The BBB Program is rooted in two core components: a pregnancy-education book and a community education model tailored to a low-literacy audience. Illustrated with sensitive drawings and written in simple Liberian English, the month-to-month book helps pregnant women to anticipate the various changes to their bodies and provides the knowledge and behaviors needed to ensure a healthy pregnancy and delivery. The book is accompanied by community education and ANC clubs that were designed to reach 500,000 families, women's health providers, and health educators across Liberia. The first phase (2012-2014) included the materials development and dissemination. In phase 2, (2015-2017), 18 NGOs that offer a variety of services including ANC, women’s literacy, education and empowerment, received training, technical assistance and implementation support from the Open Society Initiative of West Africa (OSIWA) to use the materials and establish big belly clubs. Big Belly Sisters and Brothers have held more than 100 weekly clubs at pilot sites.

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