Effect of community based behavioural change communication intervention
BACKGROUND: A great burden of infant and under-five childhood mortality occurs during the neonatal period, usually within a few days of birth. Community based behavioural change communication (such as interpersonal, group and mass media channels, including participatory methods at community level) intervention trials have been shown to be effective in reducing this mortality. However, to guide policy makers and programme planners, there is a need to systematically appraise and synthesise this evidence.
OBJECTIVE: To systematically search, appraise and synthesise the best available evidence on the effect of community based behavioural change communication intervention to improve neonatal mortality in developing countries. Inclusion Criteria This review considered randomised controlled community trials on the effectiveness of community based behavioural change communication interventions aimed at decreasing neonatal mortality that were conducted in developing countries.
SEARCH STRATEGY: This review considered English language articles on studies published between December, 2006 to January, 2011 and indexed in PubMed, CINAHL, EMBASE, Mednar, popline, Proquest, or Hinari.
METHODOLOGICAL QUALITY: Studies that met the inclusion criteria were assessed for methodological quality using the Joanna Briggs Institute Meta Analysis of Statistical Assessment and Review Instrument by two independent reviewers. Data were analysed using a fixed effects model with RevMan5 software.
RESULTS: Community based behavioural change communication interventions were found to be associated with a significant reduction in neonatal mortality of 19% (average OR 0.81; 95%CI 0.75 to 0.88), early neonatal mortality by 20% (average 0.80; 95%CI 0.70 to 0.91), late neonatal mortality by 21% (average 0.79; 95%CI 0.63 to 0.99). In addition, the intervention also resulted in significant improvement of newborn care practice; breast feeding initiation, clean cord cutting and delay in bathing were improved by 185%, 110% and 196% respectively.
CONCLUSIONS: Community-based behavioural change communication interventions such as health education, information education and communication, behavioural change communication, social mobilisation, community mobilisation, community conversation, and home based counselling were found to be associated with a significant reduction in neonatal mortality, early neonatal mortality and post neonatal mortality. The findings of this systematic review call for integration of such interventions into conventional strategies in developing countries.