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Effect of Facilitation of Local Stakeholder Groups on Equity in Neonatal Survival; Results from the NeoKIP Trial in Northern Vietnam

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  • Mats Målqvist
  • Dinh Phuong Thi Hoa
  • Lars-Åke Persson
  • Katarina Ekholm Selling

Abstract

Background: To operationalize the post-MDG agenda, there is a need to evaluate the effects of health interventions on equity. The aim of this study is to evaluate the effect on equity in neonatal survival of the NeoKIP trial (ISRCTN44599712), a population-based, cluster-randomized intervention trial with facilitated local stakeholder groups for improved neonatal survival in Quang Ninh province in northern Vietnam. Methods: Semi-structured interviews were conducted with all mothers experiencing neonatal mortality and a random sample of 6% of all mothers with a live birth in the study area during the study period (July 2008-June 2011). Multilevel regression analyses were performed, stratifying mothers according to household wealth, maternal education and mother’s ethnicity in order to assess impact on equity in neonatal survival. Findings: In the last year of study the risk of neonatal death was reduced by 69% among poor mothers in the intervention area as compared to poor mothers in the control area (OR 0.31, 95% CI 0.15–0.66). This pattern was not evident among mothers from non-poor households. Mothers with higher education had a 50% lower risk of neonatal mortality if living in the intervention area during the same time period (OR 0.50, 95% CI 0.28–0.90), whereas no significant effect was detected among mothers with low education. Interpretation: The NeoKIP intervention promoted equity in neonatal survival based on wealth but increased inequity based on maternal education.

Suggested Citation

  • Mats Målqvist & Dinh Phuong Thi Hoa & Lars-Åke Persson & Katarina Ekholm Selling, 2015. "Effect of Facilitation of Local Stakeholder Groups on Equity in Neonatal Survival; Results from the NeoKIP Trial in Northern Vietnam," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-10, December.
    • Handle: RePEc:plo:pone00:0145510
    DOI: 10.1371/journal.pone.0145510
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    References listed on IDEAS

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    3. Amartya Sen, 2002. "Why health equity?," Health Economics, John Wiley & Sons, Ltd., vol. 11(8), pages 659-666, December.
    4. Kang, Woojin & Imai, Katsushi S., 2012. "Pro-poor growth, poverty and inequality in rural Vietnam," Journal of Asian Economics, Elsevier, vol. 23(5), pages 527-539.
    5. Mats Målqvist & Beibei Yuan & Nadja Trygg & Katarina Selling & Sarah Thomsen, 2013. "Targeted Interventions for Improved Equity in Maternal and Child Health in Low- and Middle-Income Settings: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(6), pages 1-10, June.
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