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Evaluation of a health promotion intervention associated with birthing centres in rural Nepal.

Mahato, P. K., van Teijlingen, E., Simkhada, P., Angell, C. and Hundley, V., 2020. Evaluation of a health promotion intervention associated with birthing centres in rural Nepal. PLoS One, 15 (5), e0233607.

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Mahato et al PLOSOne birth centres 2020.pdf - Published Version
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DOI: 10.1371/journal.pone.0233607


INTRODUCTION: Birthing centres (BC) in Nepal are mostly situated in rural areas and provide care for women without complications. However, they are often bypassed by women and their role in providing good quality maternity services is overlooked. This study evaluated an intervention to increase access and utilisation of perinatal care facilities in community settings. METHODS: This longitudinal cross-sectional study was conducted over five years in four villages in Nepal and included two BCs. An intervention was conducted in 2014-2016 that involved supporting the BCs and conducting a health promotion programme with local women. Population-based multi-stage sampling of women of reproductive age with a child below 24 months of age was undertaken. Household surveys were conducted (2012 and 2017) employing trained enumerators and using a structured validated questionnaire. The collected data were entered into SPSS and analysed comparing pre- and post-intervention surveys. RESULTS: The intervention was associated with an increase in uptake in facility birth, with an increase in utilisation of perinatal services available from BCs. The post-intervention survey provided evidence that women were more likely to give birth at primary care facilities (OR 5.60, p-value <0.001) than prior to the intervention. Similarly, the likelihood of giving birth at a health facility increased if decision for birthplace was made jointly by women and family members for primary care facilities (OR 1.76, p-value 0.023) and hospitals/tertiary care facilities (OR 1.78, p-value 0.020. If women had less than four ANC visits, then they were less likely to give birth at primary care facilities (OR 0.39, p-value <0.001) or hospitals/tertiary care facilities (OR 0.63, p-value 0.014). Finally, women were less likely to give birth at primary care facilities if they had only primary level of education (OR 0.49, p-value 0.014). CONCLUSION: BCs have the potential to increase the births at health facilities and decrease home births if their services are promoted by the local health promoters. In addition, socio-economic factors including women's education, the level of women's autonomy and having four or more ANC visits affect the utilisation of perinatal services at the health facility.

Item Type:Article
Additional Information:Funding: This was a PhD study (PM) which was supported financially through the fund obtained from Open Society Foundation (IN2016-30452). The support was mostly available for the fieldwork done in Nepal.
Data available from BORDaR:
Group:Faculty of Health & Social Sciences
ID Code:34071
Deposited By: Symplectic RT2
Deposited On:01 Jun 2020 16:01
Last Modified:14 Mar 2022 14:22


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