Sharma, S., van Teijlingen, E., Hundley, V., Stephens J., Simkhada, P., Angell, C., Sicuri, E., Belizan, JM. (2013) Mixed-methods evaluation of a maternity care intervention in rural Nepal: measuring what works, Poster P.2.3.004 (A), Tropical Medicine & International Health 18(Suppl. 1): 108–231.

Authors: Sharma, S., van Teijlingen, E., Hundley, V., Stephens, J., Simkhada, P., Angell, C., Sicuri, E. and Belizan, J.M.

Conference: 8th European Congress on Tropical Medicine & International Health, 2013 (ECTMIH-2013) - See more at:

Dates: 10-13 September 2013

Journal: Tropical Medicine & International Health

Volume: Supplement 1

Issue: 18

Pages: 183-184

Publisher: Wiley

ISSN: 1365-3156


Brief Introduction The Buddhist charity Green Tara Nepal (GTN) set up a programme to improve the uptake of maternal care practices in rural Nepal via health promotion activities in the community. The programme is novel because it seeks to improve maternal service uptake via bottom-up participatory methods in rural communities. This research aimed to compare the effectiveness of the GTN health promotion strategy, with standard care for mothers in a developing country community setting.

Material and Methods The research was a mixed-methods evaluation of a maternity care intervention in rural Nepal; conducted in collaboration with GTN. Data were collected using a controlled before-and-after, cross-sectional survey; with socio-economic, cost and health uptake questions.

A questionnaire-based interview was conducted with 1236 women, with their last child <2 years old. Ethical approval provided by the Nepal Health Research Council. The relation between the number of ANC (antenatal care) visits, belonging to the intervention group, and the respondents’ background (education, household income & parity) was examined.

Results The health promotion intervention appeared to improve ANC attendance. Low educational level, low household income, and multiparty were risk factors for non-attendance. The evaluation suggests that practice should be socio-culturally appropriate and inclusive not only of women but also their families; mother-in-laws’ and men’s participation should be sought. Conclusions Nepal will be able to achieve most of its MDG targets by 2015, particularly MDG5 and evaluations, like these have implications for future policy; findings can be used to shape policy to be ‘inclusive’ to those marginalised, for example rural communities in Nepal. Furthermore, as impact evaluations influence policy, here the implications for Nepalese policy is that maternal health promotion is central to achieving maternal health goals nationally and should be part of the nurse midwifery curriculum. Finally, funding was provided from Bournemouth and Santander Universities

Source: Manual

Preferred by: Edwin van Teijlingen