Maternal, newborn and child health
Effect of a participatory intervention with women’s groups on birth outcomes in Nepal: cluster-randomised controlled trial
Community-based approach leads to reduction in maternal and newborn mortality, Nepal
Authors:
D. S. Manandhar; D. Osrin; H. Standing; A. M. de L. Costello
Publisher:
The Lancet, 2004
This article, published in The Lancet, reports on the effects of a community-based participatory intervention to reduce neonatal (newborn) mortality in rural Makwanpur district, Nepal. The intervention was conducted among random clusters or groups of local women. In each cluster, a local female facilitator convened nine group meetings each month. Findings showed that from 2001 to 2003, the neonatal mortality rate was 26.2 per 1000 live births in the intervention groups compared with 36.9 per 1000 in the control clusters. The maternal mortality ratio was 69 per 100,000 live births in the intervention clusters compared with 341 per 100,000 in the controls. Women in the intervention groups were also more likely than those in the control groups to have antenatal care, institutional delivery, trained birth attendance and hygienic care.
The authors conclude that a community-based approach based on local participation can substantially reduce neonatal and maternal mortality in poor and remote communities by enabling changes in home-care practices and care-seeking. They argue that such an intervention has the benefit of being acceptable, sustainable and cost-effective and, with sufficient investment and political commitment, could also be rapidly scaled up. They recommend further research into how to replicate the approach in different settings.
*This document is reproduced with permission of Elsevier Ltd.
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