Impact on health outcomes
We will analyze the records from the home visits to measure impact on maternal and child health outcomes, comparing visited wards with not-yet-visited wards (control wards).
A 2019 paper in BMJ Global Health compares maternal outcomes after one year in the two first-wave wards (with home visits) with outcomes in the two second-wave wards (without home visits). It confirms a reduction in complications of pregnancy and in post-partum sepsis in the visited wards, of 20% or more, as well as big improvements in the targeted risk factors. There was no significant difference in use of health facilities for antenatal care or delivery between the visited and non-visited wards.
The findings support our idea that the improvement in maternal outcomes is due to changes in these actionable risk factors, achieved by actions taken together by women and men in the households.
Stories of change
We collected stories from women and men about how the home visits had affected their lives. These stories show how the visits changed the position of women in the households, increased male involvement in pregnancy and childbirth, and led to actions to tackle the four upstream risk factors. The home visitors and government officers involved in the home visits also gave their stories, which showed how their work on the project had made a difference in their lives.
“I felt very confident, strong and healthy up to the time of my safe delivery.”
(Woman aged 24 years. Married, with four children).
“I learned how to take care of my wife, and how to look out for danger signs during her
pregnancy (…). I feel very happy and appreciative as I can advise my wife, family, and
other relatives on danger signs during pregnancy and child birth.”
(Man aged 30 years. Married, with five children).
“I ensured that my wife did not do any kind of heavy work during pregnancy.
When she delivered, it was an easy delivery.”
(Man aged 37 years. Married, with three wives and 15 children)
“My interaction with households in the communities has been the most significant change in my life.
I am happier in my life now. I feel more satisfied. I feel that I have made a difference in the lives of people.
I have achieved what I wanted to do in life – to visit communities and change the lives of people in a small way.”
(Nurse, midwife and MCH coordinator in Toro LGA)