Evaluation of a community-based intervention for health and economic empowerment of marginalized women in India

Abstract

Background Empowered women have improved decision-making capacity and can demand equal access to health services. Community-based interventions based on building women’s groups for awareness generation on maternal and child health (MCH) are the best and cost-effective approaches in improving their access to health services. The present study evaluated a community-based intervention aimed at improving marginalized women’s awareness and utilization of MCH services, and access to livelihood and savings using the peer-led approach from two districts of India. Methods We used peer educators as mediators of knowledge transfer among women and for creating a supportive environment at the household and community levels. The intervention was implemented in two marginalized districts of Uttar Pradesh, namely Banda and Kaushambi. Two development blocks in each of the two districts were selected randomly, and 24 villages in each of the four blocks were selected based on the high percentage of a marginalized population. The evaluation of the intervention involved a non-experimental, ‘post-test analysis of the project group’ research design, in a mixed-method approach. Data were collected at two points in time, including qualitative interviews at the end line and tracking data of the intervention population (n = 37,324) through an online management information system. Results Most of the women in Banda (90%) and Kaushambi (85%) attended at least 60% of the education sessions. Around 39% of women in Banda and 35% of women in Kaushambi registered for the livelihood scheme, and 94 and 80% of them had worked under the scheme in these two places, respectively. Women’s awareness about MCH seemed to have increased post-intervention. The money earned after getting work under the livelihood scheme or from daily savings was deposited in the bank account by the women. These savings helped the women investing money at times of need, such as starting their work, in emergencies for the medical treatment of their family members, education of their children, etc. Conclusion Peer-led model of intervention can be explored to improve the combined health and economic outcomes of marginalized women.

Investment case approach for equitable access to maternal neonatal and child health services: Stakeholders’ perspective in Nepal

“…Evidence shows that engagement of the community brings about equitable and high-quality MNCH services [ 26 ]. Empowering women on health and economic aspects has shown to have positive impact on improving awareness and utilizing maternal, neonatal and child health related services as well as uplifting livelihood of the community people [ 27 ].…”

How and why do women’s groups (WGs) improve the quality of maternal and child health (MCH) care? A systematic review of the literature

“…In eight studies the country’s government 6 47–53 was responsible for initiating WGs. Information was unavailable for two documents 54 55. Twenty-two studies reported WGs that were new or remobilised2 6 23–25 27–34 36 39 40 44 45 50 52 54 55 and the remainder used existing groups 35 38 41 46 48 49 51 53.…”

“…Information was unavailable for two documents 54 55. Twenty-two studies reported WGs that were new or remobilised2 6 23–25 27–34 36 39 40 44 45 50 52 54 55 and the remainder used existing groups 35 38 41 46 48 49 51 53. All groups included MCH education, two-way learning, awareness raising or information sharing components.…”

“…The four documents reporting on a community development approach involving autonomous programming and independent decision-making were also usually led by local trained facilitators 27 44 45 49. Those WGs primarily providing health promotion/education delivered in a group setting were usually led by a health professional 23 24 28 38 47 48 51–53 55. These groups appeared to involve a didactic educative programme on aspects of MCH.…”

“…In one document, decision-making was at a level removed from the WG that is, sitting with a research team 24. For a proportion of documents, it was unclear where decision-making rested 6 23 32 37 43 47 48 50 52 55…”