Community mobilization to strengthen support for appropriate and timely use of antenatal and postnatal care: A review of reviews

Abstract

Background Antenatal care (ANC) and postnatal care (PNC) are critical opportunities for women, babies and parents/families to receive quality care and support from health services. Community-based interventions may improve the accessibility, availability, and acceptance of this vital care. For example, community mobilization strategies have been used to involve and collaborate with women, families and communities to improve maternal and newborn health. Objective To synthesize existing reviews of evidence on community mobilization strategies that strengthen support for appropriate and timely use of ANC and PNC. Methods Six databases (MEDLINE, Embase, CINAHL, PsychINFO, Cochrane Library, PROSPERO) were searched for published reviews that describe community mobilization related strategies for ANC and/or PNC. Reviews were eligible for inclusion if they described any initiatives or strategies targeting the promotion of ANC and/or PNC uptake that included an element of community mobilization in a low- or middle-income country (LMIC), published after 2000. Included reviews were critically appraised according to the Joanna Briggs Institute (JBI) Checklist for Systematic Reviews and Evidence Syntheses. This review of reviews was conducted following JBI guidelines for undertaking and reporting umbrella reviews. Results In total 23 papers, representing 22 reviews were included. While all 22 reviews contained some description of community mobilization and ANC/PNC, 13 presented more in-depth details on the community mobilization processes and relevant outcomes. Seventeen reviews focused on ANC, four considered both ANC and PNC, and only one focused on PNC. Overall, 16 reviews reported at least one positive association between community mobilization activities and ANC/PNC uptake, while five reviews presented primary studies with no statistically significant change in ANC uptake and one included a primary study with a decrease in use of antenatal facilities. The community mobilization activities described by the reviews ranged from informative, passive communication to more active, participatory approaches that included engaging individuals or consulting local leaders and community members to develop priorities and action plans. Conclusions While there is considerable momentum around incorporating community mobilization activities in maternal and newborn health programs, such as improving community support for the uptake of ANC and PNC, there is limited evidence on the processes used. Furthermore, the spectrum of terminology and variation in definitions should be harmonized to guide the implementation and evaluation efforts.

Extreme events and gender-based violence: a mixed-methods systematic review

“…48,110 For example, women's groups using participatory-learning-action cycles facilitated by local peers have been used to sustainably improve reproductive and maternal health by enabling women to identify and prioritise local challenges and solutions. 111 Similar programmes could be adapted and applied in extreme event management to empower women as decision makers in local communities. 110,112 Quality of the literature The quality and rigour across studies were not consistent, including a number of studies being assessed as poor quality.…”

Community Engagement to support COVID-19 Vaccine Uptake: A living systematic review protocol

“…Such terminology is regular vernacular within some contexts, specifically the implementation of health programmes within low- and middle-income countries. Yet, even within this work, how community engagement is defined and what it encompasses is varied and often unclear (50,51). Moreover, the use of ‘community engagement’ as a term may be limited in contexts that implement fewer activities at the community level, for instance in high-income contexts or contexts with well-developed health systems.…”

A realist review protocol on communications for community engagement in maternal and newborn health programmes in low- and middle-income countries

“…For example, substantive theories, like the theory of interpersonal relationships, point to the importance of the relationship between the individual/patient and the health worker/implementer as a source of motivation to engage with a programme because of the empathy and trust built in this relationship [ 67 , 68 ]. Two other common theories centred on individuals’ cognitive logic are the health belief model and the theory of planned behaviour (previously known as the theory of reasoned action) [ 19 , 69 , 70 ]. Both of these theories describe how individuals’ beliefs or understanding of something influence their behaviour — and these beliefs can be informed through communication [ 69 ].…”

“…individual, interpersonal, social systems). Terms such as community or social mobilization, participation, community action and empowerment, and communication are often used together and/or interchangeably with CE [ 19 , 22 , 23 ].…”

“…A number of factors have been described above as important considerations in the development or application of CE, yet the literature is limited when it comes to how and why these factors are important and/or influential, especially across different contexts. This may be in part because the research in this field is often focused on reporting health outcomes without a clear understanding of what causes these outcomes [ 19 ]. As a result, it is challenging to extrapolate which components or processes of CE may be transferrable across different health programmes.…”