Mobilizing community action to improve maternal health in a rural district in Tanzania: lessons learned from two years of community group activities

Andrea Solnes Miltenburg; Sandra van Pelt; Willemijn de Bruin; Laura Shields-Zeeman

doi:10.1080/16549716.2019.1621590

Mobilizing community action to improve maternal health in a rural district in Tanzania: lessons learned from two years of community group activities

Glob Health Action. 2019;12(1):1621590. doi: 10.1080/16549716.2019.1621590.

Authors

Andrea Solnes Miltenburg¹, Sandra van Pelt², Willemijn de Bruin³, Laura Shields-Zeeman³

Affiliations

¹ a Institute of Health and Society, Section for International Health, Faculty of Medicine, University of Oslo , Oslo , Norway.
² b Department of Work and Social Psychology , Maastricht University , Maastricht , The Netherlands.
³ c African Woman Foundation , Den Haag , The Netherlands.

Abstract

Background: Community participation can provide increased understanding and more effective implementation of strategies that seek to improve outcomes for women and newborns. There is limited knowledge on how participatory processes take place and how this affects the results of an intervention. Objective: This paper presents the results of two years of implementing (2013-2015) community groups for maternal health care in Magu District, Tanzania. Method: A total of 102 community groups were established, and 77 completed the four phases of the participatory learning and action cycle. The four phases included identification of problems during pregnancy and childbirth (phase 1), deciding on solutions and planning strategies (phase 2), implementation of strategies (phase 3) and evaluation of impact (phase 4). Community group meetings were facilitated by 15 trained facilitators and groups met monthly in their respective villages. Data was collected as an ongoing process from facilitator and meeting reports, through interviews with facilitators and local leaders and from focus group discussions with community group participants. Results: The majority of groups prioritized problems related to the availability of and accessibility to health services. The most commonly actioned solution was the provision of health education to the community. Almost all groups (95%) experienced a positive impact on the community as results of their actions, including increased maternal health knowledge and positive behaviour changes among health care workers. Facilitators were positive about the community groups, stating that they were grateful for the gained knowledge on maternal health, and positively regarded the involvement of men in community groups, which are traditionally women-only. Conclusion: The process of establishing and undertaking community groups in itself appeared to have a positive perceived impact on the community. However, sustained behaviour change, power dynamics and financial incentives need to be carefully considered during implementation and sustaining the community groups.

Keywords: Community participation; community group intervention; maternal health; participatory learning and action cycle; reproductive health.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Community Health Centers / organization & administration*
Community Participation
Delivery, Obstetric / education*
Female
Focus Groups
Health Personnel / education*
Health Promotion / methods*
Humans
Infant, Newborn
Male
Maternal Health Services / organization & administration*
Middle Aged
Pregnancy
Pregnant Women / education*
Rural Population / statistics & numerical data*
Tanzania

Grants and funding

This research was supported by funds raised through the African Woman Foundation. The Woman Centered Care Project was supported financially through Triple Jump Funds. During the time of writing of this manuscript ASM was supported by the Research Council of Norway through the Global Health and Vaccination Programme (GLOBVAC) for her PhD, project number 244674; Norges Forskningsråd (NO).