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Implementation Science Alliance for Maternal HealthMHAP Project Overview
PROJECT GOAL: The overall goal of the Implementation Science Alliance 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


MHAP Photos

Growing MHAP's Family Tree to Amplify Impact

Maternal Health Alliance Project Summary

Official Launch of Muuni Wauchembere Wabwino

MHAP Progress Indicator Tracking Table (Dec 2012-Jun 2013)

A letter from the Director, MHAP Update 2013

What partners are saying about MHAP

Example MHAP Score Card


The Community Score Card Wiki

CARE Community Score Card Toolkit

Community Score Card.ppt

Community Score Card Implementation Guidance Notes


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