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Mobilizing community action to improve maternal health in a rural district in Tanzania: lessons learned from two years of community group activities

Background: Community participation can provide increased understanding and more effective implementation of strategies that seek to improve outcomes for women and newborns. There is limited knowledge on how participatory processes take place and how this affects the results of an intervention. Obje...

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Autores principales: Solnes Miltenburg, Andrea, van Pelt, Sandra, de Bruin, Willemijn, Shields-Zeeman, Laura
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566771/
https://www.ncbi.nlm.nih.gov/pubmed/31190635
http://dx.doi.org/10.1080/16549716.2019.1621590
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author Solnes Miltenburg, Andrea
van Pelt, Sandra
de Bruin, Willemijn
Shields-Zeeman, Laura
author_facet Solnes Miltenburg, Andrea
van Pelt, Sandra
de Bruin, Willemijn
Shields-Zeeman, Laura
author_sort Solnes Miltenburg, Andrea
collection PubMed
description Background: Community participation can provide increased understanding and more effective implementation of strategies that seek to improve outcomes for women and newborns. There is limited knowledge on how participatory processes take place and how this affects the results of an intervention. Objective: This paper presents the results of two years of implementing (2013–2015) community groups for maternal health care in Magu District, Tanzania. Method: A total of 102 community groups were established, and 77 completed the four phases of the participatory learning and action cycle. The four phases included identification of problems during pregnancy and childbirth (phase 1), deciding on solutions and planning strategies (phase 2), implementation of strategies (phase 3) and evaluation of impact (phase 4). Community group meetings were facilitated by 15 trained facilitators and groups met monthly in their respective villages. Data was collected as an ongoing process from facilitator and meeting reports, through interviews with facilitators and local leaders and from focus group discussions with community group participants. Results: The majority of groups prioritized problems related to the availability of and accessibility to health services. The most commonly actioned solution was the provision of health education to the community. Almost all groups (95%) experienced a positive impact on the community as results of their actions, including increased maternal health knowledge and positive behaviour changes among health care workers. Facilitators were positive about the community groups, stating that they were grateful for the gained knowledge on maternal health, and positively regarded the involvement of men in community groups, which are traditionally women-only. Conclusion: The process of establishing and undertaking community groups in itself appeared to have a positive perceived impact on the community. However, sustained behaviour change, power dynamics and financial incentives need to be carefully considered during implementation and sustaining the community groups.
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spelling pubmed-65667712019-06-21 Mobilizing community action to improve maternal health in a rural district in Tanzania: lessons learned from two years of community group activities Solnes Miltenburg, Andrea van Pelt, Sandra de Bruin, Willemijn Shields-Zeeman, Laura Glob Health Action Original Article Background: Community participation can provide increased understanding and more effective implementation of strategies that seek to improve outcomes for women and newborns. There is limited knowledge on how participatory processes take place and how this affects the results of an intervention. Objective: This paper presents the results of two years of implementing (2013–2015) community groups for maternal health care in Magu District, Tanzania. Method: A total of 102 community groups were established, and 77 completed the four phases of the participatory learning and action cycle. The four phases included identification of problems during pregnancy and childbirth (phase 1), deciding on solutions and planning strategies (phase 2), implementation of strategies (phase 3) and evaluation of impact (phase 4). Community group meetings were facilitated by 15 trained facilitators and groups met monthly in their respective villages. Data was collected as an ongoing process from facilitator and meeting reports, through interviews with facilitators and local leaders and from focus group discussions with community group participants. Results: The majority of groups prioritized problems related to the availability of and accessibility to health services. The most commonly actioned solution was the provision of health education to the community. Almost all groups (95%) experienced a positive impact on the community as results of their actions, including increased maternal health knowledge and positive behaviour changes among health care workers. Facilitators were positive about the community groups, stating that they were grateful for the gained knowledge on maternal health, and positively regarded the involvement of men in community groups, which are traditionally women-only. Conclusion: The process of establishing and undertaking community groups in itself appeared to have a positive perceived impact on the community. However, sustained behaviour change, power dynamics and financial incentives need to be carefully considered during implementation and sustaining the community groups. Taylor & Francis 2019-06-13 /pmc/articles/PMC6566771/ /pubmed/31190635 http://dx.doi.org/10.1080/16549716.2019.1621590 Text en © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Solnes Miltenburg, Andrea
van Pelt, Sandra
de Bruin, Willemijn
Shields-Zeeman, Laura
Mobilizing community action to improve maternal health in a rural district in Tanzania: lessons learned from two years of community group activities
title Mobilizing community action to improve maternal health in a rural district in Tanzania: lessons learned from two years of community group activities
title_full Mobilizing community action to improve maternal health in a rural district in Tanzania: lessons learned from two years of community group activities
title_fullStr Mobilizing community action to improve maternal health in a rural district in Tanzania: lessons learned from two years of community group activities
title_full_unstemmed Mobilizing community action to improve maternal health in a rural district in Tanzania: lessons learned from two years of community group activities
title_short Mobilizing community action to improve maternal health in a rural district in Tanzania: lessons learned from two years of community group activities
title_sort mobilizing community action to improve maternal health in a rural district in tanzania: lessons learned from two years of community group activities
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566771/
https://www.ncbi.nlm.nih.gov/pubmed/31190635
http://dx.doi.org/10.1080/16549716.2019.1621590
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