title: Promoting Healthy Behaviors among Egyptian Mothers: A Quasi-Experimental Study of a Health Communication Package Delivered by Community Organizations.
abstract: Decisions made at the household level, for example, to seek antenatal care or breastfeed, can have a direct impact on the health of mothers and newborns. The SMART Community-based Initiatives program in Egypt worked with community development associations to encourage better household decision-making by training community health workers to disseminate information and encourage healthy practices during home visits, group sessions, and community activities with pregnant women, mothers of young children, and their families. A quasi-experimental design was used to evaluate the program, with household surveys conducted before and after the intervention in intervention and comparison areas. Survey questions asked about women's knowledge and behaviors related to maternal and newborn care and child nutrition and, at the endline, exposure to SMART activities. Exposure to program activities was high in intervention areas of Upper Egypt: 91% of respondents reported receiving home visits and 84% attended group sessions. In Lower Egypt, these figures were 58% and 48%, respectively. Knowledge of danger signs related to pregnancy, delivery, and newborn illness increased significantly more in intervention than comparison areas in both regions (with one exception in Lower Egypt), after controlling for child's age and woman's education; this pattern also occurred for two of five behaviors (antenatal care visits and consumption of iron-folate tablets). Findings suggest that there may have been a significant dose-response relationship between exposure to SMART activities and certain knowledge and behavioral indicators, especially in Upper Egypt. The findings demonstrate the ability of civil society organizations with minimal health programming experience to increase knowledge and promote healthy behaviors among pregnant women and new mothers. The SMART approach offers a promising strategy to fill gaps in health education and counseling and strengthen community support for behavior change.
authors.affiliation: Maternal and Child Survival Program, Save the Children, Washington, DC, United States of America.
authors.forename: Angela
authors.initials: A
authors.lastname: Brasington
authors.affiliation: Maternal and Child Survival Program, Jhpiego, Washington, DC, United States of America.
authors.forename: Ali
authors.initials: A
authors.lastname: Abdelmegeid
authors.affiliation: Maternal and Child Survival Program, John Snow, Inc., Boston, Massachusetts, United States of America.
authors.forename: Vikas
authors.initials: V
authors.lastname: Dwivedi
authors.affiliation: Jhpiego, Baltimore, Maryland, United States of America.
authors.forename: Adrienne
authors.initials: A
authors.lastname: Kols
authors.affiliation: Jhpiego, Baltimore, Maryland, United States of America.
authors.forename: Young-Mi
authors.initials: YM
authors.lastname: Kim
authors.affiliation: Maternal and Child Survival Program, Save the Children, Washington, DC, United States of America.
authors.forename: Neena
authors.initials: N
authors.lastname: Khadka
authors.affiliation: Maternal and Child Survival Program, Jhpiego, Washington, DC, United States of America.
authors.forename: Barbara
authors.initials: B
authors.lastname: Rawlins
authors.affiliation: Maternal and Child Survival Program, Save the Children, Washington, DC, United States of America.
authors.forename: Anita
authors.initials: A
authors.lastname: Gibson
mesh_terms: D000328:Adult; D003150:Community Health Workers; D003657:Decision Making; D004534:Egypt; D005260:Female; D015438:Health Behavior; D058015:Health Communication; D006792:House Calls; D006801:Humans; D008427:Maternal Health Services; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy; D011295:Prenatal Care