Community Engagement to Enhance Child Survival and Early Development in Low- and Middle-Income Countries: An Evidence Review

Abstract

As part of a broader evidence summit, USAID and UNICEF convened a literature review of effective means to empower communities to achieve behavioral and social changes to accelerate reductions in under-5 mortality and optimize early child development. The authors conducted a systematic review of the effectiveness of community mobilization and participation that led to behavioral change and one or more of the following: child health, survival, and development. The level and nature of community engagement was categorized using two internationally recognized models and only studies where the methods of community participation could be categorized as collaborative or shared leadership were eligible for analysis. The authors identified 34 documents from 18 countries that met the eligibility criteria. Studies with shared leadership typically used a comprehensive community action cycle, whereas studies characterized as collaborative showed clear emphasis on collective action but did not undergo an initial process of community dialogue. The review concluded that programs working collaboratively or achieving shared leadership with a community can lead to behavior change and cost-effective sustained transformation to improve critical health behaviors and reduce poor health outcomes in low- and middle-income countries. Overall, community engagement is an understudied component of improving child outcomes.

Community dialogues for child health: results from a qualitative process evaluation in three countries

“…This corresponds to a previous review which found that community sensitization around seeking timely and appropriate treatment led caregivers to favour CHWs over traditional healers as first point of care [43]. These findings confirm that such participatory approaches can improve dialogue and action-oriented decision-making and increase participation by communities, families and individuals, which can result in increased demand for health services and information seeking/sharing and positive changes in individual behaviours and social norms and practices [18]. A recently published study demonstrated that a community dialogue intervention was effective at producing changes in underlying social and cultural factors related to HIV in Mozambique, including gender norms and roles, stigma, knowledge and some behaviours [33].…”

Development and Evaluation of the Korean Health Literacy Instrument

“…They need to be complemented with interventions targeting communities and health care systems (Elder, 2001; Pequegnat, 2011). Other articles in this issue of the journal focus on these other levels of analysis (Farnsworth et al, 2014; Vélez et al, 2014). …”

Growing healthy children and communities: Children’s insights in Lao People’s Democratic Republic

“…Ultimately, the purpose is to facilitate ways for young children to contribute to their own communities. There is evidence that 'programs working collaboratively or achieving shared leadership with a community can lead to behaviour change and cost-effective sustained transformation to improve critical health behaviours and reduce poor health outcomes in low-and middle-income countries' (p. 68) yet children are more often than not considered as part of the desired target group or outcome rather than key actors in effective community mobilisation and participation (Farnsworth et al, 2014).…”