印度比哈尔邦参与基于小额信贷的自助小组的妇女分享健康信息对产前保健行为的影响。
Effect of sharing health messages on antenatal care behavior among women involved in microfinance-based self-help groups in Bihar India.
机构信息
1Population Council, Zone 5A, Ground Floor India Habitat Centre, Lodi Road, New Delhi, Delhi 110003 India.
Project Concern International, 38, Okhla Phase 3 Rd, Okhla Phase III, Okhla Industrial Area, New Delhi, Delhi 110020 India.
出版信息
Glob Health Res Policy. 2020 Feb 7;5:3. doi: 10.1186/s41256-020-0132-0. eCollection 2020.
BACKGROUND
Bihar state in India has one of the highest rates of maternal and infant mortality in South Asia. Microfinance-based self-help groups (SHGs), involving rural women, are being utilized to improve maternal and child health practice and reduce mortality. SHG members receive information on key maternal and child health practices as well as encouragement for their practice. This study measures the association of health messaging to SHG members with their antenatal care (ANC) behaviors.
METHODS
The study was conducted in eight districts of Bihar in 2016. A three-stage cluster sampling design (with a random selection of blocks, villages, and SHGs) selected the sample of 1204 SHG members who had an infant child; of these, 597 women were members of SHGs that received dedicated sessions on health messages, while 607 women belonged to SHGs that did not. To examine the impact of the health intervention on ANC practice, radius caliper method of propensity score matching controlled for various socio-demographic characteristics between the two groups.
RESULTS
Most of the interviewed women (91.5%) belonged to a scheduled caste or tribe. Nearly 44% of SHG members exposed to the health intervention were engaged in some occupation, compared to 35% of those not exposed to the intervention. After matching unexposed SHG women with exposed SHG women, no significant differences were found in their socio-demographic characteristics. Findings suggest that exposure to a health intervention is associated with increased likelihood of at least four ANC visits by SHG women (ATE = 7.2, 95% CI: 0.76-13.7, < 0.05), consumption of iron-folic acid for at least 100 days (ATE = 8.7, 95% CI: 5.0-12.5, < 0.001) and complete ANC (ATE = 3.6, 95% CI: 2.3-4.9, < 0.001), when compared to women not exposed to the health intervention.
CONCLUSIONS
The study shows that sharing health messages in microfinance-based SHGs is associated with significant increase in ANC practice. While the results suggest the potential of microfinance-based SHGs for improved maternal health services, the approach's sustainability needs to be further examined.
背景
印度比哈尔邦是南亚母婴死亡率最高的邦之一。基于小额信贷的自助小组（SHG）涉及农村妇女，正在被用于改善母婴健康实践并降低死亡率。SHG 成员会收到关于关键母婴健康实践的信息，并受到鼓励去实践这些信息。本研究旨在衡量向 SHG 成员传递健康信息与他们接受产前护理（ANC）行为之间的关联。
方法
该研究于 2016 年在比哈尔邦的 8 个地区进行。采用三阶段聚类抽样设计（随机选择街区、村庄和 SHG），选取了 1204 名有婴儿的 SHG 成员作为样本；其中，597 名妇女是接受了专门的健康信息课程的 SHG 成员，而 607 名妇女则属于未接受此类课程的 SHG 成员。为了检验健康干预对 ANC 实践的影响，使用半径卡尺法进行倾向评分匹配，以控制两组之间的各种社会人口学特征。
结果
大多数接受访谈的妇女（91.5%）属于在册种姓或部落。与未接受干预的妇女相比，约有 44%的接受健康干预的 SHG 成员从事某种职业。在将未暴露于干预措施的 SHG 妇女与暴露于干预措施的 SHG 妇女进行匹配后，发现两组妇女在社会人口学特征方面没有显著差异。研究结果表明，接受健康干预与 SHG 妇女接受至少四次 ANC 检查的可能性增加有关（ATE=7.2，95%CI：0.76-13.7，<0.05），至少 100 天服用铁叶酸（ATE=8.7，95%CI：5.0-12.5，<0.001）和完全接受 ANC（ATE=3.6，95%CI：2.3-4.9，<0.001），与未接受健康干预的妇女相比。
结论
本研究表明，在基于小额信贷的 SHG 中分享健康信息与 ANC 实践的显著增加有关。虽然结果表明基于小额信贷的 SHG 在改善孕产妇健康服务方面具有潜力，但需要进一步研究这种方法的可持续性。
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