Participatory Learning and Action (PLA) Innovations
PLA-MNH works. We aim to scale-up through community health workers, in rural communities, to improve maternal and newborn health and reduce mortality.
Women and Children First is actively investigating if the community health group PLA methodology can be adapted through other mechanisms, in other settings, to improve other global health issues.
These questions underpin our portfolio of PLA research projects.
PLA through…
If scaled up to rural areas in all countries with the highest rates of maternal and newborn mortality, PLA-MNH could save over 350,000 maternal and newborn lives per year.
Successful scale-up of PLA-MNH currently relies to a large extent on the public sector – particularly systems of community health workers who can support groups. Even though cost-effective, it would require functional community health worker systems, sophisticated management platforms and multi-million dollar budgets.
To reach more communities and save more lives, we have designed new ways to achieve scale-up when these are not present:
Radio: PLA has been adapted for delivery through interactive community radio shows which guide listening groups to take collective action to address health problems with locally designed solutions.
Markets: Promoters and distribution agents selling subsidised health commodities already work hard to reach clients in the last mile. PLA has been adapted for delivery by family planning promoters, benefiting the communities while building a client base for the health commodities that are on sale.
A child skips in Padun Latwong Village, Uganda
Nhkwang pa Dabang IDP, Myanmar
PLA in…
PLA has a World Health Organisation global recommendation promoting its implementation, particularly in rural settings with low access to services, where current evidence is strongest.
However, recent experiences suggest there may also be potential for the approach in humanitarian settings, specifically Internally Displaced People (IDP) camps.
PLA has been adapted for delivery in IDP camps and findings from a trial by our partners at UCL found that, running PLA in partnership with local indigenous social groups in Somalia, can help achieve important changes in childhood vaccination knowledge and practices.
PLA for…
PLA is a tool that can bring people together, effectively activating communities to take collective action to address health problems with locally designed solutions.
It has worked for maternal and newborn health and mortality, but what about other global health issues affecting local communities?
We have started where our experience is strongest and adapted PLA to address unintentional childhood injuries, family planning uptake, adolescent sexual and reproductive health, health service access for people with disabilities and vaccination uptake.
A women's health group meets in Kutambala village, Malawi (Photo: Corrie Wingate)
What we are doing now
Working on PLA-MNH for over 20 years has shown time and again the incredible changes communities can make and provided a blueprint for how we work on new PLA innovations. Collaborating closely to identify and design simple innovations > rigorously testing them > bringing those with the greatest potential to scale.
Using this blueprint, we are proud to have developed a rich pipeline of new PLA innovations:
Alternative models of PLA:
- Unintentional Injuries: PLA to reduce mortality from unintentional injuries in children aged 0-5.
- Family Planning: PLA to increase uptake of family planning services.
- Adolescent Sexual and Reproductive Health and Rights (ASRHR): PLA to improve ASRHR.
- Disability: PLA to reduce mortality through improved health care access.
- Vaccination: PLA to increase uptake of vaccination services.
Alternative delivery mechanisms for PLA:
- Capsule-PLA: A rapid, ‘curriculum-based’ version of PLA amenable to contexts where access to communities is more time-limited and delivery by health workers.
- Radio-PLA: A remotely radio-facilitated version of PLA.
- Private sector-PLA: A version of PLA adapted for delivery by community-based private health-care workforces.
Alternative settings for PLA:
- Humanitarian-PLA: A version of PLA appropriate for delivery in internally displaced people (IDP) camps.
Women and Children First has also adapted the PLA community health group approach for a project to improve infant feeding, care and dental hygiene amongst South Asians under 2 year olds in Tower Hamlets and Newham, East London, UK. You can read more about the Nurture Early for Optimal Nutrition project here.
All these innovations are currently under evaluation, with all undergoing pilot testing and two scheduled for effectiveness testing. We plan to continue incubating and guiding these new innovations through the pipeline and preparing them for scale-up.
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