TY - JOUR
T1 - Improving birth preparedness and complication readiness in rural India through an integrated microfinance and health literacy programme
T2 - evidence from a quasi-experimental study
AU - Ahmad, Danish
AU - Mohanty, Itismita
AU - Niyonsenga, Theophile
N1 - Funding Information:
Funding The paper was part of the PhD research of the first author (Danish Ahmad), who was supported by the University of Canberra’s Higher Degree by Research scholarship for his PhD. The Bill and Melinda Gates Foundation provided open access funding for the publication.The IMFHL program was supported, in whole, by the Bill & Melinda Gates Foundation [INV-006915]. Competing interests None declared. Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research. Patient consent for publication Not applicable. Ethics approval This study involves human participants and was approved by Ethics approval was granted by the Human Research Ethics Committee, at the University of Canberra for the program ‘2266 - PhD:The Impact of An Integrated Health Literacy and Microfinance Program on Care Awareness and Care Seeking Behaviour During Maternal Complication: The Case of Rural India’. Previously, an independent ethics committee of Population Council, New York, USA, approved the primary data collection under the IMFHL program. Participants gave informed consent to participate in the study before taking part.
Funding Information:
Acknowledgements We wish to thank Professor Rachel Davey, Health Research Institute, the University of Canberra, for her guidance and for reviewing the final draft of this manuscript. The authors would also like to thank the University of Canberra (Australia), the Public Health Foundation of India (India),the Indian Institute of Public Health-Gandhinagar(India) and the Population Council (India) for supporting this international research collaboration.
Publisher Copyright:
©
PY - 2022/2/21
Y1 - 2022/2/21
N2 - OBJECTIVE: Recently, a novel community health programme-the integrated microfinance and health literacy (IMFHL) programme was implemented through microfinance-based women's only self-help groups (SHGs) in India to promote birth preparedness and complication readiness (BPCR) to improve maternal health. The study evaluated the impact of the IMFHL programme on BPCR practice by women in one of India's poorest states-Uttar Pradesh-adjusting for the community, household and individual variables. The paper also examined for any diffusion of knowledge of BPCR from SHG members receiving the health literacy intervention to non-members in programme villages. DESIGN: Quasi-experimental study using cross-sectional survey data. SETTINGS: Secondary survey data from the IMFHL programme were used. PARTICIPANTS: Survey data were collected from 17 244 women in households with SHG member and non-member households in rural India. PRIMARY OUTCOMES: Multivariable logistic regression was used to estimate main and adjusted IMFHL programme effects on maternal BPCR practice in their last pregnancy. RESULTS: Membership in SHGs alone is positively associated with BPCR practice, with 17% higher odds (OR=1.17, 95% CI 1.07 to 1.29, p<0.01) of these women practising BPCR compared with women in villages without the programmes. Furthermore, the odds of practising complete BPCR increase to almost 50% (OR=1.48, 95% CI 1.35 to 1.63, p<0.01) when a maternal health literacy component is added to the SHGs. A diffusion effect was found for BPCR practice from SHG members to non-members when the health literacy component was integrated into the SHG model. CONCLUSIONS: The results suggest that SHG membership exerts a positive impact on planned health behaviour and a diffusion effect of BPCR practice from members to non-members when SHGs are enriched with a health literacy component. The study provides evidence to guide the implementation of community health programmes seeking to promote BPCR practise in low resource settings.
AB - OBJECTIVE: Recently, a novel community health programme-the integrated microfinance and health literacy (IMFHL) programme was implemented through microfinance-based women's only self-help groups (SHGs) in India to promote birth preparedness and complication readiness (BPCR) to improve maternal health. The study evaluated the impact of the IMFHL programme on BPCR practice by women in one of India's poorest states-Uttar Pradesh-adjusting for the community, household and individual variables. The paper also examined for any diffusion of knowledge of BPCR from SHG members receiving the health literacy intervention to non-members in programme villages. DESIGN: Quasi-experimental study using cross-sectional survey data. SETTINGS: Secondary survey data from the IMFHL programme were used. PARTICIPANTS: Survey data were collected from 17 244 women in households with SHG member and non-member households in rural India. PRIMARY OUTCOMES: Multivariable logistic regression was used to estimate main and adjusted IMFHL programme effects on maternal BPCR practice in their last pregnancy. RESULTS: Membership in SHGs alone is positively associated with BPCR practice, with 17% higher odds (OR=1.17, 95% CI 1.07 to 1.29, p<0.01) of these women practising BPCR compared with women in villages without the programmes. Furthermore, the odds of practising complete BPCR increase to almost 50% (OR=1.48, 95% CI 1.35 to 1.63, p<0.01) when a maternal health literacy component is added to the SHGs. A diffusion effect was found for BPCR practice from SHG members to non-members when the health literacy component was integrated into the SHG model. CONCLUSIONS: The results suggest that SHG membership exerts a positive impact on planned health behaviour and a diffusion effect of BPCR practice from members to non-members when SHGs are enriched with a health literacy component. The study provides evidence to guide the implementation of community health programmes seeking to promote BPCR practise in low resource settings.
KW - epidemiology
KW - international health services
KW - maternal medicine
KW - obstetrics
KW - public health
UR - http://www.scopus.com/inward/record.url?scp=85125002643&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2021-054318
DO - 10.1136/bmjopen-2021-054318
M3 - Article
C2 - 35190433
AN - SCOPUS:85125002643
SN - 2044-6055
VL - 12
SP - 1
EP - 12
JO - BMJ Open
JF - BMJ Open
IS - 2
M1 - e054318
ER -
