PMID- 15970243
OWN - NLM
STAT- MEDLINE
DCOM- 20051028
LR  - 20061115
IS  - 0277-9536 (Print)
IS  - 0277-9536 (Linking)
VI  - 61
IP  - 6
DP  - 2005 Sep
TI  - Understanding the relationship of maternal health behavior change and 
      intervention strategies in a Nicaraguan NGO network.
PG  - 1356-68
AB  - Few studies of community interventions examine independent effects of investments 
      in: (1) capital (i.e., physical, human and social capital), and (2) management 
      systems (e.g., monitoring and evaluation systems (M&E)) on maternal and child 
      health behavior change. This paper does this in the context of an 
      inter-organizational network. In Nicaragua, international non-governmental 
      organizations (NGOs) and local NGOs formed the NicaSalud Federation. Using Lot 
      Quality Assurance Sampling (LQAS), 14 member organizations took baselines 
      measures of maternal safe motherhood and child health behavior indicators during 
      November 1999 and August 2000, respectively, and final evaluation measures in 
      December 2001. In April 2002, retrospective interviews were conducted with 
      supervisors and managers in the 14 organizations to explore changes made to 
      community health strategies, factors associated with the changes, and impacts 
      they attributed to participating in NicaSalud. Physical capital (density of 
      health huts), human capital (density and variety of paramedical personnel) and 
      social capital (density of health committees) were associated with pregnant women 
      attending antenatal care (ANC) 3+ times, and/or retaining ANC cards. The variety 
      of paramedic personnel was also associated with women making post-partum visits 
      to clinics. Physical capital (density of health huts) and social capital (density 
      of health committees and mothers' clubs) were associated with child diarrhea case 
      management indicators. One safe motherhood indicator (delivery of babies by a 
      clinician) was not associated with intervention strategies. At the management 
      level, NicaSalud's training of members to use LQAS for M&E was associated with 
      the number of strategic and tactical changes they subsequently made to 
      interventions (organizational learning). Organizational learning was related to 
      changes in maternal and child health behaviors of the women (including changes in 
      the proportion using post-partum care). As the latter result would not have 
      occurred without NicaSalud, we conclude that this inter-organizational network 
      provided added value by instigating organizational learning.
FAU - Valadez, Joseph J
AU  - Valadez JJ
AD  - Global HIV/AIDS Monitoring and Evaluation Support Team, Global HIV/AIDS Program, 
      The World Bank, Mail Stop G8-802, 1818 H Street NW, Washington, DC, USA. 
      jvaladez@worldbank.org
FAU - Hage, Jerald
AU  - Hage J
FAU - Vargas, William
AU  - Vargas W
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20050426
PL  - England
TA  - Soc Sci Med
JT  - Social science & medicine (1982)
JID - 8303205
SB  - IM
MH  - Female
MH  - *Health Behavior
MH  - Health Promotion/*methods
MH  - Humans
MH  - Maternal Welfare/*psychology
MH  - Nicaragua
MH  - Organizations/*organization & administration
MH  - Quality Assurance, Health Care/*methods
MH  - Sampling Studies
EDAT- 2005/06/23 09:00
MHDA- 2005/10/29 09:00
CRDT- 2005/06/23 09:00
PHST- 2004/04/05 00:00 [received]
PHST- 2005/02/22 00:00 [accepted]
PHST- 2005/06/23 09:00 [pubmed]
PHST- 2005/10/29 09:00 [medline]
PHST- 2005/06/23 09:00 [entrez]
AID - S0277-9536(05)00076-6 [pii]
AID - 10.1016/j.socscimed.2005.02.002 [doi]
PST - ppublish
SO  - Soc Sci Med. 2005 Sep;61(6):1356-68. doi: 10.1016/j.socscimed.2005.02.002. Epub 
      2005 Apr 26.