Community-driven impact of a newborn-focused behavioral intervention on maternal health in Shivgarh, India

Int J Gynaecol Obstet. 2012 Apr;117(1):48-55. doi: 10.1016/j.ijgo.2011.10.031. Epub 2012 Jan 26.


Objective: To assess the effect on maternal health outcomes of a community-based behavior change management intervention for essential newborn care leading to a reduction in neonatal mortality.

Methods: A cluster-randomized controlled trial involving 1 control and 2 intervention arms was conducted in Shivgarh, India, between January 2004 and May 2005. Risk-enhancing domiciliary newborn care behaviors, including those posing a concomitant risk to maternal health, were targeted through home visits and community meetings. Secondary outcomes included knowledge of maternal danger signs, self-reported complications, maternal care practices, care-seeking from trained providers, and maternal mortality ratio (MMR). The intervention arms were combined for analysis, which was done by intention to treat.

Results: Significant improvements were observed in maternal health equity and outcomes including knowledge of danger signs, care practices, self-reported complications, and timely care-seeking from trained providers. The difference in adjusted MMR was not significant (relative risk 0.44; 95% confidence interval, 0.14-1.43; P=0.11) owing to the inadequate sample size for this outcome, but may suggest a decline in MMR given improvements in other outcomes in the causal pathway to mortality.

Conclusion: Community-based strategies focused on prevention and care-seeking effectively complemented facility-based strategies toward improving maternal health, while synergizing with newborn care interventions.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Community Health Workers*
  • Female
  • Health Behavior
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • India
  • Infant Care
  • Infant, Newborn
  • Maternal Mortality
  • Maternal Welfare*
  • Obstetric Labor Complications / mortality*
  • Patient Acceptance of Health Care
  • Patient Education as Topic*
  • Postpartum Period
  • Pregnancy
  • Prenatal Care
  • Preventive Health Services
  • Rural Health Services*
  • Rural Population
  • Self Report
  • Social Class