Abstract
A realist review of community mobilization for maternal/newborn health programming
Anne Kuhlmann, PhD, MPH
St Louis University, St Louis, MO
2015 APHA Annual Meeting & Expo (Oct. 31 - Nov. 4, 2015)
Community participation, engagement, and mobilization are common components of many maternal/newborn health programs, but there is little consensus on how critical these components are to achieving program goals. Using a realist review perspective, we systematically reviewed a spectrum of community mobilization (CM) interventions to evaluate the evidence-base supporting their use in maternal/newborn health programs. Consistent with theoretical assumptions, we found that interventions engaging community members more thoroughly tend to produce better outcomes than those with less community engagement. Despite this, many fewer programs exist with thorough engagement than with more cursory engagement. Of the 27 interventions reviewed, the strongest evidence exists for improving newborn care, increasing post-natal visits and reducing neonatal mortality. Although CM appears to contribute to improvements for maternal/newborn health, gaps remain. More evaluation research on how, and under what conditions, CM is most effective is needed in order to target program resources strategically.
Assessment of individual and community needs for health education Implementation of health education strategies, interventions and programs Other professions or practice related to public health Public health or related education Public health or related public policy Social and behavioral sciences
Abstract
Community Engagement as Delivery Strategy in Bangladesh Maternal Newborn Health
Alan Talens, MD, MPH
World Renew Health Advisor, Grand Rapids, MI
2015 APHA Annual Meeting & Expo (Oct. 31 - Nov. 4, 2015)
The World Renew project in rural Bangladesh, with high maternal/newborn mortality and inadequate health services, used the People’s Institution (PI) model as the delivery platform for interventions to engage communities in improving maternal newborn health (MNH) outcomes.
The strategy involved the mobilization and capacity-building of a 3-tiered community-based organization (CBO) structure that were linked in public–private partnerships (PPP) for MNH through active involvement in policy formation, facility management committees, and care coordination.
Locally-lead CBOs in 493 poor communities developed strong PPPs for MNH, including regular meetings with officials, CHWs linked with providers, referral and emergency health systems. Significant (p≤0.05) increases from baseline to end line in the intervention vs. comparison groups occurred in ANC visits, institutional delivery, SBA delivery, PNC, exclusive breastfeeding, newborn care, ORT use, care-seeking and quality of care.
Community engagement through the PI model of community systems strengthening is an effective delivery strategy to improve MNH.
Implementation of health education strategies, interventions and programs Protection of the public in relation to communicable diseases including prevention or control Provision of health care to the public Social and behavioral sciences
Abstract
Unplugging the Gender and Cultural Norm Bottleneck to MNCH
Lori Pappas
Global Team for Local Initiatives, Minneapolis, MN
2015 APHA Annual Meeting & Expo (Oct. 31 - Nov. 4, 2015)
Pastoralist Dasenech and BenaTsemay women (67,210 women) living in remote southwest Ethiopia are constrained by adverse gender norms, cultural beliefs and traditions and as a result, they cannot make decisions about their own health and well-being. The goal of this holistic integrated approach was to blend traditional wisdom with modern thinking in order to transform the cultural belief that large families mean wealth into healthy families mean wealth, by leveraging their traditional desire to have enough children to work. The initiative tested the impact of integrating adult literacy classes (women gain confidence to self-advocate) with livelihood activities (women contribute to household assets) with a series of structured discussions where the community discovers that in order to have enough healthy children, they need to practice healthy timing and spacing of births. The ability to access health services was improved by the establishment of community-owned and -operated “donkey ambulances.”
Advocacy for health and health education Communication and informatics Diversity and culture Planning of health education strategies, interventions, and programs Provision of health care to the public Social and behavioral sciences
Abstract
Community engagement : Essential for all community Child Survival programs?
Paul Freeman, DR PH. MBBS, MHP(ED) MPH(TH)
University of Washington, Seattle, WA
2015 APHA Annual Meeting & Expo (Oct. 31 - Nov. 4, 2015)
Using examples from three successful projects he has recently evaluated in Cambodia, Mozambique and Benin, and recently published evidence-based literature, the presenter proposes to address the above question. In Cambodia child and maternal nutrition (including the Hearth Approach) and other integrated MCH activities were the focus; in Mozambique, an integrated project was implemented in which Community Health Councils had a key role. In Benin the project focused on iCCM with community participation contributing to success. There are also many other successful approaches to community engagement/participation- such as Care Groups. Has not the time come that we should advocate that a strong rather than token emphasis on community participation be considered essential to maximize the effectiveness of community projects? The presentation will not be an exhaustive presentation of all aspects of these projects- or community engagement in general- but rather present evidence relevant to the proposed question to stimulate ongoing discussion and change.
Administer health education strategies, interventions and programs Diversity and culture Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Program planning Public health or related organizational policy, standards, or other guidelines