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Support Groups Improve Birth Outcomes
Reported March 10, 2010
(Ivanhoe Newswire) -- Community support groups may be able to reduce
neonatal deaths and lower rates of maternal depression, but only if the
population coverage is wide enough and the programs are appropriately
designed.
In trials in Nepal, participatory women's groups reduced neonatal mortality
by about one-third. To test this approach further, two research teams
undertook randomized controlled trials led by Anthony Costello of University
College London, Centre for International Health and Development, Institute
of Child Health in London.
Prasanta Tripathy of Ekjut in Chakradharpur, Jharkand, India, and colleagues
assigned a population of 228,186 people in Jharkand and Orissa in eastern
India either to participate in women's groups focused on the reduction of
maternal and newborn health problems, or not. The researchers monitored
19,030 births over three years and found that neonatal mortality dropped by
32 percent overall, and by 45 percent in years two and three, for women who
had been living in areas where support groups existed. Moderate maternal
depression had fallen by 57 percent by the third year.
The authors were quoted as saying, "Women's groups led by peer facilitators
reduced neonatal mortality rates and moderate maternal depression at low
cost in largely tribal, rural populations of eastern India. The most likely
mechanism of mortality reduction was through improved hygiene and care
practices."
"Participatory groups have the advantage of helping the poorest, being
scalable at low cost, and producing potentially wide-ranging and
long-lasting effects,” they concluded. “By addressing critical
consciousness, groups have the potential to create improved capability in
communities to deal with the health and development difficulties arising
from poverty and social inequalities."
In an accompanying article, Professor Kishwar Azad of the Perinatal Care
Project, Diabetic Association of Bangladesh, and colleagues monitored
neonatal mortality for 36,113 births over three years in a population of
503,163. The study population was divided into clusters, some of which were
assigned to receive support from women's groups. The authors found that in
Bangladesh, the community support made no difference to neonatal mortality
rates.
They were quoted as saying, "For participatory women's groups to have a
significant effect on neonatal mortality in rural Bangladesh, detailed
attention to program design and contextual factors, enhanced population
coverage, and increased enrolment of newly pregnant women might be needed."
They added, "Women's groups, if scaled to an adequate coverage, have the
potential to reach the poorest people and bring about substantial health and
non-health benefits. Nonetheless, a women's group approach requires adequate
human resources support for community mobilization and appropriate
coverage."
SOURCE: The Lancet, published online March 7, 2010 |
