Testing a scalable community-based approach to improve maternal and neonatal health in rural Nepal.
OBJECTIVE
The aim of the study was to determine the feasibility of improved maternal-neonatal care-seeking and household practices using an approach scalable under Nepal's primary health-care services.


METHODS
Impact was assessed by pre- and post-intervention surveys of women delivering within the previous 12 months. Each district sample comprised 30 clusters, each with 30 respondents. The intervention consisted primarily of community-based antenatal counseling and dispensing and an early postnatal home visit; most activities were carried out by community-based health volunteers.


RESULTS
There were notable improvements in most household practice and service utilization indicators, although results regarding care-seeking for danger signs were mixed.


CONCLUSIONS
It is feasible in a Nepal setting to significantly improve utilization of maternal-neonatal services and household practices, using the resources available under the government primary health-care system. This has the potential to significantly reduce neonatal mortality.
Hodgins
S
S
NFHP-II, John Snow Inc. Research and Training Institute, Kathmandu, Nepal. stephen_hodgins@yahoo.com
McPherson
R
R
Suvedi
B K
BK
Shrestha
R B
RB
Silwal
R C
RC
Ban
B
B
Neupane
S
S
Baqui
A H
AH
D000328:Adult; D016000:Cluster Analysis; D003150:Community Health Workers; D019587:Dietary Supplements; D005260:Female; D005500:Follow-Up Studies; D006792:House Calls; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007407:Interviews as Topic; D008297:Male; D055118:Medication Adherence; D009390:Nepal / Q000453:epidemiology; D010353:Patient Education as Topic; D011181:Postnatal Care; D011247:Pregnancy; D011295:Prenatal Care; D012424:Rural Population; D050497:Stillbirth / Q000453:epidemiology; D055815:Young Adult