Background In developing countries, where the majority of the world’s maternal deaths occur it is recognised that to target maternal mortality within limited resources, safe motherhood strategies need to be targeted to rural areas and to the poor in order to increase access to antenatal care and delivery care. In these populations, a lack of understanding of local beliefs and practices, and the reasons for them, can hinder the development of appropriate interventions.
The Green Tara Nepal intervention, Pharping, Nepal, aims to improve the uptake of maternal care practices in rural Nepal via health promotion activities in the community. The expectation is that the measured aspect of health-seeking behaviour should improve in the intervention area relative to the control.
Methods In 2008, Green Tara Nepal (GTN), a Nepalese Non-Governmental Organisation implemented a 5 year health promotion intervention to improve maternal and neonatal health in 2 rural village development communities (VDC) in Pharping, Nepal. The GTN programme works with midwives and community health workers to target fertile women, in health promotion groups and on a one-to-one basis. During this interaction, women receive advice on health behaviours and care-seeking practice.
Two surveys were conducted a baseline (2008) and a midline (2010) on the intervention communities and in 2 control communities.; 833 women of childbearing age with their last child of less than 2 years old, were interviewed in this controlled before and after, cross-sectional study.
Results After the intervention the proportion of women, during their last pregnancy, attending antenatal care, at least once, increased by from 84.6% to 96.8% (p=0.00). The proportion of women who had their first prenatal visit in the first trimester was increased from 39.9% to 58.1% (p=0.00). Women attending more than 4 visits increased from 37.1% to 42.6% (p=0.28).
Conclusion This ongoing community intervention providing health promotion shows an improvement on women’s attendance of antenatal care.