Mobilizing communities to improve maternal health: results of an intervention in rural Zambia

Effect of a participatory multisectoral maternal and newborn intervention on maternal health service utilization and newborn care practices: a quasi-experimental study in three rural Ugandan districts

“…This was probably because health workers and VHTs educate newly delivered women and households about these practices. This increased awareness enhances the implementation of positive practices and aids in reducing delay in deciding to seek care [6,8,38]. Furthermore, VHTs are trusted by the community and so their messages are often more acceptable [6].…”

“…Delay in seeking care and delay in reaching care are caused by inadequate birth preparedness and delay in recognizing danger signs [6–11]; long distances to health facilities, compounded by poor transport and inability to afford transport costs [6,8–14]; and a preference for alternative traditional providers for prenatal or delivery care services [8,11]. Intra-institutional delay has been attributed to factors such as inadequate human resources for health, who are poorly motivated and may not have the appropriate skills set; poor attitudes towards pregnant women; lack of an enabling environment and inadequate infrastructure (equipment, theatres, electricity, ambulances) required to provide emergency obstetric care services; and lack of adherence to quality of care standards [6,8–12,15,16]. …”

“…The latter includes strategies that provide easier access to cash, through the use of vouchers and conditional cash transfers, and community-based initiatives that improve the transportation itself [22–25]. Quality improvement initiatives such as maternal and newborn audits, monitoring labour, referral protocols and transport, are some of the strategies that have been used to reduce inter-institutional delays in providing care [6,16,22,26]. …”

“…Community mobilization and the use of community support groups have also resulted in increased awareness and knowledge about maternal and newborn health and increased facility deliveries [6]. Facility-based strategies that include provision of emergency obstetric care, training of health workers, provision of equipment, drugs and supplies, and refurbishment of facilities, have also had positive effects on facility delivery [3,16].…”

“…Facility-based strategies that include provision of emergency obstetric care, training of health workers, provision of equipment, drugs and supplies, and refurbishment of facilities, have also had positive effects on facility delivery [3,16]. The effectiveness of these different intervention strategies depends on several factors that include the effectiveness of the intervention package, the implementation efficiency, and the availability of an enabling social and political environment [6,16]. Interventions often fail because they do not harness stakeholder resources across sectors.…”