Abstract
BackgroundNeonatal mortality rates are high in rural Nepal where more than 90% of deliveries are in the home. Evidence suggests that death rates can be reduced by interventions at community level. We describe an intervention which aimed to harness the power of community planning and decision making to improve maternal and newborn care in rural Nepal.MethodsThe development of 111 women's groups in a population of 86 704 in Makwanpur district, Nepal is described. The groups, facilitated by local women, were the intervention component of a randomized controlled trial to reduce perinatal and neonatal mortality rates. Through participant observation and analysis of reports, we describe the implementation of this intervention: the community entry process, the facilitation of monthly meetings through a participatory action cycle of problem identification, community planning, and implementation and evaluation of strategies to tackle the identified problems.ResultsIn response to the needs of the group, participatory health education was added to the intervention and the women's groups developed varied strategies to tackle problems of maternal and newborn care: establishing mother and child health funds, producing clean home delivery kits and operating stretcher schemes. Close linkages with community leaders and community health workers improved strategy implementation. There were also indications of positive effects on group members and health services, and most groups remained active after 30 months.ConclusionA large scale and potentially sustainable participatory intervention with women's groups, which focused on pregnancy, childbirth and the newborn period, resulted in innovative strategies identified by local communities to tackle perinatal care problems.
Highlights
Participatory approaches to health have been advocated since the 1978 Alma Ata declaration in which the World Health Organisation emphasised the need for citizen participation in primary health care [1]
What makes an active women's group? The continuing activity of most groups suggests that usually group members found the experience useful and enjoyable
We found no specific formula for an active women's group
Summary
Planning together The objective of these meetings was to encourage women to identify local and low cost ways of tackling the prioritised problems using local resources. Many examples were listed in the manual and the supervisor was encouraged to support the facilitator during these meetings The idea behind these meetings was to enable the women to prepare a plan to tackle the problems they had found, which would be presented to their community. We describe an intervention which aimed to harness the power of community planning and decision making to improve maternal and newborn care in rural Nepal. This paper details the development and implementation of a participatory project to improve perinatal care at the community level in rural Nepal. At the other end of the continuum, superficial participation of community representatives is sought to validate the aims of programme planners, usually already decided
Sign-in/Register to view highlights & summary 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.
