loading page

Maternal and child health handbook to improve continuum of maternal and child care in rural Bangladesh: Findings of a cluster randomized controlled trials
  • +3
  • Ruoyan Gai Tobe,
  • Syed Emdadul Haque ,
  • Sanzida Mubassara,
  • Rushdana Rahman,
  • Kiyoko Ikegami,
  • Rintaro Mori
Ruoyan Gai Tobe
National Institute of Population and Social Security Research
Author Profile
Syed Emdadul Haque
Author Profile
Sanzida Mubassara
Jahangirnagar University Faculty of Biological Sciences
Author Profile
Rushdana Rahman
Dhaka Medical College and Hospital
Author Profile
Kiyoko Ikegami
School of Tropical Medicine and Global Health, Nagasaki University
Author Profile
Rintaro Mori
Kyoto University Graduate School of Medicine Faculty of Medicine
Author Profile

Abstract

Objective: This study aimed to evaluate the effectiveness of maternal and child health handbook (MCH) enhanced by mobile tools and to generate evidence informing the adoption of the program in Bangladesh Design: Cluster randomized controlled trial Setting: Two Upazilas in Bangladesh Population or Sample: Pregnant women Methods: Unions of the study settings were randomly allocated in either one of three groups: (1) Intervention 1 using both mobile platform and MCH, (2) Intervention 2 using MCH alone, or (3) the Control. A total of 3,002 participants were recruited. The interventions were designed to promote two-way communications between pregnant women/their families and community health workers by an empowering approach. Main outcome measures: continuum of care (CoC), neonatal mortality and morbidities Results: The interventions both significantly improved the utilization of CoC, although the overall proportion of CoC was relevantly low: 2.79% in the Control (95% CI: 1.37-3.54%), 6.16% in Intervention 2 (95% CI: 4.67-7.86%), and 7.89% in Intervention 1 (95% CI: 6.29-9.90%). Neonatal mortality rate with and without CoC was 5.43 per 1,000 (95% CI: 3.63 - 9.57 per 1,000) and 34.8 per 1,000 (95% CI: 24.3 - 45.4 per 1,000), respectively. Conclusion: our study indicated the effectiveness of the interventions by leveraging MCH and a mobile platform to promote uptake of CoC throughout prepartum, intrapartum and postpartum/neonatal periods, potentially bringing long-lasting benefits to mothers and their offspring. The explicit approach is expected to guide policy makers to adopt MCH interventions in primary healthcare strengthening at the community level.