Abstract
BackgroundInvolving communities in identifying and addressing determinants of their own health is effective in addressing complex problems, such as low birth weight (LBW). LBW is an important public health problem which has not improved significantly in Sri Lanka in the last 10 years. This study reports the ability of lay persons to identify and address determinants of LBW.MethodsA health promotion intervention was conducted among 403 mothers registering at 26 antenatal clinics in the district of Anuradhapura, in Sri Lanka. The components of a health promotion process—initiation, maintenance and continual monitoring, and re-direction towards greater effectiveness—were explained to the mothers. Inputs were initially provided through different methods to enable mothers’ groups to identify determinants of LBW and to decide actions to address those identified determinants. The overall study was carried out over a period of 1 year, of which the intervention phase took around 7 months. The mothers in the clinic group were encouraged to continue an ongoing process in smaller “neighborhood action committees” (NACs)—of which there were 71. The findings are based on field notes maintained during the process, analyzed using thematic analysis.ResultsEach group of mothers identified at least eight determinants of LBW at the first attempt (without first author’s guidance), four of which corresponded with those already mentioned in published studies. Up to five other determinants were agreed, after facilitation by the first author, at the second attempt. Of the total, 10 determinants of LBW were finally prioritized. Twenty actions to address the 10 selected prioritized determinants were agreed through a collective consensus development process.ConclusionsLay communities successfully identified determinants of LBW and household level actions to address these, with relatively simple guidance, when stimulated to initiate the relevant process. This capacity should be nurtured and better used in interventions to improve LBW.
Highlights
Involving communities in identifying and addressing determinants of their own health is effective in addressing complex problems, such as low birth weight (LBW)
This paper reports the ability of lay persons to identify and address determinants of low birth weight through community empowerment through health promotion process model
Participants Pregnant mothers were selected from three Medical Officer of Health (MOH) areas to identify determinants and actions to address low birth weight (Table 2)
Summary
Involving communities in identifying and addressing determinants of their own health is effective in addressing complex problems, such as low birth weight (LBW). LBW is an important public health problem which has not improved significantly in Sri Lanka in the last 10 years. Birth weight is an important determinant of an individual’s health and a globally accepted predictor of childhood survival [1, 2], and improving birth weight is a critical step in breaking the life cycle effect of undernutrition [3]. Current global prevalence of low birth weight is 15.5% and is considered a complex public health problem [3]. Even though Sri Lanka has good health indicators, LBW has remained high at a prevalence of 16–18% [4]. There are many potential modifiable factors related to dietary intake and care practices of the pregnant mother that can be effectively addressed during the antenatal period to prevent LBW [5,6,7,8,9,10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
