Extrait

Background and study aims Improving maternal and newborn health in low-income settings requires both health service and community action. Previous community initiatives have generally been rural, but India is urbanizing. While working with health services to improve their quality of care, the trial tests an intervention in which slum-dweller women's groups try to improve health during pregnancy and birth, and for newborn babies in their own communities. Who can participate? Key participants will be women who join the community groups. We will try to involve young women and mothers, but older women may also get involved. Group members will reach out to other women and key stakeholders in their neighbourhoods. Since the aim is to improve the health of pregnant women and their newborn infants, any participant who may influence this situation may be involved. Particular examples may be older women, male community members and leaders, health workers and local opinion formers. The project outcomes will be measured by checking for all births and deaths in the project areas. All women and their newborn infants will be eligible to participate in this process, which will involve an interview as close to delivery as possible. What does the study involve? We will employ local community-based female facilitators to convene groups and help them to explore maternal and neonatal health issues. The groups will meet fortnightly through a seven-phase process of sharing experiences, discussion of the issues raised, discovery of potential community strengths, building of a vision for action, design and implementation of community strategies, and evaluation. The process is one of learning from each other and solving problems together. 48 slum areas have been selected randomly. 24 will have women's groups. 24 will not, but both sets of areas will benefit from health service quality improvement. We will collect information about births, healthcare and outcomes in all 48 areas and compare the two sets. We are particularly interested in seeing if the women's groups make mothers more likely to have antenatal care and safe deliveries, and improve the survival of their babies. What are the possible benefits and risks of participating? We don't know if the women's groups will improve mother and baby health. They have not been tested enough for us to have an opinion on whether they will be successful in a city. Since the trial is part of the City Initiative for Newborn Health, all the areas involved will benefit from improvement of provision and quality of maternal and newborn services at health posts, maternity homes, peripheral hospitals and tertiary hospitals. Where is the study run from? SNEHA (Society for Nutrition, Education and Health Action), Mumbai, Maharashtra, India. When is the study starting and how long is it expected to run for? The study started in October 2006 and ended in September 2009. Who is funding the study? The Wellcome Trust (UK). Who is the main contact? Neena Shah More. SNEHA, Urban Health Centre, 60 Feet Road, Dharavi, Mumbai 400 017, Maharashtra, India. David Osrin. Institute for Global Health, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK

Critère d'inclusion

• Maternal and child health

Liens

• ictrp
• isrctn