process evaluation of a community-based intervention promoting multiple maternal and neonatal care practices in rural nepal过程评估的以社区为基础的干预促进多个在尼泊尔农村孕产妇和新生儿保健行为.pdfVIP

McPherson et al. BMC Pregnancy and Childbirth 2010, 10:31 /1471-2393/10/31 R E S E A R C H A R T I C L E Open Access Research article Process evaluation of a community-based intervention promoting multiple maternal and neonatal care practices in rural Nepal †1 †2 †3 4 3 1 Robert A McPherson* , Jyotsna Tamang , Stephen Hodgins , Laxmi R Pathak , Ram C Silwal , Abdullah H Baqui and Peter J Winch†1 Abstract Background: The challenge of delivering multiple, complex messages to promote maternal and newborn health in the terai region of Nepal was addressed through training Female Community Health Volunteers (FCHVs) to counsel pregnant women and their families using a flipchart and a pictorial booklet that was distributed to clients. The booklet consists of illustrated messages presented on postcard-sized laminated cards that are joined by a ring. Pregnant women were encouraged to discuss booklet content with their families. Methods: We examined use of the booklet and factors affecting adoption of practices through semi-structured interviews with district and community-level government health personnel, staff from the Nepal Family Health Program, FCHVs, recently delivered women and their husbands and mothers-in-law. Results: The booklet is shared among household members, promotes discussion, and is referred to when questions arise or during emergencies. Booklet cards on danger signs and nutritious foods are particularly well-received. Cards on family planning and certain aspects of birth preparedness generate less interest. Husbands and mothers-in-law control decision-making for maternal and newborn care-seeking and related household-level behaviors. Conclusions: Interpersonal pee