Trial reportPLoS medicine2012
Community mobilization in Mumbai slums to improve perinatal care and outcomes: a cluster randomized controlled trial.
Trial report in PLoS medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 80 papers, 19 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
80 citing papers in PubMed, 19 syntheses or guidelines pooled it, 117 citations in OpenAlex.
- Pooled it
- Community Health Worker Impact on Knowledge, Antenatal Care, And Birth Outcomes: A Systematic Review.Maternal and child health journal · 2022Pooled it
- Participatory learning and action cycles with women's groups to prevent neonatal death in low-resource settings: A multi-country comparison of cost-effectiveness and affordability.Health policy and planning · 2021Pooled it
- Community interventions with women's groups to improve women's and children's health in India: a mixed-methods systematic review of effects, enablers and barriers.BMJ global health · 2020Pooled it
- Pooled it
- Pooled it
- Community-based maternal and newborn educational care packages for improving neonatal health and survival in low- and middle-income countries.The Cochrane database of systematic reviews · 2019Pooled it
- The equity impact of community women's groups to reduce neonatal mortality: a meta-analysis of four cluster randomized trials.International journal of epidemiology · 2019Pooled it
- Pooled it
- Pooled it
- Community-based approaches for neonatal survival: meta-analyses of randomized trial data.Bulletin of the World Health Organization · 2017Pooled it
- A systematic review of strategies to increase access to health services among children in low and middle income countries.BMC health services research · 2017Pooled it
- Pooled it
- Health system and community level interventions for improving antenatal care coverage and health outcomes.The Cochrane database of systematic reviews · 2015Pooled it
- Community-based intervention packages for reducing maternal and neonatal morbidity and mortality and improving neonatal outcomes.The Cochrane database of systematic reviews · 2015Pooled it
- Pooled it
- Preconception care: closing the gap in the continuum of care to accelerate improvements in maternal, newborn and child health.Reproductive health · 2014Pooled it
- Women's groups practising participatory learning and action to improve maternal and newborn health in low-resource settings: a systematic review and meta-analysis.Lancet (London, England) · 2013Pooled it
- Community-Based Initiatives to Improve Maternal and Newborn Health in High-Income Settings: A Mixed-Methods Systematic Review.Journal of midwifery & women's healthPooled it
- Community resource centres to improve the health of women and children in informal settlements in Mumbai: a cluster-randomised, controlled trial.The Lancet. Global health · 2017Trial
20 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
Abstract
introductionImproving maternal and newborn health in low-income settings requires both health service and community action. Previous community initiatives have been predominantly rural, but India is urbanizing. While working to improve health service quality, we tested an intervention in which urban slum-dweller women's groups worked to improve local perinatal health. METHODS AND
findingsA cluster randomized controlled trial in 24 intervention and 24 control settlements covered a population of 283,000. In each intervention cluster, a facilitator supported women's groups through an action learning cycle in which they discussed perinatal experiences, improved their knowledge, and took local action. We monitored births, stillbirths, and neonatal deaths, and interviewed mothers at 6 weeks postpartum. The primary outcomes described perinatal care, maternal morbidity, and extended perinatal mortality. The analysis included 18,197 births over 3 years from 2006 to 2009. We found no differences between trial arms in uptake of antenatal care, reported work, rest, and diet in later pregnancy, institutional delivery, early and exclusive breastfeeding, or care-seeking. The stillbirth rate was non-significantly lower in the intervention arm (odds ratio 0.86, 95% CI 0.60-1.22), and the neonatal mortality rate higher (1.48, 1.06-2.08). The extended perinatal mortality rate did not differ between arms (1.19, 0.90-1.57). We have no evidence that these differences could be explained by the intervention.
conclusionsFacilitating urban community groups was feasible, and there was evidence of behaviour change, but we did not see population-level effects on health care or mortality. In cities with multiple sources of health care, but inequitable access to services, community mobilization should be integrated with attempts to deliver services for the poorest and most vulnerable, and with initiatives to improve quality of care in both public and private sectors.
trial registrationCurrent Controlled Trials ISRCTN96256793
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.