{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T17:48:57Z","timestamp":1759513737048,"version":"3.41.2"},"reference-count":40,"publisher":"BMJ","issue":"6","funder":[{"DOI":"10.13039\/501100000659","name":"Research Trainees Coordinating Centre","doi-asserted-by":"publisher","award":["CL-2010-18-007"],"award-info":[{"award-number":["CL-2010-18-007"]}],"id":[{"id":"10.13039\/501100000659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["085417\/Z\/08\/Z"],"award-info":[{"award-number":["085417\/Z\/08\/Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Glob Health"],"accepted":{"date-parts":[[2018,10,28]]},"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Community-based women\u2019s groups practising participatory learning and action (PLA) can reduce maternal and neonatal mortality in low-income countries. However, it is not clear whether these reductions are associated with subsequent increased or decreased rates of childhood death and disability. We assessed the impact on child deaths and disability beyond the perinatal period among participants in the earliest trial in Nepal 2001\u20132003.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Household interviews were conducted with mothers or household heads. At cluster and individual levels, we analysed disability using pairwise log relative risks and survival using multilevel logistic models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Findings<\/jats:title>\n                  <jats:p>From 6075 children and 6117 mothers alive at 4 weeks post partum, 44\u2009419 children (73%) were available for interview a mean 11.5 years later. Rates of child deaths beyond the perinatal period were 36.6 and 52.0 per 1000 children in the intervention and control arms respectively. Rates of disability were 62.7 and 85.5 per 1000 children in the intervention and control arms respectively. Individual-level analysis, including random effects for cluster pairing and adjusted for baseline maternal literacy, socioeconomic status and maternal age, showed lower, statistically non-significant, odds of child deaths (OR 0.70 (95% CI 0.43 to 1.18) and disability (0.64 (0.39 to 1.06)) in the intervention arm.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Community-level exposure to women\u2019s groups practising PLA did not significantly impact childhood death or disability or death beyond the perinatal period. Follow-up of other trials with larger sample sizes is warranted in order to explore the possibility of potential long-term survival and disability benefits with greater precision.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjgh-2018-001024","type":"journal-article","created":{"date-parts":[[2018,12,1]],"date-time":"2018-12-01T13:45:12Z","timestamp":1543671912000},"page":"e001024","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Long-term impact of community-based participatory women\u2019s groups on child and maternal mortality and child disability: follow-up of a cluster randomised trial in rural Nepal"],"prefix":"10.1136","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1458-505X","authenticated-orcid":false,"given":"Michelle","family":"Heys","sequence":"first","affiliation":[{"name":"UCL Institute for Global Health, University College London, London, UK"},{"name":"Great Ormond Street Institute of Child Health, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu","family":"Gram","sequence":"additional","affiliation":[{"name":"UCL Institute for Global Health, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angie","family":"Wade","sequence":"additional","affiliation":[{"name":"Great Ormond Street Institute of Child Health, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2191-8166","authenticated-orcid":false,"given":"Edward James Norman","family":"Haworth","sequence":"additional","affiliation":[{"name":"Great Ormond Street Institute of Child Health, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Osrin","sequence":"additional","affiliation":[{"name":"UCL Institute for Global Health, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khadkha","family":"Sagar","sequence":"additional","affiliation":[{"name":"Mother and Infant Research Activities (MIRA), Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dej Krishna","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Mother and Infant Research Activities (MIRA), Kathmandu, Nepal"},{"name":"Health Systems Unit, WHO Country Office for Nepal, Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rishi Prasad","family":"Neupane","sequence":"additional","affiliation":[{"name":"Mother and Infant Research Activities (MIRA), Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhruba","family":"Adhikari","sequence":"additional","affiliation":[{"name":"Mother and Infant Research Activities (MIRA), Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramesh Kant","family":"Adhikari","sequence":"additional","affiliation":[{"name":"Mother and Infant Research Activities (MIRA), Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bharat","family":"Budhathoki","sequence":"additional","affiliation":[{"name":"Mother and Infant Research Activities (MIRA), Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dharma","family":"Manandhar","sequence":"additional","affiliation":[{"name":"Mother and Infant Research Activities (MIRA), Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Costello","sequence":"additional","affiliation":[{"name":"UCL Institute for Global Health, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,12,1]]},"reference":[{"key":"2025073014114514000_3.6.e001024.1","unstructured":"Wold Bank . 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