| Despite the utility of each of these
frameworks, they all focus on the medical model of maternal
survival. Improved recognition of danger signs will automatically
increase timely use of skilled care. In addition, they
imply that the "pathway to maternal survival"
is a direct, linear route. Several additional dimensions
need to be addressed for these frameworks to represent
the complex contextual and cultural factors that contribute
to maternal careseeking decision-making and the frequent
"detours" off the pathway that women and families
make when seeking skilled care.
The CHANGE approach can enhance the effectiveness of
current methods of creating demand for skilled care
among households and families. It expands the conventional
"danger-centric" framework to identify and
integrate the contextual domains where maternal health
behaviors occur. It focuses on understanding the broader
socio-cultural context of household decision-making
so this information can be incorporated into behavior
change strategies. |
