Effect Of A Participatory Intervention With Women’s Groups On Birth Outcomes And Maternal Depression In Jharkhand And Orissa, India: A Cluster-Randomised Controlled Trial

Women’s groups led by peer facilitators reduced neonatal mortality rates and maternal depression in tribal, rural populations of eastern India.

Introduction

Every year, an estimated 3.7 million children die worldwide in their first month of life. About 800 women die daily from childbirth and pregnancy, and 99% of these deaths occur in developing countries. Maternal and child mortality remains an urgent global challenge. India, in particular, accounts for 20% of maternal deaths worldwide, 21% of deaths for children under the age of 5, and 25% of all neonatal deaths. Urgent efforts are needed to reduce these mortality rates quickly through cost-effective and scalable interventions.

Interventions that have shown promising results in Bolivia and Nepal in reducing neonatal and maternal mortality are participatory women’s groups, in which participants identify the causes and problems that lead to maternal and newborn deaths, develop practical strategies with community leaders and men, and implement and assess the outcomes of these strategies. This study examines the effect of women’s groups on neonatal mortality and maternal depression in two states in Eastern India: Jharkhand and Orissa. These states are two of the poorest in Eastern India, with 40% of the population living below the poverty line and with an illiteracy rate of 63%. The women’s groups met monthly for a total of 20 meetings, which were facilitated by a trained local woman. Information about clean delivery practices and care-seeking behavior was shared through stories and games, and group members identified and prioritized maternal and newborn health problems in the community, collectively selected relevant strategies to address these problems, implemented their strategies, and assessed the results.

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