Systematic review of community participation interventions to improve maternal health outcomes in rural South Asia

Sharma, Binod Bindu; Jones, Lisa J; Loxton, Deborah; Booth, Debbie; Smith, Roger

doi:10.1186/s12884-018-1964-1

Cited by 24 publications

(30 citation statements)

References 41 publications

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“…[25,26] Besides, community-based intervention was suggested to minimize urban-rural difference. [27,28] Primary care at hospital and emergency care accessibility is proved to be useful. [29] Another point needs to be considered is that there is spatial correlation between different regions, areas with high MMR could affect surroundings.…”

Section: Discussionmentioning

confidence: 99%

Analyzing maternal mortality rate in rural China by Grey-Markov model

Wang

Shen²,

Jiang³

2019

Medicine

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Maternal mortality rate (MMR) in China has reduced during a decade but still higher than many countries around the world. Rural China is the key region which affects over all maternal death. This study aims to develop a suitable model in forecasting rural MMR and offer some suggestions for rural MMR intervention. Data in this study were collected through the Health Statistical Yearbook (2017) which included the overall MMR in China and urban and rural mortality rate. A basic grey model (GM(1,1)), 3 metabolic grey models (MGM), and a hybrid GM(1,1)–Markov model were presented to estimate rural MMR tendency. Average relative error (ARE), the post-test ratio ( C ), and small error probability ( P ) were adopted to evaluate models’ fitting performance while forecasting effectiveness was compared by relative error. The MMR in rural China reduced obviously from 63.0 per 100,000 live births in 2005 to 21.1 per 100,000 live births in 2017. One basic GM(1,1) model was built to fit the rural MMR and the expression was X ^((1)) ( k + 1) = 553.80e^0.0947 k – 550.00 ( C = 0.0456, P > .99). Three MGM models expressions were X ^((1)) ( k + 1) = 548.67e^0.0923 k – 503.17 ( C = 0.0540, P > .99), X ^((1)) ( k + 1) = 449.39e^0.0887 k – 408.09 ( C = 0.0560, P > .99), X ^((1)) ( k + 1) = 461.33e^0.0893 k – 425.23( C = 0.0660, P > .99). Hybrid GM(1,1)–Markov model showed the best fitting performance ( C = 0.0804, P > .99). The relative errors of basic GM(1,1) model and hybrid model in fitting part were 2.42% and 2.03%, respectively, while 5.35% and 2.08%, respectively, in forecasting part. The average relative errors of MGM were 2.07% in fitting part and 17.37% in forecasting part. Data update was crucial in maintain model's effectiveness. The hybrid GM(1,1)–Markov model was better than basic GM(1,1) model in rural MMR prediction. It could be considered as a decision-making tool in rural MMR intervention.

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Section: Discussionmentioning

confidence: 99%

Analyzing maternal mortality rate in rural China by Grey-Markov model

Wang

Shen²,

Jiang³

2019

Medicine

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“…Instead, community-based programs integrated with multiple interventions greatly improved maternal health outcomes [7,8]. There is emerging evidence on the impact of fostering financial security and social inclusion in reducing inequities for access to maternal health care [9,10].…”

Section: Introductionmentioning

confidence: 99%

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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“…Most systematic reviews of literature reporting improvements in MCH associated with PWGs are set in low/middle-income countries, for example, the reviews by Marston et al ,5 Prost et al 1 and Sharma et al 6. In these settings, interventions were described as ‘community participation’ but all involved some type of women’s group, operating formally or informally, in a community and engaging in participatory cycles of action and learning.…”

Section: Introductionmentioning

confidence: 99%

“…Eleven studies were included by Sharma et al 6 in a review on the effectiveness of community interventions in improving MCH outcomes in South Asia. Electronic databases were searched to June 2017, and randomised or cluster-randomised studies in communities within rural/remote areas of Nepal, Bangladesh, India and Pakistan were included.…”

Section: Introductionmentioning

confidence: 99%

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How and why do participatory women’s groups (PWGs) improve the quality of maternal and child health (MCH) care? A systematic review protocol

et al. 2019

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IntroductionCommunity-based Participatory Women’s Groups (PWGs) have proven to be an effective intervention to improve maternal and child health (MCH) outcomes in low/middle-income countries (LMICs). Less is known about how PWGs exert their effects in LMICs and virtually nothing is known about the contextual issues, processes and power relationships that affect PWG outcomes in high resource settings. The aim of this systematic review is to synthesise and critically analyse the current evidence on how and why PWGs improve the quality of MCH care. We aim to demonstrate how PWGs function and why PWG interventions contribute to social and health outcomes.Methods and analysisThe protocol will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. The databases Medline (Ovid): Cumulative Index to Nursing and Allied Health Literature (Ebsco); Informit health suite Scopus, Australian HealthInfoNet, the Cochrane Library and other sources will be searched under broad categories: intervention, context and outcomes to 30 June 2019.Ethics and disseminationAs only secondary data will be analysed; ethical approval is not required. The review will be disseminated to relevant organisations and presented in peer-reviewed papers and at conferences. This will be the first attempt to summarise the current available evidence on the characteristics, contextual influences and mechanisms that are associated with the outcomes and effectiveness of PWGs.PROSPERO registration numberCRD42019126533.

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Systematic review of community participation interventions to improve maternal health outcomes in rural South Asia

Cited by 24 publications

References 41 publications

Analyzing maternal mortality rate in rural China by Grey-Markov model

Analyzing maternal mortality rate in rural China by Grey-Markov model

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

How and why do participatory women’s groups (PWGs) improve the quality of maternal and child health (MCH) care? A systematic review protocol

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