ArticlePloS one2018
Evaluation of a community-based intervention to improve maternal and neonatal health service coverage in the most rural and remote districts of Zambia.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 23 papers, 2 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Community health workers and health equity in low- and middle-income countries: systematic review and recommendations for policy and practice.International journal for equity in health · 2022Pooled it
- Access to care solutions in healthcare for obstetric care in Africa: A systematic review.PloS one · 2021Pooled it
- Urban-Rural Disparities in Non-Adherence to Iron Supplementation Among Pregnant Women Aged 15 to 49 in Sub-Saharan Africa.International journal of environmental research and public health · 2025Article
- Strengthening the role of community health assistants in delivering primary health care: the case of maternal health services in Zambia.BMC primary care · 2025Article
- Trends and Inequalities in Maternal and Newborn Health Services for Unplanned Settlements of Lusaka City, Zambia.Journal of urban health : bulletin of the New York Academy of Medicine · 2024Article
- Effect of community - facility linked interventions on maternal health service utilization and newborn care in rural low-resource settings in Eastern Uganda.BMC pregnancy and childbirth · 2024Article
- Article
- How Zambia reduced inequalities in under-five mortality rates over the last two decades: a mixed-methods study.BMC health services research · 2023Article
- Effect of community-level intervention on antenatal care attendance: a quasi-experimental study among postpartum women in Eastern Uganda.Global health action · 2022Article
- Article
- Participation in community-based healthcare interventions and non-communicable diseases early detection of general population in Indonesia.SSM - population health · 2022Article
- Contribution of community health care volunteers in facilitating mobilization for diabetes and hypertension screening among the general population residing in urban puducherry - An operational research study.Journal of family medicine and primary care · 2022Article
- Association between socioeconomic status and fertility among adolescents aged 15 to 19: an analysis of the 2013/2014 Zambia Demographic Health Survey (ZDHS).Reproductive health · 2021Article
- A scoping review of current practices on community engagement in rural East Africa: Recommendations for snakebite envenoming.Toxicon: X · 2021Article
- Predictors of Health Seeking Behaviours for Common Childhood Illnesses in Poor Resource Settings in Zambia, A Community Cross Sectional Study.Frontiers in public health · 2021Article
- Prevalence and determinants of the place of delivery among reproductive age women in sub-Saharan Africa.PloS one · 2020Article
- Maternity waiting homes as part of a comprehensive approach to maternal and newborn care: a cross-sectional survey.BMC pregnancy and childbirth · 2019Article
- Maternity Waiting Home Use by HIV-positive Pregnant Women in Zambia: Opportunity for Improved Prevention of Maternal to Child Transmission of HIV.International journal of MCH and AIDS · 2019Article
- How a woman's interpersonal relationships can delay care-seeking and access during the maternity period in rural Zambia: An intersection of the Social Ecological Model with the Three Delays Framework.Social science & medicine (1982) · 2019Article
- Implementation of a community-based intervention in the most rural and remote districts of Zambia: a process evaluation of safe motherhood action groups.Implementation science : IS · 2018Article
Corrections and comments
- Erratum issued
Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundA community-based intervention comprising both men and women, known as Safe Motherhood Action Groups (SMAGs), was implemented in four of Zambia's poorest and most remote districts to improve coverage of selected maternal and neonatal health interventions. This paper reports on outcomes in the coverage of maternal and neonatal care interventions, including antenatal care (ANC), skilled birth attendance (SBA) and postnatal care (PNC) in the study areas. METHODOLOGY: Three serial cross-sectional surveys were conducted between 2012 and 2015 among 1,652 mothers of children 0-5 months of age using a 'before-and-after' evaluation design with multi-stage sampling, combining probability proportional to size and simple random sampling. Logistic regression and chi-square test for trend were used to assess effect size and changes in measures of coverage for ANC, SBA and PNC during the intervention.
resultsMothers' mean age and educational status were non-differentially comparable at all the three-time points. The odds of attending ANC at least four times (aOR 1.63; 95% CI 1.38-1.99) and SBA (aOR 1.72; 95% CI 1.38-1.99) were at least 60% higher at endline than baseline surveillance. A two-fold and four-fold increase in the odds of mothers receiving PNC from an appropriate skilled provider (aOR 2.13; 95% CI 1.62-2.79) and a SMAG (aOR 4.87; 95% CI 3.14-7.54), respectively, were observed at endline. Receiving birth preparedness messages from a SMAG during pregnancy (aOR 1.76; 95% CI, 1.20-2.19) and receiving ANC from a skilled provider (aOR 4.01; 95% CI, 2.88-5.75) were significant predictors for SBA at delivery and PNC.
conclusionsStrengthening community-based action groups in poor and remote districts through the support of mothers by SMAGs was associated with increased coverage of maternal and newborn health interventions, measured through ANC, SBA and PNC. In remote and marginalised settings, where the need is greatest, context-specific and innovative task-sharing strategies using community health volunteers can be effective in improving coverage of maternal and neonatal services and hold promise for better maternal and child survival in poorly-resourced parts of sub-Saharan Africa.
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