Abstract
Objective
To find out the effect of community mobilization and health education effort on health care seeking behavior of families with sick newborns, and to explore the rationale behind the changed health care seeking behaviors of mothers in a rural Indian community.
Methods
In the present community based participatory intervention, a triangulated research design of quantitative (survey) and qualitative (Focus group discussions, FGDs) method was undertaken for needs assessment in year 2004. In community mobilization, women’s self help groups; Kishori Panchayat (KP, forum of adolescent girls), Kisan Vikas Manch (Farmers’ club) and Village Coordination Committees (VCC) were formed in the study area. The trained social worker facilitated VCCs to develop village health plans to act upon their priority maternal and child health issues. The pregnant women and group members were given health education. The Lot Quality Assurance Sampling (LQAS) technique was used to monitor awareness regarding newborn danger signs among pregnant women. In year 2007, a triangulation of quantitative survey and a qualitative study (free list and pile sort exercise) was undertaken to find out changes in health care seeking behaviors of mothers.
Results
There was significant improvement in mothers’ knowledge regarding newborn danger signs. About half of the mothers got information from CLICS doot (female community health worker). The monitoring over three years period showed encouraging trend in level of awareness among pregnant women. After three years, the proportion of mothers giving no treatment/home remedy for newborn danger signs declined significantly. However, there was significant improvement in mothers’ health care seeking from private health care providers for sick newborns.
Conclusion
The present approach improved mothers’ knowledge regarding newborn danger signs and improved their health care seeking behavior for newborn danger signs at community level. Due to lack of faith in government health services, women preferred to seek care from private providers.
Similar content being viewed by others
References
Government of India, Child Health Division, Department of Health and Family Welfare, Newborn Health: Key to Survival: Present Scenario, Current Strategies and Future Directions for Newborn Health in India, 2001.
Bang AT, Bang RA, Baitule SB, Reddy MH, Deshmukh MD. Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India. Lancet 1999; 354:1955–1961.
Bhutta ZA, Darmstadt GL, Hasan BS, Haws RA. Communitybased interventions for improving perinatal and neonatal health outcomes in developing countries: a review of the evidence. Pediatrics 2005; 115 suppl. 2: 519–617.
Ahluwalia IB, Schmid T, Kouletio M, Kanenda O. An evaluation of a community-based approach to safe motherhood in north-western Tanzania. Intern J gyne obstetr 2003, 82:231–240.
Government of India, Ministry of Health & Family Welfare. Integrated Management of Neonatal and Childhood Illness: training modules for Medical officers. New Delhi; 2005.
Ministry of Health and Family Welfare (MOHFW). National Rural Health Mission (2005-2012), Mission document. New Delhi: MOHFW, Government of India, New Delhi. 2006.
Registrar General of India. Sample Registration System. SRS bulletin 2005; 39(1).
Dawson S, Manderson L, Tallo VL. The focus group manual: Methods for social research in disease. Boston: International Nutrition Foundation for Developing Countries (INFDC);1993.
Taffa N, Chepngeno G. Determinants of health care seeking for childhood illnesses in Nairobi slums. Tropi Med and Inter Health 2005;10:240–245.
Jajoo UN, Rao NS. Financing for social insurance - Wisdom from Jawar Health Insurance Scheme of Sewagram. Journal MGIMS 2005;10:7–18.
Zimmerman M, Newton N, Frumin L, Wittett S. Developing Health and Family Planning Materials For Low-Literate Audiences: A Guide. Washington DC, Program for Appropriate Technology in Health, 1996.
Kelly LM, Black RE, ed. Research to Support Household and Community IMCI. [Online] 2001 [Cited on 2008 Feb 18]; Available from URL: ih.jhsph.edu/chr/fhacs/c-imci.pdf
Figueroa ME, Kincaid DL, Rani M, Lewis G. Communication for social change: An integrated model for measuring the process and its outcome. [Online]. [Cited 2007 Nov. 12]. Available from URL:www.communicationforsocialchange.org
Valadez JJ, Weiss W, Leburg C, Davis R, ed. A participant’s manual for base line surveys and regular monitoring. [Online]. 2001. [cited 2007 November 12]. Available from: www.coregroup.org/tools/LQAS_Participant_Manual_L.pdf
ANTHROPAC [computer program]. Version 4.98.1/X Natik MA: Analytic Technologies; 1998.
Miller S, Graft-Johnson J, McNatt KE, Buffington ST, Daly P, Turan JM et al. Home and Community-Based Health Care for Mothers and Newborns. U.S. Agency for International development. September 2006.
Osrin D, Mesko N, Shrestha BP, Shrestha D, Tamang S, Thapa S, et al. Implementing a community based participatory intervention to improve essential newborn care in rural Nepal. Trans R Soc Trop Med Hyg 2003; 97: 18–21.
World Health Organization. WHO Recommended Interventions for Improving Maternal and Newborn Health. [Online]. [Cited 2008 Feb 18]. Available from URL: whqlibdoc.who.int/hq/2007/WHO_MPS_07.05_eng.pdf
Koot J. Monitoring and evaluation for NGOs in health and AIDS programmes. [Online]. [Cited 2007 November 12]. Available from: http://www.phcamsterdam.nl/artikelen/monitering_and_evaluation_for_ngos_in_health_aids_programmes_JK.pdf?PHPSES
Stewart JC, Schroeder DG, Marsh, DR Allhasane S, Kone D. Assessing a computerized routine health information system in Mali using LQAS. Health Policy Planning 2001; 16: 248–255.
Valadez JJ, Brown LD, Vargas WV, Morley D. Using Lot Quality Assurance Sampling to Assess Measurements for growth monitoring in developing country’s Primary Health Care System. Int J Epidemiol 1996;25:381–387.
National Rural Health Mission. Community based monitoring of health services under NRHM. [Online]. [Cited 2007 November 12]. Available from: http://mohfw.nic.in/NRHM/adv_grp.htm#section2
Howard-Grabman L, Storti C. Demystifying Community Mobilization: An Effective Strategy to Improve Maternal and Newborn Health. U.S. Agency for International development. February 2007.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Dongre, A.R., Deshmukh, P.R. & Garg, B.S. A community based approach to improve health care seeking for newborn danger signs in rural wardha, India. Indian J Pediatr 76, 45–50 (2009). https://doi.org/10.1007/s12098-009-0028-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12098-009-0028-y