Magnesium sulphate for fetal neuroprotection: benefits and challenges of a systematic knowledge translation project in Canada

Administration of magnesium sulphate (MgSO4) to women with imminent preterm birth a

Impact of Community-Based Maternal Health Workers on Coverage of Essential Maternal Health Interventions among Internally Displaced Communities in Eastern Burma: The MOM Project

Mullany and colleagues report outcomes from a project involving delivery of community-based maternal health services in eastern Burma, and report substantial increases in coverage of care

Community-based delivery of maternal care in conflict-affected areas of eastern Burma: Perspectives from lay maternal health workers

In settings where active conflict, resource scarcity, and logistical constraints prevail, provision of maternal health services within health centers and hospitals is unfeasible and alternative community-based strategies are needed. In eastern Burma, such conditions necessitated implementation of the "Mobile Obstetric Maternal Health Worker" (MOM) project, which has employed a community-based approach to increase access to essential maternal health services including emergency obstetric care. Lay Maternal Health Workers (MHWs) are central to the MOM service delivery model and, because they are accessible to both the communities inside Burma and to outside project managers, they serve as key informants for the project. Their insights can facilitate program and policy efforts to overcome critical delays and insufficient management of maternal complications linked to maternal mortality. Focus group discussions (n = 9), in-depth interviews (n = 18), and detailed case studies (n = 14) were collected from MHWs during centralized project management meetings in February and October of 2007. Five case studies are presented to characterize and interpret the realities of reproductive health work in a conflict-affected setting. Findings highlight the process of building supportive networks and staff ownership of the MOM project, accessing and gaining community trust and participation to achieve timely delivery of care, and overcoming challenges to manage and appropriately deliver essential health services. They suggest that some emergency obstetric care services that are conventionally delivered only within healthcare settings might be feasible in community or home-based settings when alternatives are not available. This paper provides an opportunity to hear directly from community-based workers in a conflict setting, perspectives seldom documented in the scientific literature. A rights-based approach to service delivery and its suitability in settings where human rights violations are widespread is highlighted.Burma Reproductive health Emergency obstetrical care Community health Internally displaced populations Health workers Conflict setting Childbirth

Comparison in demographic and socioeconomic characteristics between baseline (2006) and endline (2008) survey participants.

a<p>Continuous indicators are shown as mean (standard deviation), while binary variables are given in terms of percentage.</p>b<p>The proportion Karen is a function of the sampling strategy and the response rate. In the 2008 endline survey, an entire Karen site was not accessed because of escalating conflict.</p

Survey sampling frame, coverage and response rate, and household size.

a<p>Represents participation rate among those approached.</p><p>N/A, not available.</p

Changes in coverage of antenatal and postnatal interventions.

a<p>Statistically significant comparisons are shown in bold.</p