Maternal and Child Health Implementation Research in Mozambique: Effective Community Interventions to Promote Sexual and Reproductive Health
Bibliographic record
Abstract
Abstract Background: High maternal and neonatal mortality rates in Mozambique, are due to adolescent pregnancies, difficulties in accessing health services, traditional constraints, and gender inequalities. An implementation research project, Alert Community to Prepared Hospital in Natikiri, Nampula, Mozambique was developed to reduce maternal and new-born mortality. From 2016 to 2020, it implemented activities to improve population knowledge and function in sexual and reproductive health, and to enable community participation in maternal health services. In this paper we will assess and discuss the impact of community participation on improving sexual and reproductive health.Methods: Implementation research with community intervention and programmed mid-term evaluations, using mixed methods research, with descriptive quantitative surveys and qualitative focus groups discussions and interviews, applied from 2017 to 2020. Local health committees, traditional birth attendants, traditional healers and local leadership all participated: trained in sexual and reproductive health and participated in radio discussion groups; community and hospital members of the co-management committee enabled local programming. Maternal and child health indicators were evaluated with health unit’s operational data. Quantitative data were captured in Microsoft Office Excel, analysed with SPSS21 to find frequency, percentage, mean and standard deviation; qualitative data registered in Word was analysed with NVIVO. This research received bioethical approvals from both the Mozambique and Canadian universities and followed Helsinki Declaration recommendations.Results: Comparing changes from 2016 to 2019, the number of health committees operating in Natikiri rose from 7 to 20. Each committee integrated four Family Health Champions, who attained 24738 residents with health education interventions on reproductive health. A theatre group developed dramas about the same key messages, presented in communities. Population access to contraceptives was facilitated, from 42% to 91% in women and from 65% to 90% in men. At Marrere Health Centre, women with four ante-natal visits rose by 185%, and children less than one year of age’ visits 89%; at Marrere General Hospital deliveries rose 60%.Conclusion: Community participation, at all levels of maternal and child health service care continuum, from community to hospital, enhanced with complementary interventions well contextualised, is effective in improving adolescent and adult sexual and reproductive health.Trial registrationThis study was not registered in any data base.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.014 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".