Addressing behavior change in maternal, neonatal, and child health with quality improvement and collaborative learning methods in Guatemala

Abstract

This case describes how two projects in Guatemala, both funded by the US Agency for International Development (USAID), applied quality improvement (QI) principles and methods to social and behavior change communication (SBCC) interventions. QI has been mostly associated with improving clinical care, where teams review medical records to determine whether caregivers complied with care quality criteria and then suggest and test process changes to address gaps. Project leaders and stakeholders were convinced that QI elements, such as the plan-do-study- act (PDSA) cycle and collaborative learning methods, could also work to improve SBCC interventions. This case recounts the experiences of a community-based improvement collaborative involving 166 health posts and 429 community centers in Guatemala. The initiative focused on improving processes of care and nutritional results during the first 1000 days of life (from pregnancy to the child’s second birthday) to improve the effectiveness of interpersonal communication and counseling and other SBCC strategies to increase the health knowledge of women and their families and achieve change in 19 health and nutrition-related behaviors.