1. Improving maternal and newborn health in tribal communities in Jharkhand and Orissa, India An evaluation of the impact of participatory community groups on maternal and neonatal mortality using a cluster randomised controlled trial

2. A joint collaboration between … EKJUT ‘coming together for a cause’ UCL Centre for International Health and Development, Institute of Child Health, London Funded by: The Health Foundation for 3 years since September 15 th 2004

3. Background Millennium Development Goals 3. Promote gender equality and empower women 4. Reduce child mortality reduce U5MR by 2/3 1990-2015 5. Improve maternal health reduce MMR by 3/4 1990-2015

4. Intervention needs to be …  Effective  Affordable  Acceptable  Scalable  Sustainable

5. Objectives This project is a research and development initiative incorporating three objectives. Research Objective: To measure the impact of working through women’s groups on maternal and newborn health – a cluster randomised controlled trial. Development Objectives: To promote good governance and influence policy and practices in order to improve health service delivery at all levels. To strengthen links between the community and primary health care providers by improving health service delivery and increasing the use of these services for routine care.

6. Study Area This project is based in 3 contiguous Districts: West Singhbhum (Jharkhand) Saraikela-Kharswan (Jharkhand) Keonjhar (Orissa) Total population of clusters: 228,186

7. Cluster Selection 12 clusters selected in each district 36 clusters in total Clusters had to meet the following selection criteria: Total population approximately 5000-7000 High proportion of tribal / scheduled caste people High proportion of poor / disadvantaged people Preferably with existing micro-credit groups but not health related women’s groups in operation. Not contiguous to another cluster – all clusters surrounded by buffer zones Physically or functionally remote from health services

8. Random Allocation Within each district, clusters are randomly allocated as control or intervention clusters, with 12 intervention clusters and 12 control clusters in each district Control Cluster Intervention Cluster

9. Study Design All 36 clusters receive health service strengthening. In addition all 18 intervention clusters have women’s groups. 18 CONTROL CLUSTERS Women’s’ Groups 36 CLUSTERS Health Service Strengthening 18 INTERVENTION CLUSTERS Women’s Groups

10. Thank You