Navigation Links
Women's support groups make dramatic improvements on neonatal survival rates

Women's community groups have had a dramatic effect on reducing neonatal mortality rates in some of the poorest areas on India, according to a study published today in the journal the Lancet. The groups provide a cost-effective intervention with added benefits such as reducing significantly maternal depression and improving decision-making amongst the women.

Every year, an estimated four million children worldwide die within the first month of their lives. Less than a quarter of the sixty-eight countries targeted by the Millennium Development Goal 4 (reduction of mortality rate in children less than five years old by two-thirds by 2015) are on track to achieve that goal.

A previous study conducted in Nepal and published by the Lancet in 2004 suggested that participatory women's groups could achieve a significant impact on neonatal health in poorer countries, far more than one-to-one contact with a health worker. To see if these findings could be applied in other countries, the researchers repeated the exercise in Jharkhand and Orissa, two of the poorest states in eastern India. Neonatal mortality rates in the two regions are 49 and 45 per 1000 live births respectively, disproportionately higher than India's national estimates of 39 per 1000. By comparison, in the UK the figures are 4 per 1000.

Between 2005 and 2008, a team of researchers led by Professor Anthony Costello from the Institute of Child Health, UCL (University College London), and Dr Prasanta Tripathy, from the Indian voluntary organisation Ekjut, evaluated how women's groups affected neonatal mortality and maternal depression in intervention areas as compared to areas where no participatory groups were set up. The groups were evaluated using a cluster-randomised controlled trial, which was funded by the Health Foundation, the UK Department for International Development, the Wellcome Trust and the UK Big Lottery Fund.

The groups were facilitated by women recruited in the local area, non-healthcare professionals who tended to be married, with some schooling, and a respected member of the community. The number of women taking part of in the groups increased from one in six women (17%) of childbearing age in the first year to over a half (55%) in the third year.

The women worked through a 'community action cycle' involving four stages: identifying the problems associated with pregnancy, childbirth and care of newborns; developing strategies to tackle these problems, such as improving hygiene, raising emergency funds and producing their own birthing kits; working with local community leaders, teachers, politicians and others to implement these strategies, and; evaluating their success.

"It was crucial that the women were allowed to think thought through the issues and implement their own strategies to tackle them, rather than us telling them what to do," says .. Dr Nirmala Nair of Ekjut. "We believe that a trained facilitator who supports informed peer learning is more effective for lasting behaviour change than a traditional instructor/learner approach."

The effects of the interventions were dramatic: by the second and third years of the trial, the neonatal mortality rate in the areas where the participatory women's groups existed had fallen by 45%. These areas also saw a significant fall (57%) in moderate depression amongst mothers by the third year of the trial.

"What we were seeing was a change in behaviour towards better hygiene practices and improved care for newborns," explains Professor Costello. "There was a move away from harmful practices such as giving birth in unclean environments and delaying breastfeeding. We saw significant improvements in areas such as basic hygiene by birth attendants, clean cord care and women responding earlier to care needs."

The researchers believe that improved social capital the access the group gave women to a wider support network of peers was potentially the most valuable aspect of the groups and would have contributed towards the improved childbirth and childcare practices and the reduction in maternal depression. It may also explain why such groups have had much greater success than direct even one-to-one interventions with healthcare workers.

"Many of the women in these groups would have been relatively young, living in arranged marriages with only their mother-in-law or a very limited network of friends for support," explains Dr Audrey Prost from UCL. "The groups empower the women to take preventive measures and to deal with problems more effectively when they arise. If you've been to a group and a problem arises, you've got a ready-made network that you can go to for help and support."

The researchers estimate that the additional cost on introducing support to these groups per newborn life saved was around US$910. However, this raises questions over who would pay for supporting these groups: federal or state government, non-governmental organisations, or a combination of the two.

The Lancet today also publishes a second study carried out by Professor Costello and colleagues using the same approach women's groups in Bangladesh. The study failed to reproduce the benefits of the India trial. However, in this case, the researchers believe that there were a number of issues which may have affected the outcome, including a failure to achieve the same coverage of women's groups and recruitment of pregnant women as the India trial.


Contact: Craig Brierley
Wellcome Trust

Related biology news :

1. SeaWeb applauds US decision to support bluefin tuna trade protection
2. Rockefeller Foundation supports expansion, training of e-health work force in developing world
3. According to new survey, Americans support strong climate, energy policies
4. Society of Interventional Radiology supports treatment for spine fractures: Patient selection key
5. Stimulus grant to support research on climate and infectious disease
6. BIO-key(R) Broadens Biometric Support for Microsoft(R) Windows Terminal Services, Citrix(R) Clients and Wyse CE Terminals
7. The PTR Group Announces Financial and Technical Support to US FIRST Robotics Competition Teams
8. Supportive materials will help regenerate heart tissue
9. Aware, Inc. Announces Support for New ITU Testing Standard with Line Diagnostics Platform
10. Glencoe Software to Support the ASCB Stimulus Grant to Build Virtual Image Library of the Cell
11. NSF grant supports Rutgers-Camden program for science majors
Post Your Comments:
Related Image:
Women's support groups make dramatic improvements on neonatal survival rates
(Date:9/29/2015)... 2015 News facts: ... saving energy , Minimized design shrinks PC footprint ... Mode and embedded Fujitsu PalmSecure authentication enable enterprises to ... today shows that good things come in small packages, ... its enterprise desktop and mobile portfolio. Featuring workplace design ...
(Date:9/28/2015)... 2015 CLEAR, the leading biometric ... traveler service is coming to Austin-Bergstrom International ... a frictionless experience, serious speed and enhanced ... offers our travelers an expedited security screening ... Jim Smith , Executive Director, Austin-Bergstrom International ...
(Date:9/28/2015)... 28, 2015 The global ... USD 12.03 billion by 2020, growing at a CAGR ... as Backside Illumination (BSI) technique to improve picture quality ... period.      (Logo: , ... to reduce loss and, thus, reduce the noise interference ...
Breaking Biology News(10 mins):
(Date:10/13/2015)... SUNNYVALE, Calif. , Oct. 13, 2015  Cepheid ... the quarter ending September 30, 2015. ... financial results, total revenue for the third quarter of ... net loss per share is expected to be approximately ... financial results, non-GAAP net loss per share for the ...
(Date:10/13/2015)... Research and Markets( ) has announced ... for Bone Morphogenetic Protein Growth Factor Therapy - 16 ... --> --> Bone morphogenetic proteins ... bone after a fracture. In nature, these proteins have ... of the skeleton. There are twenty different BMPs that ...
(Date:10/13/2015)... ... October 13, 2015 , ... AxioMx ... that it has received a Phase I Small Business Innovative Research (SBIR) grant ... of General Medical Sciences (NIGMS), will fund the development of a technique to ...
(Date:10/13/2015)... 13, 2015  According to Kalorama Information, the ... $102 billion by the end of 2015. Clinical ... industry, as it is estimated that approximately 80% ... tests. In addition to diagnosing patients, clinical lab ... progression, monitor drug treatment and conditions, and determine ...
Breaking Biology Technology: