TY - JOUR
T1 - Evaluating the moderating role of accredited social health activists on adverse birth outcomes in rural India
AU - Kiplagat, Sandra
AU - Khan, Anisa
AU - Sheehan, Diana M.
AU - Jaykrishna, Poornima
AU - Ravi, Kavitha
AU - Jo Trepka, Mary
AU - Bursac, Zoran
AU - Stephens, Dionne
AU - Krupp, Karl
AU - Madhivanan, Purnima
N1 - Funding Information:
The study was supported by the Positive Action for Children Fund [to PM] ; National Institutes of Health (NIAID grant R15AI28714-01; FIC/NHLBI/NINDS Award Number D43 TW010540 [to PM]); National Institute on Minority Health and Health Disparities of the National Institutes of Health Under Award Number NIMHD (U54MD012393 [to ZB and MJT]); the Global Health Equity Scholars Fellowship (NIH FIC/NHLBI/NINDS Award Number D43 TW010540 to [to KK]).
Funding Information:
We thank the women from the SCIL project who participated in the survey and provided their time. We acknowledge the Public Health Research Institute of India study team, physicians and nurses for assistance in the survey implementation, and data analysis and management. The study was supported by the Positive Action for Children Fund [to PM]; National Institutes of Health (NIAID grant R15AI28714-01; FIC/NHLBI/NINDS Award Number D43 TW010540 [to PM]); National Institute on Minority Health and Health Disparities of the National Institutes of Health Under Award Number NIMHD (U54MD012393 [to ZB and MJT]); the Global Health Equity Scholars Fellowship (NIH FIC/NHLBI/NINDS Award Number D43 TW010540 to [to KK]).
Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2022/12
Y1 - 2022/12
N2 - Background: The Indian government established the Accredited Social Health Activists (ASHA) program in 2006 to improve access and healthcare coverage in rural regions. The objective of this study was to examine the moderating role of ASHA home visits and ASHA-accompanied antenatal care visits (ANC) on the relationship between sociodemographic latent classes of pregnant women and preterm birth and low birth weight infants in rural Mysore District, India. Methods: Utilizing a prospective cohort study conducted between 2011 and 2014, secondary data analysis was performed among 1540 pregnant women in rural Mysore, India. Latent class analysis was performed to identify sociodemographic distinct patterns. Multivariable logistic regression was performed to examine the moderating effects of ASHA-accompanied ANC visits and ASHA home visits on preterm birth and low birth weight. Results: Among women who never/rarely had ASHA-accompanied ANC visits, women in Class 1 “low socioeconomic status (SES)/early marriage/multigravida/1 child or more” had higher odds of preterm birth (adjusted odds ratio [aOR]: 2.62, 95% confidence interval [CI]: 1.12–6.12 compared to Class 4 “high SES/later marriage/primigravida/no children.”. Women in Class 3 “high SES/later marriage/multigravida/1 child or more” had higher odds of preterm birth compared to class 4. Women in Class 2 “low SES/later marriage/primigravida/no children” had higher odds of low birth weight infant. Conclusion: The findings demonstrate that ASHA accompanying women to ANC moderates the risk of preterm births among women in high-risk SES groups. Targeted policies and interventions in improving and strengthening the ASHA program are needed to reduce inequalities in adverse birth outcomes in rural India.
AB - Background: The Indian government established the Accredited Social Health Activists (ASHA) program in 2006 to improve access and healthcare coverage in rural regions. The objective of this study was to examine the moderating role of ASHA home visits and ASHA-accompanied antenatal care visits (ANC) on the relationship between sociodemographic latent classes of pregnant women and preterm birth and low birth weight infants in rural Mysore District, India. Methods: Utilizing a prospective cohort study conducted between 2011 and 2014, secondary data analysis was performed among 1540 pregnant women in rural Mysore, India. Latent class analysis was performed to identify sociodemographic distinct patterns. Multivariable logistic regression was performed to examine the moderating effects of ASHA-accompanied ANC visits and ASHA home visits on preterm birth and low birth weight. Results: Among women who never/rarely had ASHA-accompanied ANC visits, women in Class 1 “low socioeconomic status (SES)/early marriage/multigravida/1 child or more” had higher odds of preterm birth (adjusted odds ratio [aOR]: 2.62, 95% confidence interval [CI]: 1.12–6.12 compared to Class 4 “high SES/later marriage/primigravida/no children.”. Women in Class 3 “high SES/later marriage/multigravida/1 child or more” had higher odds of preterm birth compared to class 4. Women in Class 2 “low SES/later marriage/primigravida/no children” had higher odds of low birth weight infant. Conclusion: The findings demonstrate that ASHA accompanying women to ANC moderates the risk of preterm births among women in high-risk SES groups. Targeted policies and interventions in improving and strengthening the ASHA program are needed to reduce inequalities in adverse birth outcomes in rural India.
KW - Accredited Social Health Activists
KW - India
KW - Latent Class Analysis
KW - Low Birth Weight
KW - Preterm Birth
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U2 - 10.1016/j.srhc.2022.100787
DO - 10.1016/j.srhc.2022.100787
M3 - Article
C2 - 36302276
AN - SCOPUS:85140306552
SN - 1877-5756
VL - 34
JO - Sexual and Reproductive Healthcare
JF - Sexual and Reproductive Healthcare
M1 - 100787
ER -