Luke C. Mullany|Thomas J. Lee|Lin Yone|Catherine I Lee|Katherine C. Teela|Palae Paw|Eh Kalu Shwe Oo|Cynthia Maung|Heather Kuiper|Nicole Franck Masenior|Chris Beyrer
Impact of Community-Based Maternal Health Workers on Coverage of Essential Maternal Health Interventions among Internally Displaced Communities in Eastern Burma: The MOM Project
Johns Hopkins University|University of California, Los Angeles|Johns Hopkins University|Johns Hopkins University|Maesot General Hospital|Johns Hopkins University|Johns Hopkins University
access essential maternal reproductive health care poor throughout burma particularly lacking among internally displaced communities eastern border regions settings innovative strategies accessing vulnerable populations delivering basic public health interventions urgently neededfour ethnic health organizations mon karen karenni regions collaborated pilot project 2005 2008 examine feasibility innovative threetiered network communitybased providers delivery maternal health interventions complex emergency setting eastern burma twostage clustersampling surveys among evermarried women reproductive age 1545 conducted program implementation enabled evaluation changes coverage essential antenatal care interventions attendance birth trained manage complications postnatal care family planning servicesamong 2889 2442 women reproductive age 2006 2008 respectively population characteristics age marital status ethnic distribution literacy similar compared baseline women whose recent pregnancy occurred implementation period substantially likely receive antenatal care 718 versus 393 prevalence rate ratio prr 183 95 confidence interval ci 164204 specific interventions urine testing 424 versus 157 prr 269 95 ci 269354 malaria screening 559 versus 219 prr 288 95 ci 215385 deworming 582 versus 41 prr 1418 95 ci 10761871 postnatal care visits within 7 doubled use modern methods avoid pregnancy increased 239 450 prr 188 95 ci 163217 unmet need contraception reduced 617 405 relative reduction 35 95 ci 2840 attendance birth trained deliver elements emergency obstetric care increased almost 10fold 51 487 prr 955 95 ci 7211264coverage maternal health interventions higherlevel care birth substantially higher project period mom projects focus taskshifting capacity building empowerment community level might serve model approach similarly constrained settings