How care moves from the home to the health system and back
Proactive Doorstep Care (PDC) is not a single intervention. It is a connected ecosystem, designed to ensure that every mother and child receives the right care, at the right time, at the right place.
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Care begins at the household, escalates seamlessly when needed and always returns to the family through follow-up and support.
The Care Flow at a Glance
Household → Community → Outreach → Facility → Home
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This continuous loop prevents delays, closes gaps and ensures no mother or child is lost along the way.
1. Community Health Workers (CHWs)
The entry point to care
CHWs are the foundation of the PDC ecosystem.
They live in the communities they serve and are the first point of contact for families. They move care upstream, from crisis response to prevention.
What happens here:
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Pregnant women, newborns and under-five children are identified and registered
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Regular home visits are conducted
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Pregnancies and child growth are monitored
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Nutrition, hygiene, breastfeeding and family planning guidance is provided
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Danger signs are detected early
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Referrals are initiated when higher-level care is needed
2. Midwives on Wheels (MoWs)
Skilled care closer to the home
When a mother or newborn needs skilled clinical attention, Midwives on Wheels bring professional care directly into the community. MoWs bridge the gap between community care and clinical expertise, especially where distance limits access.
What happens here:
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Skilled antenatal and postnatal care
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High-risk pregnancy follow-up
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Newborn assessments
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Birth preparedness and complication screening
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Referral for facility delivery
3. Mobile Outreach Clinics
Clinical services closer to villages
Mobile clinics extend the health system into hard-to-reach areas, reducing travel time and cost for families. They decongest facilities while ensuring families receive essential clinical services close to home.
What happens here:
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Antenatal and postnatal care
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Immunization services
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Growth monitoring
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Family planning
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Treatment of common childhood illnesses
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Follow-up for referred cases
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Treatment of Non-Communicable Diseases
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Cervical Cancer Screening
4. Public Health Facilities
Advanced and emergency care
When advanced or emergency care is required, families are referred to nearby government health facilities. Facilities focus on what they do best, complex and emergency care, while PDC ensures families arrive on time and are supported afterward.
What happens here:
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Skilled facility-based deliveries
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Emergency obstetric and newborn care
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Advanced diagnostics and treatment
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Management of severe childhood illness
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​CHWs and MoWs ensure:
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Referral slips and guidance
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Coordination of transport when needed
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Follow-up after discharge
Closing the Loop: Follow-Up Back at Home
After facility or mobile clinic care, families return to the care of their CHW.
CHWs:
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Conduct post-visit follow-ups
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Ensure medication adherence
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Monitor recovery
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Reinforce health education
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Continue routine care through early childhood
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This is how the ecosystem becomes continuous, not episodic.
Why the PDC Ecosystem Works
✔ Care starts before emergencies
✔ Families are supported at every level
✔ No single actor works alone
✔ Facilities are used strategically, not as the first line
✔ Data and referrals keep everyone connected
✔ Care always returns to the household
PDC is is not a project. It is a functioning last-mile health system.
