VoICE Immunization Evidence
Effectiveness of Multiple-Strategy Community Intervention in Reducing Geographical, Socioeconomic and Gender Based Inequalities in Maternal and Child Health Outcomes in Haryana, India.
From the VoICE Editors
India’s National Rural Health Mission (NRHM) multiple-strategy community intervention program, implemented between 2005 and 2012, aimed to reduce maternal and child health inequalities across geographical, socioeconomic and gender categories.
Integrated community based health intervention programs targeting high risk and underserved populations can lead to significant reductions in socioeconomic inequalities.
Key Evidence: In India, a multi-strategy community intervention, the National Rural Health Mission (NRHM) was successful in reducing disparities between pregnant women who had an institutional delivery in urban and rural areas. Geographic inequities reduced from 22% to 7.6% and socioeconomic disparities declined from 48.2% to 13%. Post the NRHM period, the difference between the number of children with full vaccination i.e., Bacillus Calmette Guerin (BCG) vaccine for tuberculosis, 3 doses of Diphtheria Pertussis and Tetanus vaccine (DTP), 3 doses of Oral Polio Vaccine (OPV), and measles vaccine, in urban and rural areas was observed to be non-significant.
Implementation of community based health intervention programs targeting the at-risk and underserved populations can lead to significant improvements in Maternal & Child Health outcomes.
Key Evidence: Through use of local Maternal Child Health (MCH) incentives, along with the use of locally appointed Health Activists, India’s National Rural Health Mission (NRHM) multiple-strategy community intervention program was able to achieve household level improvements in all of the following indicators for women and children over the 7 year program:
– the proportion of pregnant women having 3 or more ante-natal check-ups (from 43% to 74.5%)
– receiving at least one Tetanus Toxoid injection (from 83.5% to 93.6%)
– institutional deliveries (from 35.7% to 77%)
– post-natal check-ups within 2 weeks of delivery (from 49% to 67.2%) and,
– children who received ORS for diarrhea from (32.3% to 44.8%).
Gupta M, Angeli F, Bosma H, Rana M, Prinja S, Kumar R, et al. 2016. Effectiveness of Multiple-Strategy Community Intervention in Reducing Geographical, Socioeconomic and Gender Based Inequalities in Maternal and Child Health Outcomes in Haryana, India.. PLoS. 11(3).