Measuring What Works: An Impact Evaluation of Women’s Groups on Maternal Health Uptake in Rural Nepal

• Autores: Sharma, Sheetal; Teijlingen, Edwin van; Belizan, Jose; Hundley, Vanora; Simkhada, Padam; Sicuri, Elisa
• Año de publicación: 2016
• Idioma: inglés
• Tipo de recurso: artículo
• Materia: Maternal; Health
• Institución: Consejo Nacional de Investigaciones Científicas y Técnicas

Backgroundç: There is a need for studies evaluating maternal health interventions in low-income countries. This paper evaluates one such intervention designed to promote maternal health among rural women in Nepal. Methods and Results: This was a five-year controlled, non-randomised, repeated cross-sectional study (2007, 2010, 2012) of a participatory community-based maternal health promotion intervention focusing on women’s groups to improve maternal health services uptake. In total 1,236 women of childbearing age, who had their last child ≤ two years ago, were interviewed. Difference-in-Difference estimation assessed the effects of the intervention on selected outcome variables while controlling for a constructed wealth index and women’s characteristics. In the first three years (from 2007 to the 2010), the intervention increased women’s likelihood of attending for antenatal care at least once during pregnancy by seven times [OR = 7.0, 95%CI (2.3; 21.4)], of taking iron and folic acid by three times [OR = 3.0, 95%CI (1.2; 7.8)], and of seeking four or more antenatal care visits of two times, although not significantly [OR = 2.2, 95%CI (1.0; 4.7)]. Over five years, women were more likely to seek antenatal care at least once [OR = 3.0, 95%CI (1.5; 5.2)], to take iron/folic acid [OR = 1.9, [95% CI (1.1; 3.2)], and to attend postnatal care [OR = 1.5, [95% CI (1.1; 2.2)]. No improvement was found on attending antenatal care in the first trimester, birthing at an institution or with a skilled birth attendant. Conclusion: Community-based health promotion has a much stronger effect on the uptake of antenatal care and less on delivery care. Other factors not easily resolved through health promotion interventions may influence these outcomes, such as costs or geographical constraints. The evaluation has implications for policy and practice in public health, especially maternal health promotion.
Fil: Sharma, Sheetal. Bournemouth University; Reino Unido
Fil: Teijlingen, Edwin van. Bournemouth University; Reino Unido
Fil: Belizan, Jose. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Hundley, Vanora. Bournemouth University; Reino Unido
Fil: Simkhada, Padam. Liverpool John Moores University; Reino Unido
Fil: Sicuri, Elisa. Universitat Autònoma de Barcelona; España. Imperial College London; Reino Unido