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

Abstract

IntroductionCommunity-based Participatory Women’s Groups (PWGs) have proven to be an effective intervention to improve maternal and child health (MCH) outcomes in low/middle-income countries (LMICs). Less is known about how PWGs exert their effects in LMICs and virtually nothing is known about the contextual issues, processes and power relationships that affect PWG outcomes in high resource settings. The aim of this systematic review is to synthesise and critically analyse the current evidence on how and why PWGs improve the quality of MCH care. We aim to demonstrate how PWGs function and why PWG interventions contribute to social and health outcomes.Methods and analysisThe protocol will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. The databases Medline (Ovid): Cumulative Index to Nursing and Allied Health Literature (Ebsco); Informit health suite Scopus, Australian HealthInfoNet, the Cochrane Library and other sources will be searched under broad categories: intervention, context and outcomes to 30 June 2019.Ethics and disseminationAs only secondary data will be analysed; ethical approval is not required. The review will be disseminated to relevant organisations and presented in peer-reviewed papers and at conferences. This will be the first attempt to summarise the current available evidence on the characteristics, contextual influences and mechanisms that are associated with the outcomes and effectiveness of PWGs.PROSPERO registration numberCRD42019126533.

Effect of a lay counselor-delivered integrated maternal mental health and early childhood development group-based intervention in Northern Ghana: a cluster-randomized controlled trial

“…If similar maternal mental health and child development benefits can be found via a more generic social support women's group, there are implications for the resources needed to implement each. The psychosocial benefits of women's groups are increasingly of interest to the research community (Chomat et al ., 2019; Preston et al ., 2019).…”

“…Joy Noel Baumgartner et al psychosocial benefits of women's groups are increasingly of interest to the research community (Chomat et al, 2019;Preston et al, 2019).…”

High Impact Practices—Encouraging empowerment and self-care through participatory women’s groups and group antenatal care: Supporting women to be at the center of their own care as active participants

“…Groups may be initiated by a trained community health worker or by women themselves. Groups can involve participatory cycles of action and learning 1 [2].…”

Efficacy of Community Factors in the Implementation of Community-Based Interventions to Improve Antenatal Care: Lessons from IMCHA Programme, Tanzania

“…In order to address the causes leading to the delays in attending ANC and completion of recommended visits, different strategies have been implemented in LMICs, including Community-Based Interventions (CBIs) that are implemented by Women's Groups (WGs). WGs interventions have the potential to improve the provision of ANC services and Maternal and Child Health (MCH) services in poor resource settings [12][13][14]. For instance, in Nepal, the WGs interventions lowered neonatal mortality by 30% and maternal mortality by 80% per 100,000 live births [15].…”

“…Effective use of the existing community resources especially social norms and values [29], long-distance and lack of affordable and accessible transport [30] have also been reported as community factors hindering the performance of the interventions While community factors are important in the implementation of WGs interventions, there is scant literature from LMICs. For instance, most of the existing literature addresses holistic contextual factors as it covers all aspects of context-settings; and this limits an in-depth analysis on either part [12,21]. Moreover, in Tanzania, literature that addresses WGs interventions are unsatisfactory with few enlisted [31,32] while that which addreses community contextual factors is virtually missing.…”