Innovating for maternal and child health

Among ethnic minorities in the Lao PDR, we assessed how trust in Village Health Volunteers (VHVs) promotes facility-based postnatal care (PNC) follow-up, the least utilized Maternal and Child Health service, through male-female VHV pairs.
A mixed-methods study (July–September 2024) was conducted in 35 villages enrolling 241 mothers (mean age, 24 years; SD, 5.7) who had given birth within the past year. Trust in VHVs was measured as a composite score, and logistic regressions examined its effect on PNC uptake. Interviews with 21 mothers, 6 husbands, 10 VHVs, 5 health staff, and 3 district officials were analyzed inductively to understand the role and the communities' perception of gender-paired VHVs.
PNC coverage was only 19.0%. High trust in VHVs was associated with 12.25 times the odds of follow-up PNC use (95% CI, 2.2–67.8). Yet, frequent VHV contact is sometimes misunderstood as a substitute for professional care in high-trust communities, lowering service uptake. In villages where VHV pairs had been introduced earlier, trust in VHVs was stronger. Key explanations were: (1) gender-matched interactions enhanced comfort and acceptance of VHV activities, thereby empowering women, and (2) male VHVs played a complementary role by reinforcing husband and family support through local leadership.
Pairing male and female VHVs may foster trust by balancing leadership, family engagement, and women's empowerment. To maximize the benefit of trust on MCH service utilization, paired models must be supported by quality communication strategies that reinforce, rather than replace, facility-based care.

Social and Behaviour Change Communication (SBCC) now extends beyond traditional media, reaching new audiences through social media platforms. In Nigeria, where misinformation about maternal and child health spreads rapidly online, professional voices are urgently needed to provide accurate, relatable health education. Doctor Chandus is a physician-led digital health education platform that uses short videos, live sessions, and social media discussions to address pregnancy, postpartum, and child health issues in simple everyday language. 
This abstract reflects on lessons from seven years of creating and sustaining digital SBCC content for Nigerian mothers aged 25–40. The platform emphasizes empathy, cultural sensitivity, and evidence-based communication to promote positive health behaviours. Engagement analytics and audience feedback reveal that even modest followership can yield meaningful behavioural impact, with mothers often citing changes in practices such as exclusive breastfeeding, mental health, antenatal attendance, and postpartum care. Challenges include combating misinformation, consistency constraints due to founder's workload, audience fatigue, and limited metrics for measuring impact. The experience highlights the growing relevance of doctor-led SBCC in the digital age and the potential of social media as a bridge between medical expertise and community trust.

The Mayi and Mwana project, implemented by Catholic Relief Services (CRS) in Zambia's Eastern Province, aims to reduce maternal and newborn mortality by improving access to quality healthcare. In collaboration with the Ministry of Health, the project strengthens care during pregnancy, delivery, and post-natal periods, while promoting social behavior change. A baseline survey conducted by the project in 2023 revealed low male partner attendance in Antenatal Clinic (ANC) visits. To enhance male involvement, Mayi and Mwana designed targeted Social Ecological Model(SEM)-based SBC interventions that leveraged existing systems and structures at community and health facility levels. These included community radio listening groups and gatekeeper-led community engagements (including traditional and faith leaders). These efforts were complemented by the procurement of Modified Motor Tricycle Ambulance (MMTA) and the establishment of Health Emergency Transport Committees (HETC) to address health access transport challenges. Early results show increased early ANC enrollment and reduced home deliveries. Integrating SBC into existing community structures has empowered local stakeholders, enhanced sustainability, and reduced resource duplication. The project's comprehensive approach offers a scalable model for improving maternal and child health outcomes

Tunza Afya chat is a WhatsApp chatbot delivered as part of a broader SBCC campaign including radio and television, in Tanzania focused on child survival and maternal health. The chatbot is run in partnership between Development Media International (DMI) and the Ministry of Health and was launched in November 2023, with 64,039 ever users to date. Tunza Afya Chat covers topics related to child health and development and maternal health – using text based as well as Audio Visual (AV) content. The chatbot is promoted via several channels including radio and television as well as community health workers and clinics.  
Our mixed-methods process evaluation of Tunza Afya chat includes 90 (n=896) focus group discussion (FGDs) between January 2024 and April 2025 across rural, peri-urban and urban areas. Quantitative data is collected automatically on chatbot use and engagement, including metrics on sections of the chatbot used, number of messages sent, and self-reported responses to questions on healthcare seeking behaviours. 
FGD Results found high levels of acceptability of Tunza Afya chat, and that participants found the content accessible and informational. Quantitative data found good levels of engagement, and a high self-reported level of care seeking following chatbot advice to seek treatment. These findings together provide strong evidence for continued development of Tunza Afya chat, integrating suggested feedback from the FGDs such as expanding content, and developing further metrics to explore behaviour change as a result of chatbot interactions.