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Scaling Impact to Save Lives

November 01, 2011

This post is part of our coverage of a convening of global health and communications experts at the Bill & Melinda Gates Foundation this week, openly and creatively discussing the opportunities and challenges of promoting life-saving behavior change. Join the conversation on Twitter at #scaleimpact or leave a comment below!

As the world’s population hit 7 billion yesterday, there’s been a lot of talk about the incredible advances the global community has made improving the health of the world’s poorest people and saving lives, especially when it comes to children.  In 1960, about 20 million children died before they turned five years old. By 2010, that number was reduced to less than 8 million. This is undeniable progress.

But the fact that almost 8 million children still die each year highlights the tremendous amount of work that still lies ahead.  How will we continue to bring this number down?

First, we need to continue scaling up new and existing vaccines. These miracle technologies were critical, cost effective tools in bringing down deaths so far and they will continue to do so.

Second, we have to target the deaths that vaccines will not address. We know that over 40 percent of these nearly 8 million children die during the first 28 days of life and that percentage is growing over time.  Bringing down these deaths will mean finding ways to get best practice family health innovations into the hands of the people who need them the most. 

Fortunately, we have made significant advances in developing the interventions that will save newborn lives. Most of these are not technological, but instead require changing behaviors, such as getting mothers to adopt kangaroo care and clean cord care

The challenging step is to get more people to embrace these health innovations and adopt them as standard practice. 

Or, in other words, how do we scale impact?

We need to understand how new ideas become accepted and how certain behaviors become widely adopted within a culture.

We can say to a new mother: “Make sure the umbilical cord is clean and dry to prevent infection.” But there is so much we don’t understand about spreading this specific message.  What prevents a mother in Uttar Pradesh from letting the cord dry? What is the best way to help her understand why she should? Can you use the same message with a mother in Malawi?

To help us answer some of these questions, I am thrilled to welcome some of the world’s top family health and behavioral change experts to Seattle today for our first convening on driving social behavior change and effective knowledge-sharing: “Achieving Lasting Impact at Scale:  Social and Behavioral Change and the Spread of Family Health Innovations in Low-Income Countries.”  This diverse set of practitioners, policy makers, researchers, foundation grantees, partners and staff will spend two days analyzing how ideas spread.

Our group will explore how ideas and solutions are passed from village to village, neighbor to neighbor, mother to child.  We will anchor our discussions around the most effective ways of spreading ideas. 

Over the next few days, we’ll  share what we’re learning about behavior change and the effective spread of solutions.  Please join the conversation by commenting on the posts, or join me on Twitter (@melindagates) using the hashtag #scaleimpact. 

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