Investigating Associations between Parent Support Groups and Integrated Outreach Services for Maternal and Infant Survival: Experiences from a Project in Northern Uganda

Abstract

Background:  Globally various interventions have been undertaken to reduce maternal and child mortality rates. In low-income countries, outreach services are used systematically to deliver immunization and other health services to individuals with limited access to health facilities. In 2012, an Integrated Community Outreach Program (ICOP) was introduced by World Vision to provide women, children and their families with vital interventions like antenatal care, family planning services and on-spot treatment of illnesses with the aim of improving maternal, newborn and child health in Kitgum district, Uganda. To increase the appeal of these outreach services in targeted communities and facilitate compliance, parent support groups (PSGs) were also established as an intervention. Aim: The objective of this study was to investigate whether there is an association between parent support groups (PSGs) and integrated outreach services (IOS) for maternal and infant survival in Kitgum. Methods: We conducted a cross-sectional survey in 4 of 10 sub-counties in Kitgum where data was collected from 767 households using structured questionnaires. In addition, qualitative data was collected through in-depth interviews with key stakeholders. The association between each IOS outcome and PSGs was investigated using chi-square tests. For cross-tabulations with small counts, Fisher's exact test was used. Results: PSGs were found to be significantly associated with most of the integrated outreach services. A strong association was observed between being in a PSG household and seeking antenatal care at least four times (chi-square=14.18, p-value=0.0002) as more likely when compared to non-PSG households. Similarly, significant associations were observed between being in a PSG household and having immunized the child for measles (chi-square=6.66, p-value=0.0099) and between being in PSG household and weighing of children (chi-square =9.59, p-value=0.002). Conclusion: PSGs present a promising intervention for scaling up uptake of Integrated Outreach Services in remote settings which is integral to addressing the problem of maternal and infant survival.