Staff from World Relief (WR) developed the Care Group model in Mozambique in 1995. Food for the Hungry (FH) adopted the model in Mozambique in 1997 after discussions with WR project staff, and both organizations have pioneered the use of the model since then. Since that time, the CORE Group has helped document and disseminate the model and it has been used by 28 other NGOs (and counting), in more than 27 countries, largely through the support of the US Agency for International Development. In particular, the USAID Child Survival and Health Grants Program and the USAID Food for Peace (Title II Food Security) Program have helped to fund programs using the Care Group model.
A Care Group is a group of 10-15 volunteer, community-based health educators who regularly meet together with project staff for training and supervision. They are different from typical mother’s groups in that each volunteer is responsible for regularly visiting 10-15 of her neighbors, sharing what she has learned and facilitating behavior change at the household level. Care Groups create a multiplying effect to equitably reach every beneficiary household with interpersonal behavior change communication. They also provide the structure for a community health information system that reports on new pregnancies, births and deaths detected during home visits
Since 1995, WR, FH, and more than 21 others PVOs in more than 20 countries have “adopted the model,” but the degree to which organizations adhere to the original components of the model varies greatly. While there has been increased attention to the model and its effectiveness in lowering child deaths (e.g, mentioned in the UNICEF’s 2008 State of the World’s Children report), there is a danger that the wide variations in what is called a “Care Group” by various agencies will lead to misunderstandings about the model and the use of less effective strategies that do not fit within the model. These variations, in turn, could lead to fewer opportunities to advocate for the Care Group model and its role in child survival since the term “Care Groups” may come to mean many different things to different people, and will probably develop a very mixed track record. There are already situations in which individuals and organizations are defining Care Groups as “any group where you are teaching mothers” or “any group where you are teaching people to teach other people.” Given the excellent and low-cost results seen in the USAID Child Survival and Health Grants Program and Title II food security projects in terms of decreased child mortality and morbidity using Care Groups, we feel that it is important to define official criteria for the Care Group model.
During meetings between World Relief and Food for the Hungry staff members on April 23, 2009, the Care Group criteria in the table below were agreed upon as a draft list. The list is divided into those that we feel should be required to be present when using the term, “Care Group,” and other criteria that we feel have been helpful when included in the model, but that should not be considered required. Edits to this list were then made by the two founders of the model, Dr. Pieter Ernst and Dr. Muriel Elmer. During the CORE Group Spring Meeting in April 2010, this list was presented to other community health practitioners and revisions were made based on their input.
Of course there is no way to enforce the use of these criteria – people will use the term how they wish – but by having two organizations that are recognized as having a history of using and promoting Care Groups extensively (one organization being the original developer), defining formal criteria should provide a stronger basis for recognition of the model and lead to better adherence to the most effective components of the model. We also hope that by informing donors and others about these criteria, they will use the criteria to decide to what degree a proposed implementation strategy is really based on the Care Group model. The CORE Social & Behavioral Change Working Group (SBCWG) has helped with the dissemination of this document, and we expect this will further legitimize the list, and will lead to better compliance with the recommended criteria. The table below gives the required and suggested criteria along with a rationale for each.
This document gives the required and suggested criteria along with a rationale for each.
Care Group Criteria
Care Group Minimum Criteria Checklist: This checklist helps donors and others decide if a project is a Care Group project or not. It is based on the Care Group Criteria document.