WUNRN
Nepal
- Bangladesh - India - Malawi
Women's
Groups Improve Maternal and Newborn Health
In Nepal and Bangladesh over 80 percent of women give birth at home, usually only with the support of a family member or local birthing attendant. During their pregnancy, less than half of women receive help and advice from a trained health professional. Lack of access to health services, advice and support during pregnancy and labour contribute to the high levels of maternal and neonatal deaths and ill health in these countries.
In Nepal, Bangladesh, India and Malawi, research has been investigating the role of women’s groups in improving maternal and newborn health. Led by a local woman facilitator, women’s groups meet monthly to discuss the causes and underlying problems leading to maternal and newborn death, develop practical strategies together with community leaders and men, and implement these strategies. For instance, in Nepal women identified the high cost of emergency obstetric care as a key barrier which delayed or prevented access to care. The women’s group set up a fund that they could use in emergency situations. This enabled families to take decisions independently, without begging from others.
These simple, but important strategies have been proven to make a huge difference to women and their communities during pregnancy, childbirth and in the antenatal period and have had a significant impact in reducing newborn mortality. In Nepal and India research findings suggest that neonatal mortality was reduced by 30 and 42 percent respectively. This is despite the fact that access to health facilities in the study areas remains difficult. Reductions in mortality are likely due to changes in practices at home including: more birth attendants washing hands, using a safe delivery kit, plastic sheet and boiled thread. There was also increased exclusive breastfeeding for the first six weeks.
Four mechanisms explain the women’s group impact on health outcomes: the groups learned new knowledge; they developed confidence; they disseminated information to their community and to pregnant women who did not attend groups; and they built community capacity to take action.
Although women’s groups facilitate learning, they also enable the development of a broader understanding of health problems and develop community capacity to bring health and development benefit.
Many thanks to Rebecca Wolfe from the Towards 4+5 Research Programme Consortium, the London School of Hygiene and Tropical Medicine, UK, for writing the content for this Health Reporter.
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