Promoting positive maternal, newborn, and child health behaviors through a group-based health education and microfinance program: a prospective matched cohort study in western Kenya

Autor: Sheilah Chelagat, Laura J. Ruhl, Justus E. Ikemeri, Monica A. Okwanyi, Julia Songok, Astrid Christoffersen-Deb, Donald C. Cole, John Snelgrove, Christian B. Ochieng, Lauren Y. Maldonado
Rok vydání: 2020
Předmět:
Rural Population
Maternal Health
Health Behavior
Cohort Studies
0302 clinical medicine
Health facility
Pregnancy
Medicine
Prospective Studies
030212 general & internal medicine
Child
Health Education
Community Health Workers
Peer support
030219 obstetrics & reproductive medicine
Rural health
Child Health
Obstetrics and Gynecology
Prenatal Care
Cohort
Community health
Female
Health education
Research Article
Adult
Postnatal Care
medicine.medical_specialty
Newborn or infant health
Reproductive medicine
Health Promotion
Microfinance
Prenatal care
lcsh:Gynecology and obstetrics
Young Adult
03 medical and health sciences
Financial Support
Humans
Infant Health
Financial inclusion
lcsh:RG1-991
business.industry
Infant
Newborn
Community health volunteer
Kenya
Infant mortality
Case-Control Studies
Low- and middle-income country (LMIC)
Health Facilities
business
Demography
Zdroj: BMC Pregnancy and Childbirth
BMC Pregnancy and Childbirth, Vol 20, Iss 1, Pp 1-14 (2020)
ISSN: 1471-2393
DOI: 10.1186/s12884-020-02978-w
Popis: Background Chamas for Change (Chamas) is a group-based health education and microfinance program for pregnant and postpartum women that aims to address inequities contributing to high rates of maternal and infant mortality in rural western Kenya. In this prospective matched cohort study, we evaluated the association between Chamas participation and facility-based delivery. We additionally explored the effect of participation on promoting other positive maternal, newborn and child health (MNCH) behaviors. Methods We prospectively compared outcomes between a cohort of Chamas participants and controls matched for age, parity, and prenatal care location. Between October–December 2012, government-sponsored community health volunteers (CHV) recruited pregnant women attending their first antenatal care (ANC) visits at rural health facilities in Busia County to participate in Chamas. Women enrolled in Chamas agreed to attend group-based health education and microfinance sessions for one year; controls received the standard of care. We used descriptive analyses, multivariable logistic regression models, and random effect models to compare outcomes across cohorts 12 months following enrollment, with α set to 0.05. Results Compared to controls (n = 115), a significantly higher proportion of Chamas participants (n = 211) delivered in a health facility (84.4% vs. 50.4%, p p Chamas participants were over five times as likely as controls to deliver in a health facility (OR 5.49, 95% CI 3.12–9.64, p Chamas participants experienced a lower proportion of stillbirths (0.9% vs. 5.2%), miscarriages (5.2% vs. 7.8%), infant deaths (2.8% vs. 3.4%), and maternal deaths (0.9% vs. 1.7%) compared to controls. Conclusions Chamas participation was associated with increased odds of facility-based delivery compared to the standard of care in rural western Kenya. Larger proportions of program participants also practiced other positive MNCH behaviors. Our findings demonstrate Chamas’ potential to achieve population-level MNCH benefits; however, a larger study is needed to validate this observed effect. Trial registration ClinicalTrials.gov, NCT03188250 (retrospectively registered 31 May 2017).
Databáze: OpenAIRE
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