Enhancing community capacity for maternal health promotion: Evidence from Guinea

Assessing the contribution of community empowerment approaches to the improvement of health outcomes has been described as “chasing a mythical dragon”.   This paper will present findings from a community-level intervention that aimed to build the capacity of village committees to heighten awareness about maternal health risks and to promote use of professional maternal health services. 

Evaluation data were collected through a population-based survey. A total of 2,335 women of reproductive age were interviewed, including 878 with recent births. An index of community capacity was created to explore the effect of living in a village with strong community-level resources and support for maternal health. Other composite variables were created to measure the content of women’s antenatal counseling and their individual exposure to maternal health promotion activities at the community level. Multivariate logistic regression was used to explore the effect of community capacity and individual exposure variables on women’s use of antenatal care (> 4 visits), institutional delivery, and care for complications.

Study findings showed that women living in villages with a high score on the community capacity index were more than twice as likely to attend at least four ANC visits, to deliver in a health facility, and to seek care for perceived complications.  The research findings suggest that building the capacity of community-level cadres to promote maternity care-seeking by women in their villages is an important complement to facility-level interventions to increase the availability, quality, and utilization of essential health services.