Evaluating a Large-Scale Community-Based Intervention to Improve Pregnancy and Newborn Health Among the Rural Poor in India.
Objectives. We evaluated the effectiveness of the Sure Start project, which was implemented in 7 districts of Uttar Pradesh, India, to improve maternal and newborn health. Methods. Interventions were implemented at 2 randomly assigned levels of intensity. Forty percent of the areas received a more intense intervention, including community-level meetings with expectant mothers. A baseline survey consisted of 12 000 women who completed pregnancy in 2007; a follow-up survey was conducted for women in 2010 in the same villages. Our quantitative analyses provide an account of the project's impact. Results. We observed significant health improvements in both intervention areas over time; in the more intensive intervention areas, we found greater improvements in care-seeking and healthy behaviors. The more intensive intervention areas did not experience a significantly greater decline in neonatal mortality. Conclusions. This study demonstrates that community-based efforts, especially mothers' group meetings designed to increase care-seeking and healthy behaviors, are effective and can be implemented at large scale.
Arnab Acharya is with the London School of Hygiene and Tropical Medicine, London, England. Tanya Lalwani is with the Program for Appropriate Technology in Health (PATH), South San Francisco, CA. Rahul Dutta, Sita Wunnava, and Lysander Menezes are with PATH, New Delhi, India. Julie Knoll Rajaratnam is with PATH, Seattle, WA. Jenny Ruducha is with the Center for Global Health and Development, Boston University, Boston, MA. Leila Caleb Varkey is with the Central Institute of Nursing Education and Research, Greater Noida, India. Catharine Taylor is with PATH, Washington, DC. Jeff Bernson is with PATH, Seattle, WA.
Arnab
A
Acharya
Tanya
T
Lalwani
Rahul
R
Dutta
Julie Knoll
JK
Rajaratnam
Jenny
J
Ruducha
Leila Caleb
LC
Varkey
Sita
S
Wunnava
Lysander
L
Menezes
Catharine
C
Taylor
Jeff
J
Bernson