Michelle Heys|Lu Gram|Angie Wade|Edward James Norman Haworth|David Osrin|Khadkha Sagar|Deepti Shrestha|Rishi Neupane|Dhruba Adhikari|Ramesh Adhikari|Bharat Budhathoki|Dharma Manandhar|Anthony Costello
Long-term impact of community-based participatory women’s groups on child and maternal mortality and child disability: follow-up of a cluster randomised trial in rural Nepal
University College London|Great Ormond Street Hospital|University College London|Great Ormond Street Hospital|University College London|Great Ormond Street Hospital|University College London|University College London|Mother and Infant Research Activities|Government of Nepal|Mother and Infant Research Activities|Mother and Infant Research Activities|Mother and Infant Research Activities|Mother and Infant Research Activities|Mother and Infant Research Activities|Mother and Infant Research Activities|University College London
communitybased womens groups practising participatory learning action pla reduce maternal neonatal mortality lowincome countries however clear whether reductions associated subsequent increased decreased rates childhood death disability assessed impact child deaths disability beyond perinatal period among participants earliest trial nepal 20012003household interviews conducted mothers household heads cluster individual levels analysed disability using pairwise log relative risks survival using multilevel logistic modelsfrom 6075 children 6117 mothers alive 4 weeks post partum 44 419 children 73 available interview mean 115 years later rates child deaths beyond perinatal period 366 520 per 1000 children intervention control arms respectively rates disability 627 855 per 1000 children intervention control arms respectively individuallevel analysis including random effects cluster pairing adjusted baseline maternal literacy socioeconomic status maternal age showed lower statistically nonsignificant odds child deaths 070 95 ci 043 118 disability 064 039 106 intervention armcommunitylevel exposure womens groups practising pla significantly impact childhood death disability death beyond perinatal period followup trials larger sample sizes warranted order explore possibility potential longterm survival disability benefits greater precision