The role of Community Mobilization in maternal care provision for women in sub-Saharan Africa- A systematic review of studies using an experimental design

Abstract

BackgroundWhile the role of community mobilization in improving maternal health outcomes of HIV positive women in sub-Saharan Africa is continuously emphasized, little is known about how legitimate these claims are. The aim of this study is to systematically review the empirical evidence on this issue.MethodsA systematic search was conducted in PuBMed, Scopus, Web of Science, MEDLINE, COCHRANE, Allied Health Literature, and Cumulative Index to Nursing.ResultsOur search identified 14 publications on the role of community mobilization in maternal care provision in sub-Saharan Africa, including both HIV negative women and women with HIV, that have used experimental research designs. Regarding HIV negative women, literature has demonstrated that community mobilization is a useful strategy for promoting both positive maternal process results and maternal health outcomes. Most of the literature on women with HIV has focused only on demonstrating the causal link between community mobilization and process results. There has been very little focus on demonstrating the causal link between community mobilization and maternal outcomes for women living with HIV. Overall, the results show that while there is some empirical evidence on a causal link between community mobilization and maternal health outcomes for HIV negative women, this kind of evidence is still missing for HIV positive women. Moreover, as shown by the studies, community mobilization as a maternal health strategy is still in its infancy.ConclusionGiven the gaps identified in our review, we recommend further research with the aim of providing sound evidence on the role of community mobilization in improving maternal health outcomes of women with HIV in sub-Saharan Africa.

Women's experience with group prenatal care in a rural community in northern Nigeria

“…Setup required a huge mobilization effort at the community level. Such strategies have been shown to work well for maternal health care provision in Sub‐Saharan African countries and should be an essential component in the design of community‐based models such as in the current study, especially in conservative communities.…”

Promoting women’s and children’s health through community groups in low-income and middle-income countries: a mixed-methods systematic review of mechanisms, enablers and barriers

“…We applied our search terms to all fields. We consulted past reviews of community mobilisation to develop our search terms 2 15 22 23. We developed them so as to cover articles which (1) described interventions aiming at community mobilisation, (2) involved community groups and (3) had a health focus.…”

“…In choosing search terms, we faced challenges. The term ‘community mobilisation’ does not have a unified definition and little agreement exists on the relationship between it and its many sister constructs: community engagement, involvement, inclusion, consultation, participation, building, coalition, organisation, development, capacity, capability, resilience, power or empowerment 2 7 15 16 22. For example, some researchers consider the term ‘community engagement’ to denote less intensive interventions than ‘community mobilisation’,24 while others disagree 25.…”

“…We, therefore, chose to include only community and social mobilisation as search terms, followed by manually screening articles for mention of community groups. Previous reviews of community-related constructs have similarly included a limited number of search terms 2 15 17 22 23 25…”

A scoping review on community mobilisation for maternal and child health in sub-Saharan Africa: Impact on empowerment

“…These included an increase in uptake of modern contraceptive methods (Gullo et al, 2017;Zamawe & Mandiwa, 2016), increases in facility deliveries (Colbourn et al, 2013;Ekirapa-Kiracho et al, 2017), an increase in team births (Lori et al, 2013), increased dialogue about culturally sensitive topics (Babalola et al, 2006;Babalola et al, 2001;Ejembi et al, 2014;Gullo et al, 2017;Mburu et al, 2012;Undie et al, 2014;Wagman et al, 2015;Zamawe et al, 2016), increased intention of care seeking behaviors (Boone et al, 2016;Undie et al, 2014), increases in the number of antenatal care visits (Ekirapa-Kiracho et al, 2017;Mseu et al, 2014), increases in safe newborn practices (Ekirapa-Kiracho et al, 2017), improvement in breastfeeding practices (Ekirapa-Kiracho et al, 2017;Guyon et al, 2009), improved child and maternal dietary and feeding practices (Guyon et al, 2009) increased reliance on peer support and community networks for health concerns (Mburu et al, 2012;Prata et al, 2012;Rosato et al, 2012), a decrease in intimate partner violence (Wagman et al, 2015), and decreased intention to perform FGC (Babalola et al, 2006). One systematic review concluded CM interventions in SSA have been focused on the health of HIV negative women and lack studies on CM for HIV positive women (Muzyamba et al, 2017).…”