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Sökning: onr:"swepub:oai:DiVA.org:umu-82845" > Women's groups prac...

  • Prost, Audrey (författare)

Women's groups practising participatory learning and action to improve maternal and newborn health in low-resource settings : a systematic review and meta-analysis

  • Artikel/kapitelEngelska2013

Förlag, utgivningsår, omfång ...

  • 2013
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:umu-82845
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-82845URI
  • https://doi.org/10.1016/S0140-6736(13)60685-6DOI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

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Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • FUNDING: Wellcome Trust, Ammalife, and National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for Birmingham and the Black Country programme.
  • BACKGROUND: Maternal and neonatal mortality rates remain high in many low-income and middle-income countries. Different approaches for the improvement of birth outcomes have been used in community-based interventions, with heterogeneous effects on survival. We assessed the effects of women's groups practising participatory learning and action, compared with usual care, on birth outcomes in low-resource settings.METHODS: We did a systematic review and meta-analysis of randomised controlled trials undertaken in Bangladesh, India, Malawi, and Nepal in which the effects of women's groups practising participatory learning and action were assessed to identify population-level predictors of effect on maternal mortality, neonatal mortality, and stillbirths. We also reviewed the cost-effectiveness of the women's group intervention and estimated its potential effect at scale in Countdown countries.FINDINGS: Seven trials (119,428 births) met the inclusion criteria. Meta-analyses of all trials showed that exposure to women's groups was associated with a 37% reduction in maternal mortality (odds ratio 0.63, 95% CI 0.32-0.94), a 23% reduction in neonatal mortality (0.77, 0.65-0.90), and a 9% non-significant reduction in stillbirths (0.91, 0.79-1.03), with high heterogeneity for maternal (I(2)=58.8%, p=0.024) and neonatal results (I(2)=64.7%, p=0.009). In the meta-regression analyses, the proportion of pregnant women in groups was linearly associated with reduction in both maternal and neonatal mortality (p=0.026 and p=0.011, respectively). A subgroup analysis of the four studies in which at least 30% of pregnant women participated in groups showed a 55% reduction in maternal mortality (0.45, 0.17-0.73) and a 33% reduction in neonatal mortality (0.67, 0.59-0.74). The intervention was cost effective by WHO standards and could save an estimated 283,000 newborn infants and 41,100 mothers per year if implemented in rural areas of 74 Countdown countries.INTERPRETATION: With the participation of at least a third of pregnant women and adequate population coverage, women's groups practising participatory learning and action are a cost-effective strategy to improve maternal and neonatal survival in low-resource settings.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Colbourn, Tim (författare)
  • Seward, Nadine (författare)
  • Azad, Kishwar (författare)
  • Coomarasamy, Arri (författare)
  • Copas, Andrew (författare)
  • Houweling, Tanja A J (författare)
  • Fottrell, Edward (författare)
  • Kuddus, Abdul (författare)
  • Lewycka, Sonia (författare)
  • MacArthur, Christine (författare)
  • Manandhar, Dharma (författare)
  • Morrison, Joanna (författare)
  • Mwansambo, Charles (författare)
  • Nair, Nirmala (författare)
  • Nambiar, Bejoy (författare)
  • Osrin, David (författare)
  • Pagel, Christina (författare)
  • Phiri, Tambosi (författare)
  • Pulkki-Brännström, Anni-Maria (författare)
  • Rosato, Mikey (författare)
  • Skordis-Worrall, Jolene (författare)
  • Saville, Naomi (författare)
  • More, Neena Shah (författare)
  • Shrestha, Bhim (författare)
  • Tripathy, Prasanta (författare)
  • Wilson, Amie (författare)
  • Costello, Anthony (författare)

Sammanhörande titlar

  • Ingår i:The Lancet381:9879, s. 1736-460140-67361474-547X

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