UCL Institute for Global Health
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Participatory Women’s Groups
Community-led, Evidence-based Action from Bangladesh, India, Malawi and Nepal: Improving Maternal and Newborn Survival
New: Good Practice Guide 2013 [PDF]: Community mobilisation through Women's Groups to help improve the health of mothers and babies
- Around 270,000 women worldwide die every year from complications of pregnancy and childbirth, and nearly three million infants do not survive the first month of life.
- In sub-Saharan Africa, South Asia, and Southeast Asia, more than 70% of all births for the poorest two fifths of women happen at home.
- Community interventions are needed to increase demand for health services and protective practices for mothers and newborns at home.
Community-based interventions are crucial to reduce the shocking toll of unnecessary and preventable deaths of mothers and babies. One approach involves women’s groups meeting regularly to identify and prioritise problems during pregnancy, delivery and the postnatal period. Groups develop and implement strategies through participatory methods such as voting, role-play, storytelling and problem-solving. The groups boost women’s confidence to talk about the problems they face, take live-saving steps, and influence community members beyond the group.
"It's not a drug. It's not a vaccine. It's not a device. It's women, working together, solving problems, saving lives." says Richard Horton, Lancet Editor.
The reasons why mothers and newborns die are social as much as medical. Many life-saving preventive practices can be also performed at home if mothers know how and have the self-assurance to act. When women’s groups sit together and discuss why health problems happen from a social perspective, they find locally appropriate ways to address their problems.
The paper published in the Lancet was launched at an event at the Houses of Parliament on the 21st May.
''Maternal deaths fell by 37% and newborn deaths by 23%''
A UCL analysis of seven trials conducted in Bangladesh, India, Nepal and Malawi, with a total of 119,428 births found that women’s groups can dramatically reduce maternal and newborn deaths in the poorest communities. In all seven studies, a local woman helped to facilitate women’s groups which identified and addressed common health problems in pregnancy, and during and after birth.
The findings from the seven studies showed that maternal deaths fell by 37% and newborn deaths by 23%; but they fell by as much as 55% for maternal deaths and 33% for newborn deaths in the four studies where more than a third of pregnant women participated in the groups.
The groups could prevent an estimated 283,000 newborn infant deaths and 41,100 maternal deaths each year if they were introduced in 74 countries where maternal and child death rates remain high.
Women Deliver 2013
On 28 May 2013 Institute for Global HealthWomen and Children First joined with from Bangladesh, India, Malawi, Nepal and UCL’s to present the latest findings from over a decade of women’s group work at the third Women Deliver conference in Kuala Lumpur, Malaysia.
The side event, Women’s Groups Help Improve Maternal, Newborn and Child Health: Community-led, Evidence-based Action from Bangladesh, India, Malawi and Nepal, included presentations from Prof Dharma Manandhar (MIRA, Nepal), Prof Kishwar Azad (Perinatal Care Project, Bangladesh), Dr Nirmala Nair (Ekjut, India), Florida Banda (MaiMwana, Malawi) and Prof Anthony Costello (UCL Institute for Global Health).
The impressive results of the women’s groups work include:
• Nepal – 30% reduction in newborn deaths and substantial decreases in maternal mortality. Click here for the presentation and below for the publication:
• India – 45% reduction in newborn deaths and moderate maternal depression fell by 57%. Click here for the presentation and below for the publications:
• Bangladesh – 38% reduction in newborn deaths. Click here for the presentation and below for the publications:
• Malawi – 74% reduction in maternal deaths and 41% reduction in newborn deaths. Click here for the presentation and below for the publications:
Lewycka et al (2013), A cluster randomised controlled trial of the community effectiveness of two interventions in rural Malawi to improve health care and to reduce maternal, newborn and infant mortality
• The results of a meta-analysis including seven randomised controlled trials demonstrates a reduction in maternal deaths of up to 55% (where at least 30% of pregnant women took part in the groups) and newborn deaths reduced by a third.
You can find other relevant women’s groups resources including a women’s groups summary, Good Practice Guide, women's group facilitation manuals, picture cards and flipcharts.