Promoting positive maternal, newborn, and child health behaviors through a group-based health education and microfinance program: a prospective matched cohort study in western Kenya

• Published in: BMC pregnancy and childbirth 2020-05, Vol.20 (1), p.288-288, Article 288
• Main Authors: Maldonado, Lauren Y, Songok, Julia J, Snelgrove, John W, Ochieng, Christian B, Chelagat, Sheilah, Ikemeri, Justus E, Okwanyi, Monica A, Cole, Donald C, Ruhl, Laura J, Christoffersen-Deb, Astrid
• Format: Article
• Language: English
• Subjects: Adult; Attended births; Babies; Breastfeeding & lactation; Case-Control Studies; Child; Child Health; Childrens health; Cohort analysis; Cohort Studies; Community health volunteer; Community Health Workers; Enrollments; Family planning; Female; Financial Support; Health Behavior; Health education; Health Education - methods; Health Facilities; Health Promotion - methods; Humans; Infant Health; Infant mortality; Infant, Newborn; Kenya; Maternal Health; Maternal mortality; Microfinance; Newborn babies; Newborn or infant health; Peer support; Postnatal Care; Postpartum period; Pregnancy; Prenatal Care; Prospective Studies; Reproductive health; Rural areas; Rural Population; Sociodemographics; Socioeconomic factors; Womens health; Young Adult
• ISSN: 1471-2393; 1471-2393
• DOI: 10.1186/s12884-020-02978-w

Chamas for Change (Chamas) is a group-based health education and microfinance program for pregnant and postpartum women that aims to address inequities contributing to high rates of maternal and infant mortality in rural western Kenya. In this prospective matched cohort study, we evaluated the association between Chamas participation and facility-based delivery. We additionally explored the effect of participation on promoting other positive maternal, newborn and child health (MNCH) behaviors. We prospectively compared outcomes between a cohort of Chamas participants and controls matched for age, parity, and prenatal care location. Between October-December 2012, government-sponsored community health volunteers (CHV) recruited pregnant women attending their first antenatal care (ANC) visits at rural health facilities in Busia County to participate in Chamas. Women enrolled in Chamas agreed to attend group-based health education and microfinance sessions for one year; controls received the standard of care. We used descriptive analyses, multivariable logistic regression models, and random effect models to compare outcomes across cohorts 12 months following enrollment, with α set to 0.05. Compared to controls (n = 115), a significantly higher proportion of Chamas participants (n = 211) delivered in a health facility (84.4% vs. 50.4%, p