Testing a scalable community-based approach to improve maternal and neonatal health in rural Nepal

Objective: The aim of the study was to determine the feasibility of improved maternal-neonatal care-seeking and household practices using an approach scalable under Nepal's primary health-care services. Study Design: Impact was assessed by pre- and post-intervention surveys of women delivering within the previous 12 months. Each district sample comprised 30 clusters, each with 30 respondents. The intervention consisted primarily of community-based antenatal counseling and dispensing and an early postnatal home visit; most activities were carried out by community-based health volunteers. Result: There were notable improvements in most household practice and service utilization indicators, although results regarding care-seeking for danger signs were mixed. Conclusion: It is feasible in a Nepal setting to significantly improve utilization of maternal-neonatal services and household practices, using the resources available under the government primary health-care system. This has the potential to significantly reduce neonatal mortality. Journal of Perinatology (2010) 30, 388-395; doi: 10.1038/jp.2009.181; published online 12 November 2009