Show simple item record

dc.contributor.authorHouweling, Tanja A.J.
dc.contributor.authorLooman, Caspar W.N.
dc.contributor.authorAzad, Kishwar
dc.contributor.authorDas, Sushmita
dc.contributor.authorKing, Carina
dc.contributor.authorKuddus, Abdul
dc.contributor.authorLewycka, Sonia
dc.contributor.authorManandhar, Dharma S.
dc.contributor.authorSah More, Neena
dc.contributor.authorMorrison, Joanna
dc.contributor.authorPhiri, Tambosi
dc.contributor.authorRath, Shibanand
dc.contributor.authorRosato, Mikey
dc.contributor.authorSen, Aman
dc.contributor.authorTripathy, Prasanta
dc.contributor.authorProst, Audrey
dc.contributor.authorOsrin, David
dc.contributor.authorCostello, Anthony
dc.identifier.citationTanja A J Houweling, Caspar W N Looman, Kishwar Azad, Sushmita Das, Carina King, Abdul Kuddus, Sonia Lewycka, Dharma S Manandhar, Neena Sah More, Joanna Morrison, Tambosi Phiri, Shibanand Rath, Mikey Rosato, Aman Sen, Prasanta Tripathy, Audrey Prost, David Osrin, Anthony Costello, The equity impact of community women’s groups to reduce neonatal mortality: a meta-analysis of four cluster randomized trials, International Journal of Epidemiology, Volume 48, Issue 1, February 2019, Pages 168–182,
dc.description.abstractSocioeconomic inequalities in neonatal mortality are substantial in many developing countries. Little is known about how to address this problem. Trials in Asia and Africa have shown strong impacts on neonatal mortality of a participatory learning and action intervention with women’s groups. Whether this intervention also reduces mortality inequalities remains unknown. We describe the equity impact of this women’s groups intervention on the neonatal mortality rate (NMR) across socioeconomic strata. We conducted a meta-analysis of all four participatory women’s group interventions that were shown to be highly effective in cluster randomized trials in India, Nepal, Bangladesh and Malawi. We estimated intervention effects on NMR and health behaviours for lower and higher socioeconomic strata using random effects logistic regression analysis. Differences in effect between strata were tested. Analysis of 69120 live births and 2505 neonatal deaths shows that the intervention strongly reduced the NMR in lower (50–63% reduction depending on the measure of socioeconomic position used) and higher (35–44%) socioeconomic strata. The intervention did not show evidence of ‘elite-capture’: among the most marginalized populations, the NMR in intervention areas was 63% lower [95% confidence interval (CI) 48–74%] than in control areas, compared with 35% (95% CI: 15–50%) lower among the less marginalized in the last trial year (P-value for difference between most/less marginalized: 0.009). The intervention strongly improved home care practices, with no systematic socioeconomic differences in effect. Participatory women’s groups with high population coverage benefit the survival chances of newborns from all socioeconomic strata, and perhaps especially those born into the most deprived households.
dc.publisherOxford University Press on behalf of the International Epidemiological Association
dc.titleThe Equity Impact of Community Women's Groups to Reduce Neonatal Mortality: A Meta-analysis of Four Cluster Randomized Trials
dc.rights.holder© The Author 2017

Files in this item


This item appears in the following Collection(s)

Show simple item record
Except where otherwise noted, this item's license is described as