299. Geographic mediation of dose for PIERs On the Move (POM) in the Community Level Intervention for Preeclmpsia (CLIP) in Mozambique

Travel time and distance to health facilities are known barriers for accessing maternal health care, particularly in Mozambique. Community health workers (CHWs) are responsible for extending the reach of antenatal care to isolated communities. Less is known about the geographical barriers faced by C...

Full description

Saved in:
Bibliographic Details
Main Authors: Makanga, Prestige Tatenda, Dube, Yolisa, Sharma, Sumedha, Bone, Jeffrey, Saccor, Charfudin, Makacha, Liberty, Payne, Beth, Macuacu, Salesio, Vidler, Marianne, Vala, Anifa, Magee, Laura, Lee, Tang, Sevene, Esperanca, Dadelszen, Peter von
Format: Article
Language:English
Published: Elsevier 2022
Subjects:
Online Access:https://doi.org/10.1016/j.preghy.2018.08.121
http://hdl.handle.net/11408/5152
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1779905269107523584
author Makanga, Prestige Tatenda
Dube, Yolisa
Sharma, Sumedha
Bone, Jeffrey
Saccor, Charfudin
Makacha, Liberty
Payne, Beth
Macuacu, Salesio
Vidler, Marianne
Vala, Anifa
Magee, Laura
Lee, Tang
Sevene, Esperanca
Dadelszen, Peter von
author_facet Makanga, Prestige Tatenda
Dube, Yolisa
Sharma, Sumedha
Bone, Jeffrey
Saccor, Charfudin
Makacha, Liberty
Payne, Beth
Macuacu, Salesio
Vidler, Marianne
Vala, Anifa
Magee, Laura
Lee, Tang
Sevene, Esperanca
Dadelszen, Peter von
author_sort Makanga, Prestige Tatenda
collection DSpace
description Travel time and distance to health facilities are known barriers for accessing maternal health care, particularly in Mozambique. Community health workers (CHWs) are responsible for extending the reach of antenatal care to isolated communities. Less is known about the geographical barriers faced by CHWs that may hamper their access to these isolated communities. Objective This study aimed to evaluate the extent to which related to dose of CHW-led PIERS On the Move (POM) study visit, delivered as an intervention in the Community Level Intervention for Pre-eclampsia trial (NCT01911494) in six clusters in Maputo and Gaza provinces. Methods Access to care was measured by calculating the walking time from each community to the nearest PHC using ArcGIS software. Dose of the intervention was measured by the average number of POM visits during pregnancy. A spatial autocorrelation analysis using the Moran I statistic was used to identify regional clusters of communities with both high and low doses of POM visits and how this compared with access to PHCs. Results Regional clusters (Moran I p   0.001) of communities with poor access to PHCs had significantly lower doses of POM. The high dose areas had POM visits that were almost sevenfold higher than the POM visits in the low POM dose areas. The low dose areas required more that an additional hour of walking time to PHCs. Discussion Inequities in access to pregnancy related care persist, even when the reach of care through community health workers are implemented. Further strategies in addition to assigning community health workers are needed to counter the role of geography in mediating community interventions.
format Article
id ir-11408-5152
institution My University
language English
publishDate 2022
publisher Elsevier
record_format dspace
spelling ir-11408-51522022-08-19T07:02:27Z 299. Geographic mediation of dose for PIERs On the Move (POM) in the Community Level Intervention for Preeclmpsia (CLIP) in Mozambique Makanga, Prestige Tatenda Dube, Yolisa Sharma, Sumedha Bone, Jeffrey Saccor, Charfudin Makacha, Liberty Payne, Beth Macuacu, Salesio Vidler, Marianne Vala, Anifa Magee, Laura Lee, Tang Sevene, Esperanca Dadelszen, Peter von PIERs On the Move (POM) Community Level Intervention Preeclmpsia (CLIP) maternal health care Mozambique Travel time and distance to health facilities are known barriers for accessing maternal health care, particularly in Mozambique. Community health workers (CHWs) are responsible for extending the reach of antenatal care to isolated communities. Less is known about the geographical barriers faced by CHWs that may hamper their access to these isolated communities. Objective This study aimed to evaluate the extent to which related to dose of CHW-led PIERS On the Move (POM) study visit, delivered as an intervention in the Community Level Intervention for Pre-eclampsia trial (NCT01911494) in six clusters in Maputo and Gaza provinces. Methods Access to care was measured by calculating the walking time from each community to the nearest PHC using ArcGIS software. Dose of the intervention was measured by the average number of POM visits during pregnancy. A spatial autocorrelation analysis using the Moran I statistic was used to identify regional clusters of communities with both high and low doses of POM visits and how this compared with access to PHCs. Results Regional clusters (Moran I p   0.001) of communities with poor access to PHCs had significantly lower doses of POM. The high dose areas had POM visits that were almost sevenfold higher than the POM visits in the low POM dose areas. The low dose areas required more that an additional hour of walking time to PHCs. Discussion Inequities in access to pregnancy related care persist, even when the reach of care through community health workers are implemented. Further strategies in addition to assigning community health workers are needed to counter the role of geography in mediating community interventions. 2022-08-19T07:02:27Z 2022-08-19T07:02:27Z 2018-10 Article 2210-7789 https://doi.org/10.1016/j.preghy.2018.08.121 http://hdl.handle.net/11408/5152 en Pregnancy Hypertension;Vol. 13, Supplement 1, Page S41 open Elsevier
spellingShingle PIERs On the Move (POM)
Community Level Intervention
Preeclmpsia (CLIP)
maternal health care
Mozambique
Makanga, Prestige Tatenda
Dube, Yolisa
Sharma, Sumedha
Bone, Jeffrey
Saccor, Charfudin
Makacha, Liberty
Payne, Beth
Macuacu, Salesio
Vidler, Marianne
Vala, Anifa
Magee, Laura
Lee, Tang
Sevene, Esperanca
Dadelszen, Peter von
299. Geographic mediation of dose for PIERs On the Move (POM) in the Community Level Intervention for Preeclmpsia (CLIP) in Mozambique
title 299. Geographic mediation of dose for PIERs On the Move (POM) in the Community Level Intervention for Preeclmpsia (CLIP) in Mozambique
title_full 299. Geographic mediation of dose for PIERs On the Move (POM) in the Community Level Intervention for Preeclmpsia (CLIP) in Mozambique
title_fullStr 299. Geographic mediation of dose for PIERs On the Move (POM) in the Community Level Intervention for Preeclmpsia (CLIP) in Mozambique
title_full_unstemmed 299. Geographic mediation of dose for PIERs On the Move (POM) in the Community Level Intervention for Preeclmpsia (CLIP) in Mozambique
title_short 299. Geographic mediation of dose for PIERs On the Move (POM) in the Community Level Intervention for Preeclmpsia (CLIP) in Mozambique
title_sort 299. geographic mediation of dose for piers on the move (pom) in the community level intervention for preeclmpsia (clip) in mozambique
topic PIERs On the Move (POM)
Community Level Intervention
Preeclmpsia (CLIP)
maternal health care
Mozambique
url https://doi.org/10.1016/j.preghy.2018.08.121
http://hdl.handle.net/11408/5152
work_keys_str_mv AT makangaprestigetatenda 299geographicmediationofdoseforpiersonthemovepominthecommunitylevelinterventionforpreeclmpsiaclipinmozambique
AT dubeyolisa 299geographicmediationofdoseforpiersonthemovepominthecommunitylevelinterventionforpreeclmpsiaclipinmozambique
AT sharmasumedha 299geographicmediationofdoseforpiersonthemovepominthecommunitylevelinterventionforpreeclmpsiaclipinmozambique
AT bonejeffrey 299geographicmediationofdoseforpiersonthemovepominthecommunitylevelinterventionforpreeclmpsiaclipinmozambique
AT saccorcharfudin 299geographicmediationofdoseforpiersonthemovepominthecommunitylevelinterventionforpreeclmpsiaclipinmozambique
AT makachaliberty 299geographicmediationofdoseforpiersonthemovepominthecommunitylevelinterventionforpreeclmpsiaclipinmozambique
AT paynebeth 299geographicmediationofdoseforpiersonthemovepominthecommunitylevelinterventionforpreeclmpsiaclipinmozambique
AT macuacusalesio 299geographicmediationofdoseforpiersonthemovepominthecommunitylevelinterventionforpreeclmpsiaclipinmozambique
AT vidlermarianne 299geographicmediationofdoseforpiersonthemovepominthecommunitylevelinterventionforpreeclmpsiaclipinmozambique
AT valaanifa 299geographicmediationofdoseforpiersonthemovepominthecommunitylevelinterventionforpreeclmpsiaclipinmozambique
AT mageelaura 299geographicmediationofdoseforpiersonthemovepominthecommunitylevelinterventionforpreeclmpsiaclipinmozambique
AT leetang 299geographicmediationofdoseforpiersonthemovepominthecommunitylevelinterventionforpreeclmpsiaclipinmozambique
AT seveneesperanca 299geographicmediationofdoseforpiersonthemovepominthecommunitylevelinterventionforpreeclmpsiaclipinmozambique
AT dadelszenpetervon 299geographicmediationofdoseforpiersonthemovepominthecommunitylevelinterventionforpreeclmpsiaclipinmozambique