Technical Brief: Nurturing Care Groups

Delivering transformative WASH at scale is challenging, in part because delivering behaviour-change interventions at the necessary frequency, fidelity, and coverage levels is difficult. Further complicating the issue, behaviours may be individual, influenced by social norms, or require collective action. The Nurturing Care Group (NCG) approach is a model where 10-12 women chosen by groups of 10-15 neighbouring households each meet with health promoters, and then relay messages back to their neighbours every two weeks.

World Vision conducted a controlled before-and-after trial in two districts of Ghana from June 2019 to December 2020. The NCG program promoted a variety of key WASH behaviours, including household water treatment and storage, toilet construction and use, hand hygiene, menstrual hygiene management (MHM) knowledge and stigma, and animal faeces management.

This study demonstrated that NCGs can effectively deliver high frequency behaviour-change messaging at scale and build social capital—and intentionally leverage that into collective action.