Women's and Children's Health Research Unit, J N Medical College, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India
Department of Obstetrics and Gynaecology, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada.
BMJ Open. 2022 Dec 20;12(12):e060593. doi: 10.1136/bmjopen-2021-060593.
To describe the process of community engagement (CE) in northern Karnataka, India and its impact on pre-eclampsia knowledge, birth preparedness and complication readiness, pregnancy-related care seeking and maternal morbidity.
This study was a secondary analysis of a cluster randomised trial of Community Level Interventions for Pre-eclampsia (CLIP). A total of 12 clusters based on primary health centre catchment areas were randomised to intervention or control. CE was conducted in intervention clusters. CE attendance was summarised according to participant group using both quantitative and qualitative assessment. Pre-eclampsia knowledge, birth preparedness, health services engagement and perinatal outcomes was evaluated within trial surveillance. Outcomes were compared between trial arms using a mixed effects logistic regression model on RStudio (RStudio, Boston, USA). Community feedback notes were thematically analysed on NVivo V.12 (QSR International, Melbourne, Australia).
Belagavi and Bagalkote districts in rural Karnataka, India.
Pregnant women and women of reproductive age, mothers and mothers-in-law, community stakeholders and male household decision-makers and health workers.
A total of 1379 CE meetings were conducted with 39 362 participants between November 2014 and October 2016. CE activities may have had an effect on modifying community attitudes towards hypertension in pregnancy and its complications. However, rates of pre-eclampsia knowledge, birth preparedness, health services engagement and maternal morbidities among individual pregnant women were not significantly impacted by CE activities in their area.
Evaluation of our CE programme in India demonstrates the feasibility of reaching pregnant women alongside household decision-makers, community stakeholders and health workers. More research is needed to explore the pathways of impact between broad community mobilisation to strengthen support for maternal care seeking and clinical outcomes of individual pregnant women.
NCT01911494.
描述印度卡纳塔克邦北部的社区参与（CE）过程及其对先兆子痫知识、生育准备和并发症准备、妊娠相关护理寻求和产妇发病率的影响。
本研究是社区级干预先兆子痫（CLIP）的一项集群随机试验的二次分析。总共 12 个基于初级保健中心集水区的集群被随机分配到干预或对照组。在干预集群中进行了 CE。使用定量和定性评估，根据参与者群体总结 CE 出席情况。在试验监测中评估了先兆子痫知识、生育准备、卫生服务参与和围产期结局。使用 RStudio（美国波士顿的 RStudio）上的混合效应逻辑回归模型对试验臂进行了比较。在 NVivo V.12（澳大利亚墨尔本的 QSR International）上对社区反馈注释进行了主题分析。
印度卡纳塔克邦的 Belagavi 和 Bagalkote 区。
孕妇和育龄妇女、母亲和婆婆、社区利益相关者以及男性家庭决策者和卫生工作者。
2014 年 11 月至 2016 年 10 月期间，共举办了 1379 次 CE 会议，有 39362 名参与者参加。CE 活动可能已经影响了社区对妊娠高血压及其并发症的态度。然而，在其所在地区的 CE 活动并没有显著影响个别孕妇的先兆子痫知识、生育准备、卫生服务参与和产妇发病率。
对我们在印度的 CE 计划的评估表明，与家庭决策者、社区利益相关者和卫生工作者一起接触孕妇是可行的。需要进一步研究来探索广泛的社区动员加强对孕产妇护理寻求的支持与个别孕妇临床结局之间的影响途径。
NCT01911494。
