IDEAS home Printed from
   My bibliography  Save this article

Understanding the relationship of maternal health behavior change and intervention strategies in a Nicaraguan NGO network


  • Valadez, Joseph J.
  • Hage, Jerald
  • Vargas, William


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.

Suggested Citation

  • Valadez, Joseph J. & Hage, Jerald & Vargas, William, 2005. "Understanding the relationship of maternal health behavior change and intervention strategies in a Nicaraguan NGO network," Social Science & Medicine, Elsevier, vol. 61(6), pages 1356-1368, September.
  • Handle: RePEc:eee:socmed:v:61:y:2005:i:6:p:1356-1368

    Download full text from publisher

    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    1. Pillai, Rajamohanan K & Williams, Sankey V. & Glick, Henry A. & Polsky, Daniel & Berlin, Jesse A. & Lowe, Robert A., 2003. "Factors affecting decisions to seek treatment for sick children in Kerala, India," Social Science & Medicine, Elsevier, vol. 57(5), pages 783-790, September.
    2. Tinker, A. & Koblinsky, M.A., 1993. "Making Motherhood Safe," World Bank - Discussion Papers 202, World Bank.
    3. Goldman, Noreen & Pebley, Anne R. & Gragnolati, Michele, 2002. "Choices about treatment for ARI and diarrhea in rural Guatemala," Social Science & Medicine, Elsevier, vol. 55(10), pages 1693-1712, November.
    4. Chapman, Rachel R., 2003. "Endangering safe motherhood in Mozambique: prenatal care as pregnancy risk," Social Science & Medicine, Elsevier, vol. 57(2), pages 355-374, July.
    Full references (including those not matched with items on IDEAS)


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Robertson, Susan E. & Valadez, Joseph J., 2006. "Global review of health care surveys using lot quality assurance sampling (LQAS), 1984-2004," Social Science & Medicine, Elsevier, vol. 63(6), pages 1648-1660, September.


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:61:y:2005:i:6:p:1356-1368. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.