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Women's groups prac...
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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
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LIBRIS-ID:oai:DiVA.org:umu-82845
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-82845URI
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https://doi.org/10.1016/S0140-6736(13)60685-6DOI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:art swepub-publicationtype
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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.
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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.
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Biuppslag (personer, institutioner, konferenser, titlar ...)
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Colbourn, Tim
(författare)
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Seward, Nadine
(författare)
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Azad, Kishwar
(författare)
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Coomarasamy, Arri
(författare)
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Copas, Andrew
(författare)
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Houweling, Tanja A J
(författare)
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Fottrell, Edward
(författare)
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Kuddus, Abdul
(författare)
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Lewycka, Sonia
(författare)
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MacArthur, Christine
(författare)
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Manandhar, Dharma
(författare)
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Morrison, Joanna
(författare)
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Mwansambo, Charles
(författare)
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Nair, Nirmala
(författare)
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Nambiar, Bejoy
(författare)
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Osrin, David
(författare)
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Pagel, Christina
(författare)
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Phiri, Tambosi
(författare)
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Pulkki-Brännström, Anni-Maria
(författare)
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Rosato, Mikey
(författare)
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Skordis-Worrall, Jolene
(författare)
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Saville, Naomi
(författare)
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More, Neena Shah
(författare)
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Shrestha, Bhim
(författare)
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Tripathy, Prasanta
(författare)
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Wilson, Amie
(författare)
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Costello, Anthony
(författare)
Sammanhörande titlar
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Ingår i:The Lancet381:9879, s. 1736-460140-67361474-547X
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Till lärosätets databas
- Av författaren/redakt...
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Prost, Audrey
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Colbourn, Tim
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Seward, Nadine
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Azad, Kishwar
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Coomarasamy, Arr ...
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Copas, Andrew
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visa fler...
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Houweling, Tanja ...
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Fottrell, Edward
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Kuddus, Abdul
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Lewycka, Sonia
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MacArthur, Chris ...
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Manandhar, Dharm ...
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Morrison, Joanna
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Mwansambo, Charl ...
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Nair, Nirmala
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Nambiar, Bejoy
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Osrin, David
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Pagel, Christina
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Phiri, Tambosi
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Pulkki-Brännströ ...
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Rosato, Mikey
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Skordis-Worrall, ...
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Saville, Naomi
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More, Neena Shah
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Shrestha, Bhim
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Tripathy, Prasan ...
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Wilson, Amie
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Costello, Anthon ...
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visa färre...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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The Lancet
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