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SCOPE: Care Groups

What is a Care Group?

Global evidence has shown the effect of the Care Group model on improving health outcomes. A Care Group (CG) is composed of 10-12 Care Group Volunteers (CGVs) who meet regularly for social behavior change communication (SBCC) and related skills-building on health education topics. After receiving the lessons, each CGV cascades information to 10-15 neighbor mothers in nearby households through group meetings and home visits.

In 1995, World Relief developed the CG model in Mozambique, and since then, the model has gained global recognition and received significant funding through USAID-funded programs worldwide. Due to the model’s effectiveness, nongovernmental organizations working in over 40 countries have implemented the CG model. A CG’s unique ability to extend the health system’s reach through the multiplication of volunteer effort, peer support, and community mobilization makes the model ideal for many projects and programs.

World Relief, through the USAID-funded SCOPE project, established CGs in Haiti, Kenya, Malawi, and South Sudan, equipping them to implement a SCOPE-developed series of training modules adapted from existing USAID-approved curricula. Promoter manuals and volunteer flipcharts included the latest evidence-based best practices on RMNCH information, each adapted for a particular country and its local communities. Each of the four modules was translated and underwent a contextualization process to ensure the messages, stories, and images were locally relevant. The CG model ensured that social behavior change health information was communicated using vernacular language and practiced through simple exercises performed at the household level.

During CG meetings, guided discussions were centered around clear learning objectives. To help facilitate discussions with neighbor women at home or during group meetings, each CGV was equipped with a pictorial flip chart to assist in presenting the lessons in a user-friendly and interactive way.

How Care Groups Impact Survival Outcomes

August 23, 2021 Lokitaung, Kenya with World Relief Staff, visting care groups and chicken projects. Sean Sheridan photographs.

Extending the Reach of the Health System

CGs extended the reach of the health system down to the household level, ensuring that those who lived in hard-to-reach areas knew how and when to access health services. SCOPE CGVs complemented the work of overburdened community health workers (CHWs) by supporting case-finding and referrals so that CHWs could maximize their time in providing information and health services to the clients who needed them most. Through 18,910 CGVs, 192,355 women of reproductive age (WRA) were reached with information to improve RMNCH behavior and practices.

Providing a Key Source of Referrals

CGVs were a vital link between the community and facility services, in that they became a mechanism of the local referral system. Not only did CGVs provide information to their neighbor group members, but they could also recognize warning signs among pregnant women and children under five, and thus make the necessary referrals to the CHWs and facilities.

CGVs were trained to record and report on key vital events such as childbirth, pregnancy, child illnesses, and deaths, as well as provide timely referrals to CHWs who could feed information into existing health information systems. The Care Group model is particularly useful as it can reach a large population while maintaining cost-efficiency, sustainability, and intensive support to CGVs and beneficiaries.

This referral relationship also highlighted the difference between CHWs and CGVs. CHWs have a health background and training that CGVs do not, so the two should be viewed as an extension of each other rather than parallel entities. Therefore, careful consideration must be made regarding remuneration and incentivization. Many of these volunteers and health workers come from the same communities, and differences in incentives can be a source of conflict.

Care Group Structure

Coordinators (paid staff) are responsible for 3-6 Supervisors. Supervisors (paid staff) are responsible for 4-6 Promoters. Promoters support 4-9 CGs which are composed of 10-15 CGVs. CGVs share lessons with 10-15 Neighbor Groups (made up of Neighbor Women and their families). Through this cascade process each Promoter reaches approximately 500-1,200 women via CGVs.

Care Groups for Improved Family Planning and Maternal and Child Health Outcomes

Care Groups for Improved Family Planning and Maternal Child Health Outcomes
The system of group lesson delivery, home visits, and regular mentoring and supervision of CGs fostered peer-to-peer support, facilitated community-wide interest and improved health-seeking behavior among caregivers.

However, Care Groups were not only focused on diffusing messages, but also building their skills to reflect on what they have learned, issues they face, changing behavior, and solving problems together. As Rehema, a SCOPE Kenya CG Promoter in Kajiado reflected on the role of CGs in her community, “One transformed woman is the start point for the change to other women of this community.” In several project geographies, SCOPE found that the CG approach significantly facilitated positive behavior at scale within communities. Women took action in their households and communities. For example, it was observed that CGs across the SCOPE countries improved their hand-washing practices, built tippy taps and latrines using local resources, and grew vegetable gardens.

Despite the challenges from COVID-19 and region-specific political and environmental factors, Care Groups contributed to the positive results noted in the Midterm Evaluation. SCOPE teams reported stories of community members turning their knowledge into action, and rallying around women and young children to advocate for their healthcare needs at local facilities.

Care Groups Curriculum

In addition to the English versions below, each module has been contextualized and translated into local languages for the relevant implementing SCOPE countries (Chichewa, Maasai, Kiswahili, Turkana, Creole, and Zande). If you'd like to access copies of these resources please reach out to


Module 1:
Introduction to Care Groups & COVID Awareness

This module covers meeting protocols, group facilitation skills, and COVID-19 awareness/ prevention.

Promoter Lesson Plan
Volunteer Flipcharts


Module 2:
Child Health & Integrated Community Case Management

This module covers various child health concepts, including nutrition, hygiene, and disease prevention.

Promoter Lesson Plan
Volunteer Flipcharts

Pregnant Mother Icon

Module 3:
Maternal & Newborn Health

This module covers prenatal, maternity, and postpartum care essentials and priorities for newborn care.

Promoter Lesson Plan
Volunteer Flipcharts

Pill Pack Icon

Module 4:
Family Planning

This module covers family planning and reproductive health.

Promoter Lesson Plan
Volunteer Flipcharts

Key Results

Teams reported stories of community members turning their knowledge to action. Below is a snapshot of the project’s results of the Care Group model across the SCOPE countries:

Hear the stories of transformation through SCOPE Care Groups

Good Neighbors: Care Group Volunteers Help Neighbors Understand Family Planning Benefits

Care Group Volunteers in Manikankara, South Sudan help mothers in their communities learn about the importance of family planning.

Care Group Volunteers Help Mothers Seek Care in Modubai Maridi County

SCOPE Care Group Volunteers are helping mothers understand the value of seeking care at their local health facilities when giving birth.

Care Groups and Community Health Facility Partner Together to Increase Facility Delivery

SCOPE addresses child mortality and morbidity in Turkana Country through Care Groups and community health volunteers partnering to provide behavior change messaging for mothers.

Care Groups and Community Health Volunteers Partner Together to Reduce Respiratory Illnesses

SCOPE addresses child mortality and morbidity in Kajiado Country through Care Groups and community health volunteers partner to provide behavior change messaging for mothers.

Care Group Addresses Improved Health Seeking Behaviors

In Maridi, one Care Group Volunteer’s lesson helps a family adapt hygienic ways of preparing nutritious food for the family.

Care Group Addresses Malnutrition for Families in Ibba

SCOPE Care Groups are working to assure that more residents access healthcare services. In Ibba, a Care Group volunteer’s counsel helped a family find the treatment needed to resolve their two-year-old son’s severe malnourishment.

Access to Healthcare in Kajiado County

SCOPE’s Care Groups are working to address behavior change through family planning conversations with women of reproductive age in Kenya.

Impact of Care Groups on the Community in Turkana County

SCOPE's Care Group lessons on hygiene awareness and latrines bring positive transformation to a family in Turkana County.

Care Groups Support Community Health Workers Through Cascade Training

SCOPE’s Care Groups are working to reach the once hard-to-reach populations in the interior areas with maternal and child health message, improving community health outcomes.

Faith Community Engagement Through Outreach Groups

SCOPE is engaging faith leaders in applying religious texts to respond to difficult situations in their communities in Haiti. Through training, faith leaders are learning how to create a positive environment and encourage healthy behaviors to address maternal and child morbidity and mortality.

Derilus shares her experience as an Outreach Group Initiative Trainer and the impact it will have in her community.

Reaching Mothers on Family Planning

SCOPE is working with Care Groups to facilitate faith-sensitive family planning conversations with women of reproductive age in Kenya.

Rehema shares her experience as a Care Group Promoter in her community.

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