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Implementation of a community-based intervention in the most rural and remote districts of Zambia: a process evaluation of safe motherhood action groups

Overview of attention for article published in Implementation Science, May 2018
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  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (79th percentile)

Mentioned by

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16 tweeters

Citations

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6 Dimensions

Readers on

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112 Mendeley
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Title
Implementation of a community-based intervention in the most rural and remote districts of Zambia: a process evaluation of safe motherhood action groups
Published in
Implementation Science, May 2018
DOI 10.1186/s13012-018-0766-1
Pubmed ID
Authors

Choolwe Jacobs, Charles Michelo, Mosa Moshabela

Abstract

A community-based intervention known as Safe Motherhood Action Groups (SMAGs) was implemented to increase coverage of maternal and neonatal health (MNH) services among the poorest and most remote populations in Zambia. While the outcome evaluation demonstrated statistically significant improvement in the MNH indicators, targets for key indicators were not achieved, and reasons for this shortfall were not known. This study was aimed at understanding why the targeted key indicators for MNH services were not achieved. A process evaluation, in accordance with the Medical Research Council (MRC) framework, was conducted in two selected rural districts of Zambia using qualitative approaches. Focus group discussions were conducted with SMAGs, volunteer community health workers, and mothers and in-depth interviews with healthcare providers. Content analysis was done. We found that SMAGs implemented much of the intervention as was intended, particularly in the area of women's education and referral to health facilities for skilled MNH services. The SMAGs went beyond their prescribed roles to assist women with household chores and personal problems and used their own resources to enhance the success of the intervention. Deficiencies in the intervention were reported and included poor ongoing support, inadequate supplies and lack of effective transportation such as bicycles needed for the SMAGs to facilitate their work. Factors external to the intervention, such as inadequacy of health services and skilled healthcare providers in facilities where SMAGs referred mothers and poor geographical access, may have led SMAGs to engage in the unintended role of conducting deliveries, thus compromising the outcome of the intervention. We found evidence suggesting that although SMAGs continue to play pivotal roles in contribution towards accelerated coverage of MNH services among hard-to-reach populations, they are unable to meet some of the critical sets of MNH service-targeted indicators. The complexities of the implementation mechanisms coupled with the presence of setting specific socio-cultural and geographical contextual factors could partially explain this failure. This suggests a need for innovating existing implementation strategies so as to help SMAGs and any other community health system champions to effectively respond to MNH needs of most-at-risk women and promote universal health coverage targeting hard-to-reach groups.

Twitter Demographics

The data shown below were collected from the profiles of 16 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 112 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 112 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 23 21%
Student > Ph. D. Student 16 14%
Researcher 13 12%
Student > Doctoral Student 9 8%
Student > Bachelor 9 8%
Other 14 13%
Unknown 28 25%
Readers by discipline Count As %
Nursing and Health Professions 25 22%
Social Sciences 17 15%
Medicine and Dentistry 16 14%
Unspecified 4 4%
Engineering 2 2%
Other 15 13%
Unknown 33 29%

Attention Score in Context

This research output has an Altmetric Attention Score of 10. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 January 2019.
All research outputs
#2,741,092
of 19,534,140 outputs
Outputs from Implementation Science
#667
of 1,640 outputs
Outputs of similar age
#61,617
of 295,232 outputs
Outputs of similar age from Implementation Science
#1
of 1 outputs
Altmetric has tracked 19,534,140 research outputs across all sources so far. Compared to these this one has done well and is in the 85th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,640 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.4. This one has gotten more attention than average, scoring higher than 59% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 295,232 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 79% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them