The Maternal Health Alliance Project

The Maternal Health Alliance Project

Publication info


As a global community we know that the science around what to deliver in reproductive, maternal and newborn health (RMNH) is well-established, but the science on how to do it effectively and efficiently for the greatest impact, is not. CARE is collaborating with others on the development of fast and flexible methods to improve the science of implementation. The Maternal Health Alliance Project is part of this effort through identification of RMNH interventions in Malawi. The MHAP project uses a participatory governance approach, through the Community Score Card (CSC) tool, to find and eliminate barriers to health service utilization and effective delivery. 

Our Project

Objective: Funded by the Sall Family Foundation, The Maternal Health Alliance Project aims to broadly identify broadly applicable strategies, approaches and methodologies for systematically improving implementation of evidence-based reproductive, maternal and newborn health (RMNH) interventions.

Context: In Malawi, CARE is actively seeking to improve the quality of maternal health intervention strategies for three impact populations: 1) women in rural, ultra-poor, single-female headed households; 2) adolescent girls; and 3) women in vulnerable smallholder farming households. Recent situational analyses for these impact populations have shown that maternal, sexual and reproductive health are critical issues. There are a number of underlying factors that act as barriers to optimal maternal health outcomes (e.g. little or no voice in decision-making for accessing health care; lack of basic knowledge about maternal health; early marriage; use of transactional sex, putting them at risk for sexually transmitted infections, HIV and unplanned pregnancy; and gender-based violence).

Since the MHAP project launched in 2012, over 56,000 community members have been reached in 10 project sites, 64 Community Action Groups have been formed to carry out locally developed solutions to address barriers identified in the CSC process, and 13 barriers to women’s and newborns’ health have been identified and tackled. 

Our Approaches

CARE’s approach to participatory governance brings together the community and the health care providers, as well as key stakeholders from the local and district authorities, in a mutual process of identifying needs, concerns, and barriers. To facilitate this process we use a tool called the Community Score Card (CSC), an internationally recognized participatory governance tool developed by CARE Malawi

The CSC approach 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. The CSC consists of 5 phases: I- Planning and preparation, II- Conducting the Score Card with the community, III- Conducting the Score Card with service providers, IV- Interface meeting and action planning, and V- Action plan implementation and monitoring and evaluation. The CSC is an ongoing approach and is repeated every 6 months. 

Our Resources

Films about the Community Scorecard in Malawi

Community Scorecard Tools and Resources

Project Updates

Want to see more?

Download the project brief