Effect of behavioral change intervention around new-born care practices among most marginalized women in self-help groups in rural India: analyses of three cross-sectional surveys between 2013 and 2016

Saggurti, Niranjan; Porwal, Akash; Atmavilas, Yamini; Walia, Monika; Das, Rajshree; Irani, Laili

doi:10.1038/s41372-019-0358-1

Cited by 17 publications

(17 citation statements)

References 26 publications

(32 reference statements)

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“…A noticeable change was reported in some of the practices like institutional delivery, breastfeeding, uptake of antenatal care among women, and knowledge about sexual and reproductive health among adolescents. These results are consistent with the existing evidence on community-based interventions for improving health practices among marginalized populations in India [18][19][20][21][22]. However, a lack of change in some of the indicators, such as knowledge about HIV testing during pregnancy, uptake of contraceptives, and iron-folic acid consumption among women was evident in the interviews.…”

Section: Discussionsupporting

confidence: 87%

Evaluation of an integrated health and livelihood development program for marginalized communities in India

Sharma

Akhtar

Singh

et al. 2020

Preprint

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Background Women from marginalized communities have poorer maternal health outcomes and limited utilization of health services compared to other communities. There is empirical evidence that comprehensively designed interventions targeting health education of women and social determinants of health, such as financial security, have better outcomes than focusing on health education alone. A community-based intervention was implemented to improve maternal, child, and adolescent health practices in marginalized communities. Besides, the project aimed to promote financial literacy and enhance livelihood opportunities for young people. This three-year peer-led intervention was done in the two districts of Rajasthan, namely Nagaur and Pali. The paper aimed at assessing the effectiveness of this community-based intervention.Methods Pre-post study design based on qualitative research was used for the evaluation of the intervention. Purposive sampling was done both at baseline and the end-line assessments. Focus group discussions were done with women (15-49 years) and adolescents (10-19 years), and in-depth interviews with frontline workers and village health committees were done. Content analysis was done.Results Overall, 4853 women, and 8158 adolescents were engaged in the intervention in two districts. We found a noticeable change in some of the practices like institutional delivery, breastfeeding, uptake of antenatal care among women, and knowledge about sexual and reproductive health among adolescents. Around 23% and 67% of the young people from Nagaur and Pali, respectively, were linked with jobs in computer training centers, tailoring centers, and beauty parlors. However, we found a lack of change in some of the indicators, such as knowledge about HIV testing during pregnancy, uptake of contraceptives, and iron-folic acid consumption among women. Early marriage was widely prevalent in the districts, the reduction of which was underachieved. In the interviews, frontline workers reported having been impartial and inclusive in delivering health services.Conclusions We found evidence suggesting that peer-led interventions are equally effective in improving maternal and child health practices and livelihood promotion. The gaps at system-level, coupled with the presence of specific socio-cultural contextual factors might explain for lack of improvement in some of the indicators.

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Section: Discussionsupporting

confidence: 87%

Evaluation of an integrated health and livelihood development program for marginalized communities in India

Sharma

Akhtar

Singh

et al. 2020

Preprint

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“…Peers in the communities have an important role to play in transforming the health practices of women. Multiple studies have proven the effectiveness of peers in community-based interventions to educate women and improve the health status of the mothers and children [ 17 – 19 ]. Community engagement is central to community-based interventions and a cost-effective tool for sustained behavior change [ 16 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a community-based intervention for health and economic empowerment of marginalized women in India

et al. 2020

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Background Empowered women have improved decision-making capacity and can demand equal access to health services. Community-based interventions based on building women’s groups for awareness generation on maternal and child health (MCH) are the best and cost-effective approaches in improving their access to health services. The present study evaluated a community-based intervention aimed at improving marginalized women’s awareness and utilization of MCH services, and access to livelihood and savings using the peer-led approach from two districts of India. Methods We used peer educators as mediators of knowledge transfer among women and for creating a supportive environment at the household and community levels. The intervention was implemented in two marginalized districts of Uttar Pradesh, namely Banda and Kaushambi. Two development blocks in each of the two districts were selected randomly, and 24 villages in each of the four blocks were selected based on the high percentage of a marginalized population. The evaluation of the intervention involved a non-experimental, ‘post-test analysis of the project group’ research design, in a mixed-method approach. Data were collected at two points in time, including qualitative interviews at the end line and tracking data of the intervention population (n = 37,324) through an online management information system. Results Most of the women in Banda (90%) and Kaushambi (85%) attended at least 60% of the education sessions. Around 39% of women in Banda and 35% of women in Kaushambi registered for the livelihood scheme, and 94 and 80% of them had worked under the scheme in these two places, respectively. Women’s awareness about MCH seemed to have increased post-intervention. The money earned after getting work under the livelihood scheme or from daily savings was deposited in the bank account by the women. These savings helped the women investing money at times of need, such as starting their work, in emergencies for the medical treatment of their family members, education of their children, etc. Conclusion Peer-led model of intervention can be explored to improve the combined health and economic outcomes of marginalized women.

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“…All eligible women from every selected SHG were interviewed, using a structured interview schedule. The sample for this research came from a larger pre-post quasi-experimental study that evaluated the effect of BCC interventions on newborn care practices among the most marginalized women in SHGs [15].…”

Section: Sample Size and Sampling Methodsmentioning

confidence: 99%

Effect of sharing health messages on antenatal care behavior among women involved in microfinance-based self-help groups in Bihar India

Walia

Irani

Chaudhuri³

et al. 2020

glob health res policy

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Background: Bihar state in India has one of the highest rates of maternal and infant mortality in South Asia. Microfinance-based self-help groups (SHGs), involving rural women, are being utilized to improve maternal and child health practice and reduce mortality. SHG members receive information on key maternal and child health practices as well as encouragement for their practice. This study measures the association of health messaging to SHG members with their antenatal care (ANC) behaviors. Methods: The study was conducted in eight districts of Bihar in 2016. A three-stage cluster sampling design (with a random selection of blocks, villages, and SHGs) selected the sample of 1204 SHG members who had an infant child; of these, 597 women were members of SHGs that received dedicated sessions on health messages, while 607 women belonged to SHGs that did not. To examine the impact of the health intervention on ANC practice, radius caliper method of propensity score matching controlled for various socio-demographic characteristics between the two groups. Results: Most of the interviewed women (91.5%) belonged to a scheduled caste or tribe. Nearly 44% of SHG members exposed to the health intervention were engaged in some occupation, compared to 35% of those not exposed to the intervention. After matching unexposed SHG women with exposed SHG women, no significant differences were found in their socio-demographic characteristics. Findings suggest that exposure to a health intervention is associated with increased likelihood of at least four ANC visits by SHG women (ATE = 7.2, 95% CI: 0.76-13.7, p < 0.05), consumption of iron-folic acid for at least 100 days (ATE = 8.7, 95% CI: 5.0-12.5, p < 0.001) and complete ANC (ATE = 3.6, 95% CI: 2.3-4.9, p < 0.001), when compared to women not exposed to the health intervention.Conclusions: The study shows that sharing health messages in microfinance-based SHGs is associated with significant increase in ANC practice. While the results suggest the potential of microfinance-based SHGs for improved maternal health services, the approach's sustainability needs to be further examined.

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Effect of behavioral change intervention around new-born care practices among most marginalized women in self-help groups in rural India: analyses of three cross-sectional surveys between 2013 and 2016

Cited by 17 publications

References 26 publications

Evaluation of an integrated health and livelihood development program for marginalized communities in India

Evaluation of an integrated health and livelihood development program for marginalized communities in India

Evaluation of a community-based intervention for health and economic empowerment of marginalized women in India

Effect of sharing health messages on antenatal care behavior among women involved in microfinance-based self-help groups in Bihar India

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