Teaching mothers could cut neonatal mortality in India

Gathering women together for monthly chats on sound pregnancy practices and reproductive health may drastically cut neonatal mortality rates in rural communities in India.

Community mobilisation through participatory women's groups might improve birth outcomes in poor rural communities. To assess this approach in a largely tribal and rural population in Jharkhand and Orissa (estimated population - 228186), researchers assigned 18 clusters to intervention or control using randomisation. Women were eligible to participate if they were aged between 15 and 49 years, residing in the project area, and had given birth during the study. In intervention clusters, a facilitator convened 13 groups every month to support participatory action and learning for women, and facilitated the development and implementation of strategies to address maternal and newborn health problems. The researchers monitored the outcome of these intervention strategies for 19,030 births during 3 years (2005 - 08).

The neonatal mortality rate per 1000 dropped from 56 to 37 and finally to 36 during the first, second, and third years, respectively, in intervention clusters. This was against the increasing neonatal mortality rate among the control group, which went up from 53 to 60 and finally to 64 per 1000 in the first, second and third year respectively. The neonatal mortality rate was 32% lower in intervention clusters during the three years. Although the researchers did not notice a significant reduction in maternal depression, reduction in moderate depression was 57% in third year.

The above findings show that such intervention programmes, which involve the participation of mothers along with learning, can help improve maternal and newborn health outcomes in poor populations in India.