Abstract
BackgroundThis study evaluates an eight-session behavior change health intervention with women’s self-help groups (SHGs) aimed to promote healthy maternal and newborn practices among the more socially and economically marginalized groups.MethodsUsing a pre-post quasi-experimental design, a total of 545 SHGs were divided into two groups: a control group, which received the usual microcredit intervention; and an intervention group, which received additional participatory training around maternal, neonatal, and child health issues. Women members of SHGs who had a live birth in the 12 months preceding the survey were surveyed on demographics, practices around maternal, neonatal and child health (MNCH), and collectivization. Outcome effects were assessed using difference-in-difference (DID) methods.ResultsWomen from the SHGs with health intervention, relative to controls over time (time 1 to time 2), were more likely to: use contraceptive methods (DID: 9 percentage points [pp], p<0.001), have institutional delivery (DID: 9pp, p<0.05), practice skin-to-skin care (DID: 17pp, p<0.05), delay bathing for 3 or more days (DID: 19pp, p<0.001), initiate timely breastfeeding (DID: 21pp, p<0.001), exclusively breastfeed the child (DID: 27pp, p<0.001), and provide age-appropriate immunization (DID: 9pp, p<0.001). Additionally, women from the SHGs with health intervention when compared to the control group over time were more likely to report: collective efficacy (DID: 17pp, p<0.001), support through accompanying SHG members for antenatal care (DID: 8pp, p<0.05), receive a visit from SHG member within 2 days post-delivery (DID: 32pp, p<0.001), and receive reproductive, maternal, neonatal and child health information from an SHG member (DID: 45pp, p<0.001).ConclusionFindings demonstrate that structured participatory communication on MNCH with women’s groups improve positive health practices. In addition, SHGs can reach a substantial proportion of women while providing an avenue for pregnant women and young mothers to be assisted by others in learning and practicing healthy behaviors, thus building social cohesion on health.
Highlights
In India, the child mortality rate decreased by more than 62% between 1990 and 2015 [1]
Findings demonstrate that structured participatory communication on MNCH with women’s groups improve positive health practices
self-help groups (SHGs) can reach a substantial proportion of women while providing an avenue for pregnant women and young mothers to be assisted by others in learning and practicing healthy behaviors, building social cohesion on health
Summary
In India, the child mortality rate decreased by more than 62% between 1990 and 2015 (from 126 to 49 deaths per 1000 births) [1]. Most neonatal deaths in the northern region happen at home, and many can be avoided with changes in antenatal, delivery, and newborn care practices [4]. The spectrum of maternal, newborn and child health practices is varied and diverse including those that are one-time (e.g. immediate breastfeeding) and continuous (e.g. exclusive breastfeeding for at least 6 months)[5]; those that are supply dependent (e.g. consumption of iron and folic acid [IFA] tablets procured through public delivery) and those that depend more on learning and practice by mothers (e.g. skin-to-skin care, and delayed bathing) [6]. ANC and birth preparedness Post natal care Focus of this module is on early breastfeeding and neonatal behaviors (delayed bathing, skin-to-skin care, clean cord care). This study evaluates an eight-session behavior change health intervention with women’s self-help groups (SHGs) aimed to promote healthy maternal and newborn practices among the more socially and economically marginalized groups
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