Effectiveness of a multiple-strategy community intervention to reduce maternal and child health inequalities in Haryana, North India: a mixed-methods study protocol
Background: A multiple-strategy community intervention, known as National Rural Health Mission (NRHM), launched in India to improve the availability of and access to better-quality healthcare, especially for rural, poor mothers and children. The final goal of the intervention is to reduce maternal a...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2015-02-01
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| Series: | Global Health Action |
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| Online Access: | http://www.globalhealthaction.net/index.php/gha/article/view/25987/pdf_33 |
| _version_ | 1811198925099499520 |
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| author | Madhu Gupta Federica Angeli Onno C. P. van Schayck Hans Bosma |
| author_facet | Madhu Gupta Federica Angeli Onno C. P. van Schayck Hans Bosma |
| author_sort | Madhu Gupta |
| collection | DOAJ |
| description | Background: A multiple-strategy community intervention, known as National Rural Health Mission (NRHM), launched in India to improve the availability of and access to better-quality healthcare, especially for rural, poor mothers and children. The final goal of the intervention is to reduce maternal and child health inequalities across geographical areas, socioeconomic status groups, and sex of the child. Extensive, in-depth research is necessary to assess the effectiveness of NRHM, on multiple outcome dimensions. This paper presents the design of a new study, able to overcome the shortcomings of previous research. Objective: To propose a comprehensive, methodologically sound protocol to assess the extent of implementation and the effectiveness of NRHM measures to improve maternal and child health outcomes and reduce maternal and child health inequalities. Design: A mixed-methods approach (quantitative and qualitative) is proposed for this study in Haryana, a state in North India. NRHM's health sector plans included health system strengthening, specific maternal and child healthcare strategies, and communitization. Mission documents and reports on progress, financial monitoring, and common and joint review will be reviewed in-depth to assess the extent of the implementation of plans. Data on maternal and child health indicators will be obtained from demographic health surveys held before, during, and after the implementation of the first phase of the NRHM (2005–2012) and compared over time. Differences in maternal and child health indicators will be used to measure maternal and child health inequalities; these will be compared pre- and post-NRHM. Focus group discussions (FGDs) with service providers and in-depth interviews with program managers, community representatives, and mothers will be conducted until data saturation is achieved, in two districts of Haryana. Using Nvivo software, an inductive qualitative content analysis will be performed to search for the broader themes across the interviews and FGDs. Ethical approval was obtained from the Ethics Committee of the Post Graduate Institute of Medical Education and Research. |
| first_indexed | 2024-04-12T01:39:23Z |
| format | Article |
| id | doaj.art-41850e130c174f128286462e0d9daf39 |
| institution | Directory Open Access Journal |
| issn | 1654-9880 |
| language | English |
| last_indexed | 2024-04-12T01:39:23Z |
| publishDate | 2015-02-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Global Health Action |
| spelling | doaj.art-41850e130c174f128286462e0d9daf392022-12-22T03:53:14ZengTaylor & Francis GroupGlobal Health Action1654-98802015-02-018011010.3402/gha.v8.2598725987Effectiveness of a multiple-strategy community intervention to reduce maternal and child health inequalities in Haryana, North India: a mixed-methods study protocolMadhu Gupta0Federica Angeli1Onno C. P. van Schayck2Hans Bosma3 Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India Department of Health Services Research, CAPHRI, Maastricht University, Maastricht, The Netherlands Department of Family Practice, CAPHRI, Maastricht University, Maastricht, The Netherlands Department of Social Medicine, CAPHRI, Maastricht University, Maastricht, The NetherlandsBackground: A multiple-strategy community intervention, known as National Rural Health Mission (NRHM), launched in India to improve the availability of and access to better-quality healthcare, especially for rural, poor mothers and children. The final goal of the intervention is to reduce maternal and child health inequalities across geographical areas, socioeconomic status groups, and sex of the child. Extensive, in-depth research is necessary to assess the effectiveness of NRHM, on multiple outcome dimensions. This paper presents the design of a new study, able to overcome the shortcomings of previous research. Objective: To propose a comprehensive, methodologically sound protocol to assess the extent of implementation and the effectiveness of NRHM measures to improve maternal and child health outcomes and reduce maternal and child health inequalities. Design: A mixed-methods approach (quantitative and qualitative) is proposed for this study in Haryana, a state in North India. NRHM's health sector plans included health system strengthening, specific maternal and child healthcare strategies, and communitization. Mission documents and reports on progress, financial monitoring, and common and joint review will be reviewed in-depth to assess the extent of the implementation of plans. Data on maternal and child health indicators will be obtained from demographic health surveys held before, during, and after the implementation of the first phase of the NRHM (2005–2012) and compared over time. Differences in maternal and child health indicators will be used to measure maternal and child health inequalities; these will be compared pre- and post-NRHM. Focus group discussions (FGDs) with service providers and in-depth interviews with program managers, community representatives, and mothers will be conducted until data saturation is achieved, in two districts of Haryana. Using Nvivo software, an inductive qualitative content analysis will be performed to search for the broader themes across the interviews and FGDs. Ethical approval was obtained from the Ethics Committee of the Post Graduate Institute of Medical Education and Research.http://www.globalhealthaction.net/index.php/gha/article/view/25987/pdf_33National Rural Health MissionIndiahealth inequalitiesmixed-methods approachmaternal healthchild healthhealth indicators |
| spellingShingle | Madhu Gupta Federica Angeli Onno C. P. van Schayck Hans Bosma Effectiveness of a multiple-strategy community intervention to reduce maternal and child health inequalities in Haryana, North India: a mixed-methods study protocol Global Health Action National Rural Health Mission India health inequalities mixed-methods approach maternal health child health health indicators |
| title | Effectiveness of a multiple-strategy community intervention to reduce maternal and child health inequalities in Haryana, North India: a mixed-methods study protocol |
| title_full | Effectiveness of a multiple-strategy community intervention to reduce maternal and child health inequalities in Haryana, North India: a mixed-methods study protocol |
| title_fullStr | Effectiveness of a multiple-strategy community intervention to reduce maternal and child health inequalities in Haryana, North India: a mixed-methods study protocol |
| title_full_unstemmed | Effectiveness of a multiple-strategy community intervention to reduce maternal and child health inequalities in Haryana, North India: a mixed-methods study protocol |
| title_short | Effectiveness of a multiple-strategy community intervention to reduce maternal and child health inequalities in Haryana, North India: a mixed-methods study protocol |
| title_sort | effectiveness of a multiple strategy community intervention to reduce maternal and child health inequalities in haryana north india a mixed methods study protocol |
| topic | National Rural Health Mission India health inequalities mixed-methods approach maternal health child health health indicators |
| url | http://www.globalhealthaction.net/index.php/gha/article/view/25987/pdf_33 |
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