Over 90% of households in rural Uttar Pradesh, the most populous state of India, have at least one mobile phone. However, ownership of mobile phone among women is quite low. Implementation research was conducted in Uttar Pradesh to examine (a) whether providing information on selected maternal and child health (MCH) behaviors to a husband's mobile phone would enhance the man's knowledge and lead to discussions in their family, and (b) whether such discussions would help in the adoption of healthy practices. The m-Health intervention included biweekly voice messages in local language (Hindi) on MCH topics to the mobile phone of pregnant women's husbands. Using a quasi-experimental design, after four months of the m-Health intervention, in 2014, 881 husbands and 956 women from the study area were interviewed. Husbands' knowledge, controlling for their socio-demographic characteristics, were significantly higher among the listeners of the messages than the non-listeners. Multivariate logistic regression analysis showed that if husbands discussed the messages with family members, the odds of wives' practicing health behaviors improved significantly for three behaviors. These include one antenatal checkup in last trimester of pregnancy (odds ratio 1.72, p < 0.05), receiving a postnatal checkup within 7 days of delivery (odds ratio 3.02, p < 0.05), and delayed bathing of newborn (odds ratio 1.93, p < 0.05). Thus, communicating messages using m-Health was found to be an effective intervention for behavior change. The study demonstrated that mobile phones can be used effectively to reach men with MCH information and encourage them to promote healthy behavior in their family.
Introduction Health interventions implemented with self-help groups (SHGs) enhance the relevance and acceptability of the health services. The Parivartan program was implemented in eight districts of Bihar with women’s self-help groups to increase adoption of maternal and newborn health behaviors through layering health behavior change communication. This study estimates the cost and cost-effectiveness of a health behavior change program with SHGs in Bihar. Methods Cost analysis was conducted from a provider’s perspective. All costs have been presented in US dollars for the purpose of international comparisons and converted to constant values. The effectiveness estimate was based on the reported changes in select newborn care practices. A decision model approach was used to estimate the potential number of neonatal deaths averted based on adoption of key newborn care practices. Using India’s life expectancy of 65 years, cost per life year saved was calculated. A one-way sensitivity analysis was conducted using the upper and lower estimates for various variables in the model, and functionality of SHGs. Results The cost of forming an SHG group was US$254 and that of reaching a woman within the group was US$19. The unit cost for delivering health interventions through the Parivartan program was US$148 per group and US$11 per woman reached. During an 18 months period, Parivartan program reached around 17,120 SHGs and an estimated 20,544 pregnant women resulting in an estimated prevention of 23 neonatal deaths at a cost of US$3,825 per life year saved. Conclusion SHGs can be an effective platform to increase uptake of women’s health interventions and follow-up care, and also to broaden their utility beyond microfinance, particularly when they operate at a larger scale.
Introduction: Effective utilization of reproductive and child health (RCH) services is important to reduce morbidity and mortality among mothers as well as children under-five. After International Conference on Population and Development (ICPD), 1994 India has increasingly integrated male participation in women's reproductive health to improve the women's health care during pregnancy and child birth. This study examined effect of women's autonomy and male involvement on RCH services utilization in Uttar Pradesh State of India. Methodology: State level data of Uttar Pradesh from National Family Health Survey (NFHS-3), India for currently married women and men aged 15 -49 years was considered. The study was restricted to couples whose youngest child was born during the three years preceding the survey (N = 2685). Pearson chi-square test was used to determine the association of background characteristics with woman's autonomy and male involvement in RCH utilization. Logistic regression was used to understand the effects of male involvement and women's autonomy, using both computed indices after controlling for socio-economic and background characteristics of women and their husbands. Subsequently, the exercise was extended using individual component of both the indices. All findings were reported for 95% CI and p < 0.05. Results: Findings show that except religion, other socio-economic and demographic variables such as age of women, place of residence, number of living children, caste/tribe, women's work status, education, wealth index, household structure and exposure to mass media, husband's age, education, and occupation were statistically significant and associated with women's autonomy and male involvement. Multivariate analysis indicated women's autonomous decision making and support from their husbands (male involvement) How to cite this paper: Sahu, D., Dutta, T., Kumar, S., Mishra, N.R., Neogi, S., Mondal, S., Dadhwal-Singh, A. and Levitt-Dayal, M. 261significantly influenced their utilization of RCH services after controlling for all socio-economic and demographic variables. Conclusion: To improve RCH service utilization and overall health status of women and children male involvement and women's autonomous decision-making should be addressed in all future RCH programs in the State.
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