements include forming community health subteams, training community health volunteers, establishing emergency health funds, and integrating community-IMCI (Integrated Management of Childhood Illness). Quantitative and qualitative research was used to evaluate the model's impact on equitable health outcomes for marginalized groups. The presentation concludes that actively involving communities through mobilization and governance strategies, along with community-IMCI, can effectively increase equitable access to maternal and newborn health services.

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.

4. Netrokona District

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”

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

11. PEOPLES’ INSTITUTION

13. CHV Peoples Institution Health Sub Team Health Facilities TTBA Community People Child Survival Program

15. health promotion

16. literacy

18. Quantitative Equity Analysis

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

22. Thank You