Are birth-preparedness programmes effective? Results from a field trial in Siraha District, Nepal

Robert A. McPherson, Neena Khadka, Judith M. Moore, Meena Sharma

Research output: Contribution to journalArticlepeer-review

Abstract

The birth-preparedness package (BPP) promotes active preparation and decision-making for births, including pregnancy/postpartum periods, by pregnant women and their families. This paper describes a district-wide field trial of the BPP implemented through the government health system in Siraha, Nepal, during 2003-2004. The aim of the field trial was to determine the effectiveness of the BPP to positively influence planning for births, household-level behaviours that affect the health of pregnant and postpartum women and their newborns, and their use of selected health services for maternal and newborn care. Community health workers promoted desired behaviours through inter-personal counselling with individuals and groups. Content of messages included matemal and newborn-danger signs and encouraged the use of healthcare services and preparation for emergencies. Thirty-cluster baseline and endline household surveys of mothers of infants aged less than one year were used for estimating the change in key outcome indicators. Fifty-four percent of respondents (n=162) were directly exposed to BPP materials while pregnant. A composite index of seven indicators that measure knowledge of respondents, use of health services, and preparation for emergencies increased from 33% at baseline to 54% at endline (p=0.001). Five key newborn practices increased by 19 to 29 percentage points from baseline to endline (p values ranged from 0.000 to 0.06). Certain key maternal health indicators, such as skilled birth attendance and use of emergency obstetric care, did not change. The BPP can positively influence knowledge and intermediate health outcomes, such as household practices and use of some health services. The BPP can be implemented by government health services with minimal outside assistance but should be comprehensively integrated into the safe motherhood programme rather than implemented as a separate intervention.

Original languageEnglish (US)
Pages (from-to)479-488
Number of pages10
JournalJournal of Health, Population and Nutrition
Volume24
Issue number4
StatePublished - Dec 2006
Externally publishedYes

Keywords

  • Behaviour
  • Behaviour change communication
  • Communication
  • Community
  • Community health services
  • Counselling
  • Delivery
  • Delivery of healthcare
  • Health services
  • Interpersonal relations
  • Nepal
  • Obstetric care
  • Parturition
  • Pregnancy
  • Safe motherhood

ASJC Scopus subject areas

  • Environmental Science(all)
  • Environmental Chemistry
  • Public Health, Environmental and Occupational Health

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