The Care Group Buzz

By November 20, 2009 8 Comments

Care Groups:  Pulling Mothers Together

Welcome to Care Group Info! I’m Tom Davis, Chairman of the Board, CORE Group, and Director of Health Programs for Food for the Hungry.  The CORE Group is THE network for people who work in community health, and the CORE Group has been instrumental in documenting this approach and getting the word out to others.  If you are looking to learn more about methods to reach the poor with lifesaving information at low cost, you’re in the right place.  Care Groups have been around now for 12 years, but recently they have been gaining a lot more attention by international NGOs and multilateral organizations.  If you are new to Care Groups, I recommend you watch the narrated presentation we have posted.  If you are more of a reader, download the manual.

I learned about Care Groups 12 years ago from one of the original developers of the approach, Dr. Pieter Ernst in Mozambique.  (The other main collaborator on the methodology is Dr. Muriel Elmer, formerly with World Relief.)  In Food for the Hungry, we began using them at that point and have used them in many settings in the world (most in Africa) since then.  When — with World Relief — we started to gather information on the results of Care Groups and compared them to other child survival projects, we realized that this was a very special approach that deserved a lot more attention — hence the website.

For example, in our Care Group project using Care Groups in Mozambique (sponsored by USAID), we have seen a 42% drop in malnutrition (underweight) in only 2.5 years.  The cost per beneficiary there is a mere $3.60 per beneficiary per year.  By doing Lives Saved Analysis (using the Bellagio Lives Saved Calculator — the same one used in the Lancet Child Survival Series), we found that for only $305, we could save the life of one child.  This is about 1/4 of the cost to save life for a typical (and very cost-effective) USAID funded child survival program.

As I have read more of the literature on networks, persuasion, community-based social marketing and other disciplines, I have more and more hypotheses about the power of Care Groups and why they are successful.  But these are mostly hunches at this point.  What we do know is that they work.  What we need to do now is to better explore why they work, under what conditions they work, and how to convince policy makers to scale up the approach where it has been effective..

In future posts, we can discuss some of the possible reasons for Care Groups’ success.

Tom Davis

Chairman of the Board, CORE Group

Dir. of Health Programs, Food for the Hungry


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Join the discussion 8 Comments

  • Agung says:

    Use ful tips, can i copy this for my websites

  • Martha Butler de Lister says:

    Great work and very well documneted and presented! Does FH have experience using care groups in HIV prevention and care? to prevent MTCT of HIV?

    • tdavismph says:

      Not Care Groups per se, but FH used a type of cascade group called Youth-to-youth (Y2Y) Groups in its successful ABY HIV prevention program. Kim Buttonow, FH’s HIV/AIDS Programs Coordinator can tell you more about those.

  • Fransa Ferreira says:

    I really enjoyed working and reading through the material on care groups and hehavious change on the blog and other sites. As developing and testing a Programme for Housheold Food Security where we combine food security nutritional behaviour and food gardening, the experiences from CORE and other partners are so releavant to ours.
    Has any of the CORE model / framework been tried with garden caregivers and including nutritional behaviour? We are trying to combine the two.

  • jean kapsner says:

    Actually I have a question. How do we obtain the flip charts for teaching, both the B and W and the colored ones for the promoter. I work in Ethiopia as a Comm Health Developer and need this program. But I am one person.

  • Angie says:


    We are currently working on putting together a DFAP proposal that will use the care group model (modified slightly to align with new government SUN systems) and are looking for sustainability information on the model. Most of what I have read links the facilitators to the health system and think that is great, but is only part of the sustainability issue.

    We know that the governments we work with are resource contrained and so my question is how to ensure that, as time goes on and volunteers “retire” or new groups are formed,new volunteers are trained and acquire the necessary knowledge to be effective?

    Have there been any longitudinal studies looking at the effectiveness of volunteers after program end?


  • tdavismph says:

    In the narrated presentation on Care Groups (on the Tools and Curricula page), I mention a follow-up (longitudinal) study that World Relief did in Gaza Province, Mozambique, where they found that indicator improvements had been maintained and that CGVs were still visiting mothers. I have additional graphs (in Excel format) that I can send to you that show that if you email me (tdavis AT fh.org), but unfortunately, that study was not written up for publication. Concern also has recently conducted a follow-up study in Burundi where they used gov’t health workers as the Promoters in the system, and had as good of results as using their NGO workers. We will post that document when it comes out, but you could contact Jenn Weiss at Concern about that. Government workers would need to be given skills not only in maintenance of the system, but helping the “neighbor circles” of households with pregnant and lactating women choose a new CGV, and then to train them. Health Promotion will always have a cost, and gov’ts should plan to continue supporting the system, even as the behaviors promoted may change. And as WR’s work shows, there are times when communities themselves are willing to do the work to make sure the system is maintained. (For example, they assured retiring CGVs were replaced and current CGVs trained new CGVs.) Also, given the low cost-per-life saved (see the Global Health: Science and Practice article referred to on the home page), this is often the cheapest option for lowering child deaths, improving behavior change, and lowering malnutrition, and that should be important to gov’ts working in a resource-constrained environment. Thanks for your question!