This brief highlights key learnings for policymakers from research that explores AfriScout and the causal impact of two intervention models designed to support pastoralists in Ethiopia and Kenya.

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Savings groups—often referred to as informal community banks—are small groups of people who save together and lend to each other from their pooled funds. Globally, as many as 500 million people belong to savings groups. Approximately 80% of members are women, and many savings groups programs are designed to advance gender equality.  

This is the quintessential principle of Global Communities’ Women Empowered (WE) initiative. While helping women access financial resources and build sustainable livelihoods, WE employs innovative solutions to promote women’s participation, leadership and collective action, enabling them to become confident leaders in their homes and communities. 

But how can groups achieve the same level of agency and participation for women in communities with low literacy and financial numeracy levels? Nearly 800 million people globally are non-literate and close to one billion are unable to read and write multi-digit numbers. Two-thirds of them are women. 

In the South Omo region of Ethiopia, many communities share an unwritten mother tongue and rely on oral or visual communication, preserving cultural history through storytelling traditions. However, the lack of written language can exclude women from formal economies, negatively impact their education and economic opportunities, and make them more vulnerable to exploitation and financial losses.  

To address this challenge, the United States Agency for International Development (USAID) Resilience in Pastoral Areas South (RIPA South) project, in collaboration with My Oral Village (MOVE) and private funders, launched a pilot program called WE Record! in 2022. This collaboration set out to trial an Oral Information Management (OIM) solution with 12 WE groups in three woredas in the southern region of Ethiopia. Subsequently, 13 additional groups were engaged in the OIM and numeracy trainings in South Omo.  

The goal of this initiative was to design visual savings group tools, build the capacity of savings groups members to use them, and foster numeracy and recordkeeping skills. By centering inclusivity, WE Record! also hoped to create a safe environment for deeply oral communities to develop financial literacy and protect their economic investments.  

“Before I participated in OIM and my practice group, I was challenged to count over 2000 birr. I lost money selling my livestock because I couldn’t clearly identify notes or count large sums of money. I would sometimes pay a fee to a person who could count and identify notes very well.” 
– WE savings group member 

The collaboration between RIPA South and MOVE yielded a suite of innovative Oral Information Management (OIM) tools specifically tailored for the financial interfaces of WE groups in this region. The toolkit includes a visually intuitive passbook and ‘mini ledger’, exercise book, training manual, practice group guide, share-out form and share-out guide. These instruments are designed with step-by-step visual instructions, employing two pivotal design innovations, oral iconography and currency frames, to guide members through the WE savings group rules and procedures. 

Understanding the WE passbook is critical to participation in savings groups. Typically, the pages are text-based, but in the OIM version, they have been converted to carefully field-tested mnemonic iconography. By retaining the same structure and format, users can build their knowledge of financial syntax when comparing the original and OIM passbooks. 

The exercise book supports member learning, because it contains many blank pages and pages with currency frames. Learning depends on doing, and this is where participants practice and can keep any record they wish, such as loans they have given to others or sales they have made in the markets. 

Members use the practice group guide as a graphical, step-by-step introduction to numeracy and record-keeping that does not depend on the ability to read.  

Annually, groups perform a share-out to capture the performance and contributions, involving a lengthy and arithmetically complex process. The OIM share-out form and guide illustrates how to complete the form and undergo the process to increase participants’ confidence and ensure the long-term sustainability and transparency of the savings group.  

This suite of tools not only empowers individuals but also strengthens the financial infrastructure of the communities they serve, marking a significant stride towards inclusive financial literacy and autonomy. 

Implementing innovative solutions like OIM in rural settings has shown to help reduce WE savings groups’ dependency on community facilitators, allowing participants to have full control of their finances and creating a safe context for transactions. It’s a step towards bridging the gender gap by creating opportunities for women to take control of their finances through Women Empowered, ensuring they have the resources they need to support themselves and their families. 

“[Oral Information Management] is useful for managing our daily financial transactions. When we go to the market to sell and purchase goods and services, we don’t face stress, fear, or need additional assistance because these skills support counting and calculating numbers and transactions so easily that our confidence is increased.” 
– WE savings group member, Dasanech Woreda in South Omo 

An end-line review of the WE Record! Pilot project provided clear evidence that the OIM tools and solutions helped WE savings group members acquire new skills. At the start of the pilot, only 11% of savings group members could write a 1-digit number and by endline, 69% of the participants could do so. Members’ confidence in and satisfaction with their groups – a critical indicator of sustainability – also rose from the beginning to the end of the project. Their confidence in the accuracy of the ‘share and loan balances’ increased from 70% to 90% and their confidence in their own knowledge of the amount of money stored in their savings group lockbox grew from 58% to 88%. 

During the pilot project, the number of groups utilizing this system grew from 12 at the onset of the pilot to 25 total, and 17 were effectively transitioned to independently track their savings, loans and social funds using the OIM passbook and mini ledger. 

The post How Oral Information Management Tools Boost Women’s Financial Literacy and Savings in Ethiopia appeared first on Global Communities.

Last month, the World Bank held its 2024 Fragility Forum – a biannual conference that brings together policymakers, researchers and practitioners from humanitarian, development and peacebuilding communities to exchange knowledge and ideas about how to improve our approaches in fragile, conflict and violence-affected settings. This year’s theme was “Adapting and Innovating in a Volatile World.” 

After the Forum, I asked my Global Communities’ colleagues who attended the event for their reflections. Kelly Van Husen, Vice President for Humanitarian Assistance; Patricia Dorsher, Senior Manager for Humanitarian Business Development; Meena Grigat, Director of Humanitarian and Nexus Business Development; and Patrick Woodruff, Manager for Humanitarian Assistance participated in the exchange. The conversation was edited for length and clarity. 

Paula: In most of the sessions I attended, the panelists painted a bleak picture. The world is increasingly fragile, marred with compounded crises and intertwined risks, from protracted conflicts and climate disasters to chronic political instability and widespread food insecurity. The World Bank estimates that by 2030, almost 60% of the world’s poor will live in countries classified as fragile and conflict-affected situations (FCS). During the opening session, Anna Bjerde, Managing Director of Operations at the World Bank noted that we cannot end poverty without addressing fragility. She also said, “I’m going to be very honest with you. … We are not preventing conflict.” Why? What are the key factors behind these alarming trends?  

Patricia: I have been working on our humanitarian assistance portfolio for the past few years and found it difficult to identify funders who are willing to address the root causes of conflict in contexts like Syria, where the outcomes are very political. For example, investing in infrastructure in the non-regime areas could help stabilize the lives for millions of people, but humanitarian donors do not see this as their purview and development actors do not want to pay for something where there is no recognized government counterpart to work with. We have been working to find intermediate solutions, but with funds decreasing, humanitarian donors want to focus on the urgent, lifesaving activities and not those that can help counter systemic fragility.  

Patrick: Well said, Patricia. Humanitarian and development organizations are often forced to choose between working with actors considered illegitimate by the international community and restricting or even halting programming to at-risk populations. This was evident after the Taliban’s takeover in Afghanistan. The disengagement of many actors, including donors, not only left many people at increased risk, but resulted in brain drain of trained humanitarian workers who fled the country or went underground. The lack of funding and support for national non-governmental organizations has led to devastating backtracking on hard-won gains in the rights of women and minority groups. We can see this trend in almost every major crisis today, from Ukraine and Syria to Gaza and the West Bank. Furthermore, many, if not most humanitarian and development organizations are overly reliant on government funding from the Global North. It makes it increasingly difficult to respond to the needs on the ground when the donor countries are aligned with one side of a conflict. While this is understandable from a political standpoint, porous funding streams leave hundreds of thousands, if not millions of people without lifesaving aid, in direct contradiction to the humanitarian principles.

Patricia: So true! During the session on “State Building in Protracted Crises,” I was struck by the discussion on Palestine led by Nigel Roberts, former Country Director for Gaza and the West Bank at the World Bank. Roberts talked about how the World Bank is designed to be apolitical – at least at a technocratic level – but is beholden to a board that is, by nature, political. Because of this dichotomy, the World Bank has missed many opportunities to help realize economic improvements and development objectives for Palestinians. This resonated with me. In humanitarian assistance, we frequently grapple with the mandate to be “neutral” and “apolitical,” and yet our largest government donors are responsible for carrying out domestic and foreign policies. Being neutral or apolitical is often thought of as the refusal to choose sides, but we fail to recognize that this is also a choice with consequences. It raises the question of what it means to be neutral or apolitical, and if it is ever truly possible.  

Paula: How can we, and others in the sector, address these challenges?  

Patrick: To me, some of the most impactful discussions at the Fragility Forum were around the need to stay engaged in challenging situations, including by finding ways to work with illegitimate or diplomatically isolated actors. Many panelists emphasized that humanitarian organizations have the moral responsibility to remain engaged in order to alleviate suffering. They also noted that continued engagement decreases the financial and social costs that result from humanitarian and development actors leaving in the face of these challenges. Of course, there is no easy solution to this, and every organization needs to make its own decisions based on acceptable risk levels. I think that the most important thing that organizations can do is to protect the foundations of humanitarian work, which is rooted in the principles of impartiality, neutrality and independence. By reinforcing these ideals, organizations will be better positioned to respond to crises based on needs. 

Meena: The sessions I listened to reinforced the importance of investing time and resources into developing an in-depth understanding of the local context. It is very important to build long-term relationships with local communities and actors, and to conduct political economy and conflict analyses. We must be ready to work with communities and local systems over the long-term in order to see impact. 

Patricia: I have to echo what Meena said. You can’t ignore the political context and conflict dynamics. Understanding them at the macro, meso, micro and even household levels is essential if we want to work effectively in fragile and conflict-affected areas. I also want to second what Patrick said about staying engaged. When a new crisis emerges, donors and implementers cannot just forget about conflicts that have been going on for years or decades. When Russia invaded Ukraine, there was a sudden reassignment of critical funding and programming to Ukraine and its refugees. Now, the devastating humanitarian crisis in Gaza dominates the headlines. While we must respond to these new crises to the fullest extent possible, we must still remember about people in Yemen, Syria and other fragile states with protracted conflicts and instability. Their voices deserve to be heard, and their needs deserve to be met, too. I am proud of our programming in Syria, where we have been addressing food security, protection, water, sanitation and shelter needs for a decade. I truly hope donors will remain engaged there for years to come. 

Kelly: One theme that I heard repeatedly in the sessions I attended was around the need to be agile and innovative. This is not necessarily new, but the speakers highlighted how critical it is for implementers – particularly those working in fragile contexts – to be flexible: constantly evaluating, assessing and identifying new opportunities to shift programming to better meet humanitarian needs and more effectively achieve program outcomes. The Forum also reinforced the need for continued advocacy to our donors, policymakers and other stakeholders around flexible funding mechanisms. In a volatile world we live in, funding mechanisms must have built-in opportunities, such as crisis modifiers, to quickly adapt and pivot to rapid emergency response.  

Paula: Indeed. The ability to fluidly respond to changing circumstances is a game changer. We have witnessed how crucial this is in many contexts. In Ukraine, for example, our long-term development program – Decentralization Offering Better Results and Efficiency (DOBRE) – was able to quickly mobilize its networks and provide rapid emergency response right at the onset of Russia’s full-scale invasion in 2022. This paved a way for the Community-Led Emergency Action and Response (CLEAR) program, which we launched soon after in two regions overlapping with DOBRE. By layering life-saving humanitarian interventions with development assistance, we can more effectively respond to the crisis, set the stage for post-war recovery and foster lasting resilience to shocks and stresses.  

Ethiopia also comes to mind, where we are implementing the Resilience in Pastoral Areas South (RIPA South) project. In March 2022, amid one of the driest rainy seasons on record, RIPA South activated a Crisis Modifier to address urgent needs of the most vulnerable people affected by the drought. The Crisis Modifier sets aside funds for emergency response measures to save people’s lives, rescue livestock and safeguard economic gains made possible by development activities. We have categorized these interventions into three windows: livestock support, multi-purpose cash assistance and access to water, sanitation and hygiene.  

Paula: Where else is Global Communities adapting or innovating in the face of fragility and constant change? 

Kelly: Gaza was mentioned several times during the Forum. Since the start of the Israel-Hamas war on October 7, 2023, we have pivoted more than 20 years of programming to address the urgent needs resulting from this devastating humanitarian crisis. Our teams are managing to adapt and innovate in Gaza, despite extremely constrained and dangerous circumstances. As you know, 2.2 million people are at the imminent risk of famine, and we are proud to serve as the World Food Programme’s (WFP) main implementing partner. We have been able to shift our WFP work from cash to in-kind assistance, and we have pooled resources and knowledge to partner with others, for example the World Central Kitchen, to provide hot meals. We are also distributing nutritional supplements to pregnant women, nursing mothers and small children who are at increased risk of malnutrition. In addition, we are setting up latrines and sinks, and he have provided winterization support to many families. This represents critically needed agility and creativity that has enabled us to continue working in this extremely challenging environment.  

Paula: Agility in adapting to evolving needs is vital in our efforts to ensure efficient, timely support in both stable and crisis conditions. I imagine we have had to adapt and innovate our own internal processes and mechanisms to make it happen.  

Patrick: Yes, absolutely. Global Communities is currently developing Protocols for Emergency Response, so that we are humanitarian-ready even in relatively stable environments. I am personally involved in this effort. We want to ensure that our organization has systems in place to respond to natural disasters and conflicts quickly and effectively. We place a heavy focus on increasing the resilience, preparedness and ability of our country teams to respond with existing programming. This is often done by leveraging our ongoing development programs, like in Gaza, Ukraine or Ethiopia. 

Kelly: We work at the intersection of sustainable development and humanitarian assistance, so strenghtening the capacity of our country teams to pivot from development programming to emergency response is one of our main internal priorities.  

Paula: Many panelists emphasized how important it is to strengthen local institutions and make them more inclusive in order to solve conflicts and maintain peace. For example, Bjerde said that it is crucial to focus not just on services but also on the institutions behind the services, making sure that their capacity is built. “When things go wrong, when things get difficult and hard, it’s those institutions that need to actually step up even more,” she said. What are your thoughts on this? 

Patrick: I agree. This brings up the topic of localization, which was frequently mentioned at the Forum too. To protect hard fought gains, we must ensure that local and national actors – who do the vast majority of the work on the ground – have the adequate resources and power to adapt their programming in a way that is contextually appropriate.   

Paula: Right. Ultimately, it is the local communities and institutions who have the intimate understanding of their needs and priorities, and who can design context-specific and culturally relevant interventions. This came up a lot in the session “Gender Equality in FCV Settings: Moving from Humanitarian Responses to Creating Resilience.” Amini Kajunju from the Ellen Johnson Sirleaf Presidential Center for Women and Development spoke very passionately about investing in community-driven solutions, leveraging local expertise and elevating local women leaders. She also stressed that civil society organizations are central to providing services in fragile settings, especially when state institutions are weakened. I know that our sector has a long way to go to fully realize the localization principles, but I think we are making strides. For example, localization is a core strategy of our CLEAR project in Ukraine, where we invest in small, community-based organizations (CBOs), which deliver emergency assistance and protection services to war-affected populations. Of course, this approach has its challenges. When I visited Ukraine last year, many CBO leaders shared their struggles with strict donor compliance requirements. We hear it in other settings, like Syria, too. This is where we come in with our capacity strengthening interventions, which are extremely helpful, but take time. 

Paula: How else did the conference connect with the work you are doing at Global Communities? 

Meena: The session “Troubled Borders: Subnational Conflict in Middle Income Countries” was relevant to the context in northern Ghana, where we have extensive experience implementing water, sanitation and hygiene programs. The region is one of the key focus areas under the U.S. Global Fragility Act. Communities in the districts along the borders of northern Ghana are part of interconnected trade and migration networks, and there are major concerns over the spread of violent extremism into these communities. The speakers stressed the complexity of border economies and governance institutions, and the need to consider market systems, the flow of goods and ideas, the role of the state, and the ability of local actors to arbitrate conflict. 

Paula: Great point. Conflicts and the climate crisis do not recognize borders. Several panelists also emphasized the need to support countries receiving refugees and discussed the global impact of the war in Ukraine. The fragility that has emanated from Russia’s invasion has cascaded globally, affecting countries not just in Ukraine’s vicinity, but states on other continents. For example, the conflict has had a major impact on the global wheat supply, resulting in a widespread food security crisis.  

Thank you for sharing your reflections. As some of the panelists noted, sustainable development is not possible without sustainable peace, and we need tectonic shifts and holistic approaches to address the interconnected global risks and polycrises. I left the Fragility Forum and our conversation with the following recommendations:  

• Anticipate better and be prepared to ensure effective, timely support when conditions change. 
• Remain engaged when challenges arise. Ensure stable funding streams. Continuity is vital when fragility grows.  
• Acknowledge that conflicts and the climate crisis do not recognize borders. 
• Focus on prevention and resilience building. Address the drivers and root causes of fragility. 
• Strengthen state institutions, engage the private sector and invest in civil society organizations, including women- and youth-led groups, which are often first responders in fragile settings and play a huge role in recovery efforts. 
• Improve governance and the rule of law. 
• Ensure that interventions are inclusive and gender-responsive. Talk to people you typically do not engage with. 
• Localize development and humanitarian interventions. 

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Global Communities has worked to save mothers’ and children’s lives and improve their health and well-being since 1961. We implement integrated maternal, newborn, child health and nutrition (MNCHN) programs at the individual, family, community and institutional levels. On the supply side, we partner with governments, civil society, and frontline health workers to strengthen health systems, focusing on enhancing the accessibility, quality and equity of MNCHN services. On the demand side, we work with individuals, families and communities to increase uptake of these services; adopt improved health, nutrition and hygiene behaviors; and increase citizens’ participation in decision-making processes that shape MNCHN service delivery. We promote evidence-based interventions such as kangaroo mother care (KMC) for preterm and low birthweight babies, optimal breastfeeding and complementary feeding practices, community-based management of acute malnutrition (CMAM), growth monitoring, multiple micronutrient supplementation and anemia screening. Our solutions are community-driven, people-centered, and grounded in the principles of gender equality, universal access and accountability.

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In 2012, the United States Agency for International Development (USAID) partnered with the United Nations Children’s Fund (UNICEF) and the Governments of India and Ethiopia to convene the Child Survival Call to Action, which galvanized unprecedented commitments from governments and civil society around the world to end preventable maternal and child deaths. Three years later, UN Member States adopted the Agenda for Sustainable Development with ambitious targets to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030 and end preventable deaths of newborns and children under 5 years of age, also by 2030. Yet every two minutes a woman dies due to pregnancy or childbirth, and most of these deaths are entirely preventable.

New data released this February by several UN agencies shows significant progress in reducing maternal deaths between 2000 and 2015, but also reveals alarming setbacks for maternal health over recent years. According to the report, “The world must significantly accelerate progress to meet global targets for reducing maternal deaths, or else risk the lives of over 1 million more women by 2030.”

I recently chatted with Cara Endyke Doran, our Senior Director of Health, WASH and Nutrition, about these trends and about ways in which Global Communities is saving mothers’ and children’s lives.

This is the first conversation in our new series “Pass the Mic,” where staff from Global Communities share innovative ideas and in-depth insights on timely topics spanning the development, humanitarian and peace nexus. The interview was edited for length and clarity.

Paula: You recently traveled from Boston to Washington, D.C., to attend the global event Maternal and Child Survival: A Decade of Progress and Action for the Future, co-convened by USAID, UNICEF and the Governments of India, Senegal and the United Kingdom. A Hill Reception organized by the Global Health Council and co-sponsored by Global Communities followed. Why were these convenings important to you and what was your key takeaway?

Cara: These events were important because they provided an opportunity for global leaders, health experts, advocates and practitioners to come together to review progress made in maternal and child health since 2012 and to chart a course for future action. Despite significant improvements toward reducing maternal, newborn and child deaths since 2012, many populations around the globe do not have equitable access to high-quality care. Even when care is available and of quality, women and children still do not have access to and control over resources to attain a high standard of health and well-being. Furthermore, many health systems lack the ability to adapt to changing epidemiologic and demographic trends. During the event, USAID addressed these continued challenges and released a new strategic framework for preventing maternal and child deaths by 2030. The framework laid out a plan for improving maternal, newborn and child health outcomes through a renewed focus on coverage, quality and equity. 

Paula: While there were calls for a celebration, most experts acknowledged dramatic setbacks caused by the COVID-19 pandemic, ongoing conflicts and natural disasters. For example, Dr. Atul Gawande, Assistant Administrator at USAID, pointed out the first drop in life expectancy since World War II. What is needed to rebuild the momentum and get back on track for achieving related Sustainable Development Goals by 2030?        

Cara: Lessons from Ebola and other emergencies have taught us that women and children are often the first to suffer in a crisis. The impact of the COVID-19 pandemic on women and children is no different. Widespread disruptions in health services have impacted women’s access to lifesaving maternal health services, such as treatment for postpartum hemorrhage, infection and high blood pressure. These disruptions have also impacted children. For example, we saw major backsliding in childhood immunizations, leaving millions of children at increased risk of contracting vaccine-preventable diseases. Children have also been at risk of malnutrition due to disrupted food systems and decreased access to essential nutrition services.

At Global Communities, we understand the critical need to advocate for and maintain essential services in an emergency to avoid preventable mortality as well as improve data access and quality to support timely decision-making. We aim to reinforce stronger, more resilient and adaptable health systems that put the needs of women, children and other vulnerable people at the center of programming. This includes holistic, locally led programs that support sustained political will, adequate investment and financing of health systems. We also believe in the power of equitable partnerships and multisectoral approaches to address health and well-being. Ensuring meaningful participation of women and overlooked groups in the design and implantation of programs is of key importance. So is accountability to the people we serve.  

Paula: The speakers consistently mentioned the need to invest in primary healthcare and integrated services for moms and babies. In fact, some talked about a radical reorientation of health systems towards primary health. What is your perspective on this issue? Is Global Communities well-positioned to support this effort? 

Cara: Global Communities advances opportunity, well-being and resilience among vulnerable groups and across all ages. We believe that maternal and child health services are most effective when they are integrated across the continuum of care for mothers, newborns and children. We work with local health structures to bundle services within existing platforms, especially primary healthcare, to improve access, address multiple health needs at once and increase cost-efficiency. Our approaches are locally driven and grounded in systems-thinking, gender equality, social inclusion, evidence and ingenuity.

With our community-driven systems approaches, we are optimally placed to strengthen primary healthcare systems to improve maternal and child health. By involving community members in the planning, implementation and evaluation of primary healthcare projects, we can ensure that the healthcare services are tailored to the specific needs of the community. By leveraging the local knowledge and tapping into the existing networks and resources within the community, we can increase the effectiveness and sustainability of primary healthcare projects. And by making an effort to understand local contexts and include community members in the decision-making process, we can build trust and relationships between healthcare providers and community members. Through our partnerships with communities, we can ensure that the delivery of high-quality healthcare services can continue even after external funding ends.

Paula: I very much appreciated the focus on equity during the event. Dr. Omar Abdi from UNICEF remarked that 10 years ago equity was an ‘innovation’ in the maternal and child health space, but now everyone is talking about it. The speakers emphasized the importance of using equity data to understand who is left behind and then ensuring that health interventions reach the poorest and most marginalized populations. Advancing equity is one of the cornerstones of Global Communities’ mission. What tools and approaches do we use to promote equitable and gender-responsive access to health services?  

Cara: Global Communities uses a multipronged approach to ensure equitable and gender-responsive programs. Where appropriate, we start our programs with gender analyses that examine how gender roles, norms and relations affect access to health services and health outcomes. These analyses help us identify barriers and opportunities for addressing gender disparities and improving women’s and children’s access to care. We also embed metrics to assess health equity in our data systems. This involves tracking health outcomes and health service utilization by gender and other social determinants of health to identify gaps and monitor progress toward health equity.

Paula: At the event USAID Administrator Samantha Power launched a new strategy, Preventing Child and Maternal Deaths: A Framework for Action in a Changing World. The strategy lays out an action plan to improve health outcomes for women and children by 2030. What is your vision for Global Communities’ maternal and child health programming in the next 5-10 years?

Cara: Over the next five years, I hope to strengthen and expand our ability to support primary health systems to be able to protect women, children and adolescents in a world affected by climate change. The goal is to ensure that people we serve have access to quality health services and can achieve the highest possible level of health and well-being. That children not only survive but thrive, and that we transform systems to meet their needs. And that health systems are well-managed with the ability to adapt and respond to changing needs of the community, including in times of crisis.

Paula: Climate change and its impact on maternal and child health were also mentioned by multiple speakers. Youare representing Global Communities as a co-chair of the USAID-funded Child Health Task Force, which is exploring this issue. Can you share a few thoughts on this subject?

Cara: Through the Child Health Task Force we are unpacking the effects that changing climate has on children and exploring system-level approaches that health systems can take to adapt to changing conditions. According to the Children’s Climate Risk Index, climate change is already significantly affecting children globally, with approximately 1 billion children at ‘extremely high risk’ of experiencing the negative impacts of climate change. While research and literature linking climate change and environmental degradation to ecological and social outcomes have been rapidly proliferating, there is a noticeable lack of data on the intersection of climate, environment and health. We seek to address this information gap through a webinar series “Adapting Health Systems to Protect Children from the Impact of Climate Change.” These events foster greater discussion on under-represented but important child health themes. Please join the series here. We also promote collaboration across sectors and organizations to advocate for greater global investment in adapting child health systems to become more resilient in the face of climate change going forward.

Paula: Global Communities has worked to save mothers’ and children’s lives and improve their health and well-being for six decades. What is, in your opinion, our greatest contribution or achievement thus far? What are you most proud of?

Cara: One of the hallmarks of Global Communities’ approach is training and mentoring community health workers (CHW) to deliver high-quality maternal and child health services. We work to ensure that these frontline health workers are motivated and equipped with knowledge and skills to employ global best practices, such as kangaroo mother care, community-based management of acute malnutrition and emergency obstetric and newborn care. It is very exciting and rewarding work. My colleagues and I recently published a paper in the Journal of Social Science and Medicine titled “Effects of Engaging Fathers and Bundling Nutrition and Parenting Interventions on Household Gender Equality and Women’s Empowerment in Rural Tanzania.” EFFECTS was a cluster-randomized controlled trial co-designed and implemented by Global Communities. The study generated novel evidence that, with the right approach and resources, CHWs can deliver gender-transformative nutrition and parenting interventions to couples in low-resource community settings with potentially synergistic positive effects on household gender relations and maternal and child well-being.

Paula: Very exciting, congratulations! Empowering CHWs is so important. This was also a recurring theme of the events we talked about. One speaker, Millicent Miruka — a CHW Supervisor from Kenya — made an impassioned plea to recognize CHWs’ contributions, listen to their voices and ensure they are well-trained and supervised. I am also proud we are doing this work.

Thank you for your time! How can our readers reach you to learn more?

Cara: To learn more about Global Communities’ work in promoting maternal and child health please visit our website and read our most recent technical factsheet. If you have questions about our programs, please email us at hello@globalcommunities.org. You can also find me on LinkedIn.

Cara Endyke-Doran

Senior Director, Health, Nutrition & WASH

Cara Endyke-Doran, MPH, MSN, RN, is an advanced practice nurse with nearly 25 years of experience leading large international health programs focused on women’s, children’s, and adolescent’s health. Her technical areas of expertise include maternal, newborn, child and adolescent health, gender, and HIV prevention, care, and treatment. She is a thought leader who sits on global task forces and advisory groups. Cara is an innovative and effective problem-solver who adapts and responds to evolving program needs. She has held long-term assignments in Mozambique, Zambia, and Nicaragua and provided technical support to programs in Guatemala, Haiti, Honduras, India, Kenya, Liberia, Malawi, Tanzania, Uganda, and South Africa. She has her master’s degrees in Public Health and Nursing from Johns Hopkins University. She speaks Spanish and Portuguese.

The post Pass the Mic: Reinvigorating Global Efforts to Reduce Maternal and Child Mortality appeared first on Global Communities.

Strengthening local health care

so it truly serves the community by putting people first, especially women, children, and those most at risk.

Enhancing the systems behind health

from clinics and supply chains to trained providers — so they can serve their communities, adapt to crisis and change, all while building the foundation for lasting well-being

Supporting frontline health workers

Ensuring frontline health workers like nurses, midwives, and community health workers have access to the skills, resources, and support they need to serve their communities with compassion and confidence.

Using open-source digital tools

real-time data and analytical approaches to support the people at the center of our health systems

Improve health policy

Linking with innovative partners, corporations, regional and local governments, and communities to improve health policy, accountability and seamless care built around individuals and families

Featured Program

INSPiRE: Integrated Health Services in West Africa

In West Africa, limited access to quality care puts women and newborns at high risk during pregnancy and the first months of life. Through the INSPiRE project — implemented with IntraHealth International and funded by the Bill & Melinda Gates Foundation — Global Communities is helping transform that reality.

The INSPiRE model integrates essential services for mothers, infants, and young children into a single visit, covering prenatal care, safe delivery, postpartum follow-up, immunizations, nutrition, and family planning. This streamlined approach reduces missed opportunities and makes care more accessible for women in remote areas.

Now active in more than 14,000 health facilities across eight countries, INSPiRE has already led to dramatic gains in family planning and well-baby visits. 

Learn More

Global Communities and Partners Launch Familia Imara to Combat Violence and Support Child Development

March 4, 2026

In a major step toward scaling evidence-based solutions for domestic safety, Global Communities officially soft-launched the Familia Imara project in Dar es Salaam in February. This transformative initiative, part of the global “What Works to Prevent Violence: Impact at Scale” (What Works 2) program, convened civil society leaders, researchers, and stakeholders to align on strategies for protecting…

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The Language of Home: How UNIDOS Supports Classroom Success in Guatemala

January 23, 2026

Teaching someone how to read is rarely simple. Helping them want to read takes something even more. At the Yulchén JV elementary school in Guatemala’s Western Highlands, Marta noticed that her first- and second-grade students rarely reached for books on their own. Many of the stories available to them were not written in the languages…

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Digitizing Health Payments: A New Era for Community Health in Tanzania

December 8, 2025

Driving Community Health Systems Resilience Through Financial Inclusion and Smart Coordination In Tanzania, community health workers (CHWs) are often the first point of contact for care, particularly in underserved and hard-to-reach communities — monitoring child growth, preventing the spread of disease, delivering critical health education, and connecting people to lifesaving services. Their support is also…

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The post Global Health appeared first on Global Communities.

A responsive and well-functioning newborn referral system is a cornerstone to the continuum of child health care; however, health system and client-related barriers negatively impact the referral system. Due to the complexity and multifaceted nature of newborn referral processes, studies on newborn referral systems have been limited. The objective of this study was to assess the barriers for effective functioning of the referral system for preterm, low birth weight, and sick newborns across the primary health care units in 3 contrasting regions of Ethiopia.

The post Referral systems for preterm, low birth weight, and sick newborns in Ethiopia: a qualitative assessment appeared first on Global Communities.