Capacities of women and men to improve maternal and newborn health: Effect of a community-based intervention package in rural Bangladesh

Abstract

BackgroundDespite improvement in recent decades, maternal and newborn mortality in Bangladesh remain high. A community-based intervention package was initiated in 2009 in Netrokona, a rural district in Bangladesh, to engage individuals, families and communities to improve maternal and newborn health. In this article, we present the effect of the intervention package on improvement of women’s capacities with regard to maternal and newborn health, their husbands’ capacities to effectively support them and use of skilled services during pregnancy, childbirth and after childbirth.MethodsWe adopted a quasi-experimental design to evaluate the effect of the intervention package. A cross-sectional household survey was conducted in the intervention and comparison sites at baseline in 2014 and at endline in 2016. A total of 725 women were interviewed at baseline (intervention n = 444; comparison n = 281) and 737 at end-line (intervention n = 442; comparison n = 295). A total of 317 of their husbands were interviewed at baseline (intervention n = 178; comparison n = 139) and 731 at endline (intervention n = 440; comparison n = 291). Propensity score matching (1:1) was performed and the subsequent analysis was restricted among 235 matched women at baseline and 217 matched women at endline. Descriptive analyses were performed for the covariates for matching. Bivariate analyses between baseline and endline were done for reporting women and their husbands’ knowledge regarding pregnancy and childbirth, birth preparedness and complication readiness practices and utilization of health services.ResultsThere was significant increase in awareness of danger signs during pregnancy, childbirth and following childbirth among women and their husbands, as well as increase in awareness of rights related to maternal and newborn health. There was also significant increase in birth preparedness and complication readiness practice among pregnant women and their husbands in the intervention site. Regarding use of skilled health services, there was significant increase in early initiation of antenatal care, attending at least one antenatal care contact and attending at least four antenatal care contacts. No notable improvement was observed in giving birth in the presence of skilled attendant or use of postnatal care.ConclusionsWe conclude that the intervention package was effective in building the capacities of women and in engaging their husbands positively in maternal and newborn health. This may have translated into increased use of skilled care during pregnancy.

Factors Influencing Birth Preparedness in Rapti Municipality of Chitwan, Nepal

“…In this study, too, respondents who made the decision jointly with their husbands are found to have better birth preparedness. It is crucial to state the findings from Bangladesh that it is important to engage husband positively in maternal and newborn health [4]. These engagements might also have cultural influences.…”

“…Birth preparedness and complication readiness (BPCR) is an intervention included by World Health Orgnization (WHO) as an essential element of the antenatal care (ANC) package [3]. The BPCR intervention package based on the WHO IFC framework is effective in building the capacities of women and in engaging men positively in maternal and neonatal health [4]. Birth preparedness includes active preparation and decision-making for childbirth, pregnancy, and postpartum period by pregnant women and their family members [5,6].…”

Training programs to improve identification of sick newborns and care-seeking from a health facility in low- and middle-income countries: a scoping review

“…Of these, 635 studies met the initial inclusion criteria. Within these results, 35 articles [ 20 – 54 ] detailing 28 studies met the revised inclusion criteria. The characteristics of the 35 included articles are summarized in Table 1 and in an expanded Table in Additional file 3 .…”

“…The mothers who did not complete referral were unable to recognize infant danger signs. Rahman et al 2019 [ 54 ] Bangladesh CHW CHW meetings with women and courtyard meetings with husbands and community members. Not specified Build capacities of women (promote birth preparedness and complication readiness, increase awareness of rights and MNH needs and increase health providers’ capacity to counsel women) and engage families and communities (male involvement and community involvement).…”

Development of Intervention Package among Main Care-givers of Pregnant Women and Its Effect on Continuum of Care: Study Protocol for Quasi-experimental Study in Rural Areas of Yangon Region, Myanmar

“…Being an intervention conducting among care-givers of pregnant women, results may be answered for some contradictions regarding the importance of men and families for maternal health according to previous studies [21,25,26,27,28].…”