{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T14:57:48Z","timestamp":1790521068533,"version":"4.1.0"},"reference-count":18,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Promotion Practice"],"abstract":"<jats:p>\n                    Improving household decision-making during the perinatal period is a vital strategy for reducing low birth weight. In Sri Lanka, the prevalence of low birth weight has remained close to 17% for nearly two decades, and evidence on community-based participatory approaches to improving collective decision-making among pregnant women remains scarce. This quasi-experimental study, conducted between January and October 2022, evaluated a community-based health promotion intervention to improve collective household decision-making among 403 pregnant mothers in the North Central Province of Sri Lanka (intervention group: Anuradhapura district; comparison group: Polonnaruwa district). Grounded in an established, community-centred health promotion process model, the intervention was delivered through 71 Neighbourhood Action Committees using six community-developed participatory tools addressing community-identified determinants of poor household decision-making. Collective decision-making during pregnancy was significantly higher in the intervention group than the comparison group for five of six indicators (all\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; .05), with the largest differences for \u201citems to buy for delivery\u201d (58% vs. 36%) and \u201cwhen to seek medical care\u201d (64% vs. 50%). Postpartum collective decision-making on newborn expenditure and food and clothing spending was also significantly higher in the intervention group; decision-making on social activities and investments did not differ significantly between groups. Qualitative framework analysis identified five themes, including transformed spousal roles, enhanced financial dialogue, and increased maternal agency. Community-based participatory approaches using locally developed monitoring tools can significantly improve household-level collective decision-making during the perinatal period, contributing to greater equity in maternal health. Integration into routine antenatal services in lower-middle-income countries is recommended.\n                  <\/jats:p>","DOI":"10.1177\/15248399261485465","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T09:50:18Z","timestamp":1790329818000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Community-Based Health Promotion Intervention to Improve Household Decision-Making During the Perinatal Period: A Quasi-Experimental Study in Sri Lanka"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9342-5424","authenticated-orcid":false,"given":"G. N. Duminda","family":"Guruge","sequence":"first","affiliation":[{"name":"Rajarata University of Sri Lanka, Mihintale, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. M. T. P.","family":"Herath","sequence":"additional","affiliation":[{"name":"Eastern University, Chenkalady, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. M.","family":"Young","sequence":"additional","affiliation":[{"name":"University of Colombo, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. N.","family":"Perera","sequence":"additional","affiliation":[{"name":"University of Kelaniya, Ragama, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. D.","family":"Dharmaratne","sequence":"additional","affiliation":[{"name":"University of Peradeniya, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. W.","family":"Gunathunga","sequence":"additional","affiliation":[{"name":"University of Colombo, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"crossref","unstructured":"Abeywickrama G. Padmadas S. S. Hinde A. (2020). Social inequalities in low birthweight outcomes in Sri Lanka: Evidence from the demographic and health survey 2016. BMJ Open 10(5) Article e037223. https:\/\/doi.org\/10.1136\/bmjopen-2020-037223","DOI":"10.1136\/bmjopen-2020-037223"},{"key":"e_1_3_3_3_1","doi-asserted-by":"crossref","unstructured":"Alkire S. Meinzen-Dick R. Peterman A. Quisumbing A. Seymour G. Vaz A. (2013). The Women\u2019s Empowerment in Agriculture Index. World Development 52 71\u201391. https:\/\/doi.org\/10.1016\/j.worlddev.2013.06.007","DOI":"10.1016\/j.worlddev.2013.06.007"},{"key":"e_1_3_3_4_1","doi-asserted-by":"crossref","unstructured":"Dickerson D. Baldwin J. 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