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Welcome to the Maternal Survival Toolkit

The CHANGE Project identified, developed and applied innovative tools and approaches to design behavior change interventions for maternal survival.  CHANGE worked with partners in Kenya, Guinea and Bangladesh to adapt and field test a set of tools to support the design of effective and locally appropriate behavior change interventions.

Maternal Survival: Improving Access to Skilled Care
A Behavior Change Approach

This summary describes the CHANGE Project research and recommendations and provides an overview of the toolkit. (Download PDF - 1.14M)

Framework for Maternal Survival

The CHANGE Project Maternal Survival framework organizes behavior change interventions in three areas:

  1. Seeking Skilled Care (Danger Signs Plus) at the individual household level
  2. Birth Preparedness (Birth Preparedness Plus) in communities
  3. Providing Skilled Care (Skilled Provider Plus) in facilities 

The framework builds on a foundation of interventions at the household, community and health facility levels that are part of a comprehensive behavior change program.  The framework responds to lessons learned and global program experience from the first decade of the Safe Motherhood Initiative.


A set of tools corresponds to each area of the CHANGE framework:  These tools can help programs rapidly move from formative research to the design and implementation of effective interventions and facilitate scale-up of maternal survival programs.  Programs can adapt these tools as needed.

Development of the Toolkit

As part of the development of the toolkit, several documents were produced and are key to understanding and implementing behavior change interventions to improve maternal survival: 


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