Original Article
Journal of Perinatology advance online publication 12 November 2009; doi: 10.1038/jp.2009.181
Testing a scalable community-based approach to improve maternal and neonatal health in rural Nepal
S Hodgins1, R McPherson2, B K Suvedi3, R B Shrestha4, R C Silwal4, B Ban4, S Neupane1 and A H Baqui2
- 1NFHP-II, John Snow Inc. Research and Training Institute, Kathmandu, Nepal
- 2Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- 3Family Health Division, Ministry of Health and Population, Government of Nepal, Kathmandu, Nepal
- 4NFHP-II, John Snow Inc. Research and Training Institute, Nepalganj, Nepal
Correspondence: Dr S Hodgins, JSI R&T, 1776 Massachusetts Avenue NW, Suite 300, 44 Farnsworth St., Boston, MA 02210, USA. E-mail: stephen_hodgins@yahoo.com
Received 5 July 2009; Revised 30 September 2009; Accepted 4 October 2009; Published online 12 November 2009.
Abstract
Objective:
The aim of the study was to determine the feasibility of improved maternal–neonatal care-seeking and household practices using an approach scalable under Nepal's primary health-care services.
Study Design:
Impact was assessed by pre- and post-intervention surveys of women delivering within the previous 12 months. Each district sample comprised 30 clusters, each with 30 respondents. The intervention consisted primarily of community-based antenatal counseling and dispensing and an early postnatal home visit; most activities were carried out by community-based health volunteers.
Result:
There were notable improvements in most household practice and service utilization indicators, although results regarding care-seeking for danger signs were mixed.
Conclusion:
It is feasible in a Nepal setting to significantly improve utilization of maternal–neonatal services and household practices, using the resources available under the government primary health-care system. This has the potential to significantly reduce neonatal mortality.
Keywords:
essential newborn care, community health worker, community-based, care-seeking
