Centre for International Health and Development, Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK.
Trials. 2011 May 19;12:128. doi: 10.1186/1745-6215-12-128.
Birth attendance by trained health workers is low in rural Nepal. Local participation in improving health services and increased interaction between health systems and communities may stimulate demand for health services. Significant increases in birth attendance by trained health workers may be affected through community mobilisation by local women's groups and health management committee strengthening. We will test the effect of community mobilisation through women's groups, and health management committee strengthening, on institutional deliveries and home deliveries attended by trained health workers in Makwanpur District.
Cluster randomised controlled trial involving 43 village development committee clusters. 21 clusters will receive the intervention and 22 clusters will serve as control areas. In intervention areas, Female Community Health Volunteers are supported in convening monthly women's groups. The groups work through an action research cycle in which they consider barriers to institutional delivery, plan and implement strategies to address these barriers with their communities, and evaluate their progress. Health management committees participate in three-day workshops that use appreciative inquiry methods to explore and plan ways to improve maternal and newborn health services. Follow-up meetings are conducted every three months to review progress. Primary outcomes are institutional deliveries and home deliveries conducted by trained health workers. Secondary outcome measures include uptake of antenatal and postnatal care, neonatal mortality and stillbirth rates, and maternal morbidity.
ISRCTN99834806.
在尼泊尔农村，接受过培训的卫生工作者的分娩率较低。当地参与改善卫生服务以及加强卫生系统与社区之间的互动，可能会刺激对卫生服务的需求。通过当地妇女团体的社区动员以及加强卫生管理委员会，接受过培训的卫生工作者的分娩率可能会显著提高。我们将在马坎普尔区测试通过妇女团体和加强卫生管理委员会来动员社区，对医疗机构分娩和由接受过培训的卫生工作者进行的家庭分娩的影响。
涉及 43 个村发展委员会集群的整群随机对照试验。21 个集群将接受干预，22 个集群将作为对照区。在干预区，支持女性社区卫生志愿者每月召集妇女团体。这些团体通过行动研究周期工作，在该周期中，她们考虑机构分娩的障碍，计划并实施与社区共同解决这些障碍的策略，并评估其进展。卫生管理委员会参加为期三天的研讨会，采用欣赏式探询方法探讨并计划改善孕产妇和新生儿保健服务的方法。每三个月进行一次后续会议，以审查进展情况。主要结局指标是由接受过培训的卫生工作者进行的医疗机构分娩和家庭分娩。次要结局指标包括接受产前和产后护理、新生儿死亡率和死产率以及产妇发病率。
ISRCTN99834806。
