Abstract
In this issue of The Lancet, Dharma Manandhar and colleagues report a cluster-randomised trial of the effect of women's groups on birth outcomes in Nepal. They studied 12 matched pairs of geopolitical clusters in the Makwanpur district—a poor rural population—with random assignment of one cluster in each pair to participate in the intervention. During the 2-year study, control clusters had 37 neonatal deaths per 1000 livebirths. With a low-cost participatory intervention, Manandhar and colleagues showed a 30% reduction in neonatal mortality, the primary outcome, and an even more substantial reduction in maternal mortality, a secondary outcome of this study.
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