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Document Abstract
Published: 2013

The equity impact of participatory women's groups to reduce neonatal mortality in India: secondary analysis of a cluster-randomised trial

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Progress towards the Millennium Development Goals (MDGs) has been uneven. Inequalities in child health are large and effective interventions rarely reach the most in need. Little is known about how to reduce these inequalities. We describe and explain the equity impact of a women’s group intervention in India that strongly reduced the neonatal mortality rate (NMR) in a cluster-randomised trial. We conducted secondary analyses of the trial data, obtained through prospective surveillance of a population of 228, 186. The intervention effects were estimated separately, through random effects logistic regression, for the most and less socio-economically marginalised groups.

Key messages:

  • the effects of the women’s group intervention on NMR were substantially stronger among the most socio-economically marginalised than among less marginalised groups in the Ekjut trial.
  • socio-economic inequalities in neonatal mortality can be substantially reduced through a low-cost participatory community intervention.
  • universal coverage combined with ‘soft targeting’ of high-risk groups with effective interventions can have very substantial and equitable effects on mortality
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