%0 Journal Article
%T Explaining the impact of a women's group led community mobilisation intervention on maternal and newborn health outcomes: the Ekjut trial process evaluation
%A Suchitra Rath
%A Nirmala Nair
%A Prasanta K Tripathy
%A Sarah Barnett
%A Shibanand Rath
%A Rajendra Mahapatra
%A Rajkumar Gope
%A Aparna Bajpai
%A Rajesh Sinha
%A Anthony Costello
%A Audrey Prost
%J BMC International Health and Human Rights
%D 2010
%I BioMed Central
%R 10.1186/1472-698x-10-25
%X A participatory learning and action cycle with 244 women's groups was implemented in 18 intervention clusters covering an estimated population of 114 141. We describe the context, content, and implementation of this intervention, identify potential mechanisms behind its impact, and report challenges experienced in the field. Methods included a review of intervention documents, qualitative structured discussions with group members and non-group members, meeting observations, as well as descriptive statistical analysis of data on meeting attendance, activities, and characteristics of group attendees.Six broad, interrelated factors influenced the intervention's impact: (1) acceptability; (2) a participatory approach to the development of knowledge, skills and 'critical consciousness'; (3) community involvement beyond the groups; (4) a focus on marginalized communities; (5) the active recruitment of newly pregnant women into groups; (6) high population coverage. We hypothesize that these factors were responsible for the increase in safe delivery and care practices that led to the reduction in neonatal mortality demonstrated in the Ekjut trial.Participatory interventions with community groups can influence maternal and child health outcomes if key intervention characteristics are preserved and tailored to local contexts. Scaling-up such interventions requires (1) a detailed understanding of the way in which context affects the acceptability and delivery of the intervention; (2) planned but flexible replication of key content and implementation features; (3) strong support for participatory methods from implementing agencies.Community participation in health is a cornerstone of the World Health Organization's past and current strategies to achieve health for all [1,2]. Advocates believe that community involvement can make health services more accessible and sustainable, and that enabling communities to explore the consequences of health behaviour can yield lasting improve
%U http://www.biomedcentral.com/1472-698X/10/25