当前位置： SCI文献检索 > JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH期刊下所有文献 > Reaching the poor with health interventions: programme-incidence analysis of seven randomised trials of women's groups to reduce newborn mortality in Asia and Africa.

Reaching the poor with health interventions: programme-incidence analysis of seven randomised trials of women's groups to reduce newborn mortality in Asia and Africa.

Abstract：

BACKGROUND:Efforts to end preventable newborn deaths will fail if the poor are not reached with effective interventions. To understand what works to reach vulnerable groups, we describe and explain the uptake of a highly effective community-based newborn health intervention across social strata in Asia and Africa. METHODS:We conducted a secondary analysis of seven randomised trials of participatory women's groups to reduce newborn mortality in India, Bangladesh, Nepal and Malawi. We analysed data on 70,574 pregnancies. Socioeconomic and sociodemographic differences in group attendance were tested using logistic regression. Qualitative data were collected at each trial site (225 focus groups, 20 interviews) to understand our results. RESULTS:Socioeconomic differences in women's group attendance were small, except for occasional lower attendance by elites. Sociodemographic differences were large, with lower attendance by young primigravid women in African as well as in South Asian sites. The intervention was considered relevant and interesting to all socioeconomic groups. Local facilitators ensured inclusion of poorer women. Embarrassment and family constraints on movement outside the home restricted attendance among primigravid women. Reproductive health discussions were perceived as inappropriate for them. CONCLUSIONS:Community-based women's groups can help to reach every newborn with effective interventions. Equitable intervention uptake is enhanced when facilitators actively encourage all women to attend, organise meetings at the participants' convenience and use approaches that are easily understandable for the less educated. Focused efforts to include primigravid women are necessary, working with families and communities to decrease social taboos.

journal_name

J Epidemiol Community Health

journal_title

Journal of epidemiology and community health

authors

Houweling TA,Morrison J,Alcock G,Azad K,Das S,Hossen M,Kuddus A,Lewycka S,Looman CW,Magar BB,Manandhar DS,Akter M,Dube AL,Rath S,Saville N,Sen A,Tripathy P,Costello A,EquiNaM group.

doi

10.1136/jech-2014-204685

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

31-41

issue

eissn

0143-005X

issn

1470-2738

pii

jech-2014-204685

journal_volume

pub_type

杂志文章

在线工具

Reaching the poor with health interventions: programme-incidence analysis of seven randomised trials of women's groups to reduce newborn mortality in Asia and Africa.