{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T19:43:48Z","timestamp":1780429428284,"version":"3.54.1"},"reference-count":26,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T00:00:00Z","timestamp":1675036800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1017337"],"award-info":[{"award-number":["OPP1017337"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Delays to seek medical help can contribute to maternal deaths particularly in community settings at home or on the road to a health facility. Community engagement (CE) can improve care-seeking behaviours and complements community-based interventions strengthening maternal health. The purpose of this paper is to describe the process undertaken to develop and implement a large-scale community engagement strategy in rural southern Mozambique. The CE strategy was developed within the context of the \u201cCommunity-Level Interventions for Pre-eclampsia\u201d (NCT01911494) conducted between 2015\u20132017 in southern Mozambique. Key CE messages included pregnancy complications and their warning signs, including pre-eclampsia and eclampsia, as well as emergency readiness, birth preparedness, decision-making mechanisms, transport options and information about the trial. CE meeting logs were used to record quantitative and qualitative information on demographic data and feedback. Quantitative data was analyzed using RStudio (RStudio Inc, Boston, United States) and community feedback was qualitatively analyzed on NVivo12 (QSR International, Melbourne, Australia). CE activities reached 19,169 participants during 4,239 meetings. CE activities were reported to be well received by community members though there was a relatively lower participation of men (3565 \/18.6%). The use of recognized local leaders and personnel, such as community leaders, nurses and community health workers, allowed for greater acceptance of CE activities and maximized coverage of health messages in the community setting. Our CE strategy was effective in integrating maternal health promoting activities in routine care of community health workers and nurses in the area. Understanding district differences, engaging husbands, partners, mothers-in-law and community-level decision-makers to build local support for maternal health and flexibility to tailor messages to local needs were important in developing sustainable forms of CE. Better strategies are needed to effectively engage men in maternal health promotion who were less available due to working outside of the home or neighbourhoods<\/jats:p>","DOI":"10.1371\/journal.pgph.0001106","type":"journal-article","created":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T19:35:09Z","timestamp":1675107309000},"page":"e0001106","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":24,"title":["The development and implementation of a community engagement strategy to improve maternal health in southern Mozambique"],"prefix":"10.1371","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3874-2491","authenticated-orcid":true,"given":"Felizarda","family":"Amosse","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5846-3014","authenticated-orcid":true,"given":"Mai-Lei Woo","family":"Kinshella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Boene","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumedha","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zefanias","family":"Nhamirre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corssino","family":"Tchavana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1355-610X","authenticated-orcid":true,"given":"Laura A.","family":"Magee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"von Dadelszen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esperan\u00e7a","family":"Sevene","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Vidler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3888-5126","authenticated-orcid":true,"given":"Khatia","family":"Munguambe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the CLIP Mozambique Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,1,30]]},"reference":[{"issue":"1","key":"pgph.0001106.ref001","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-014-0401-3","article-title":"Maternal near miss and maternal deaths in Mozambique: A cross-sectional, region-wide study of 635 consecutive cases assisted in health facilities of Maputo province.","volume":"14","author":"E David","year":"2014","journal-title":"BMC Pregnancy and Childbirth"},{"issue":"1","key":"pgph.0001106.ref002","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s12978-020-0905-4","article-title":"Prevalence of institutional delivery and its correlates amongst women of reproductive age in Mozambique: a cross-sectional analysis","volume":"17","author":"S Yaya","year":"2020","journal-title":"Reproductive Health"},{"key":"pgph.0001106.ref003","article-title":"Inqu\u00e9rito Demogr\u00e1fico e de Sa\u00fade 2011","author":"MISAU INE","year":"2013","journal-title":"Maputo"},{"issue":"1","key":"pgph.0001106.ref004","article-title":"Seasonal variation in geographical access to maternal health services in regions of southern Mozambique","volume":"16","author":"PTPT Makanga","year":"2017","journal-title":"International Journal of Health Geographics"},{"issue":"8","key":"pgph.0001106.ref005","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1016\/0277-9536(94)90226-7","article-title":"Too far to walk: maternal mortality in context.","volume":"38","author":"S Thaddeus","year":"1994","journal-title":"Social science & medicine (1982)."},{"issue":"1","key":"pgph.0001106.ref006","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/s12978-016-0135-y","article-title":"Community perceptions of pre-eclampsia and eclampsia in southern Mozambique","volume":"13","author":"H Boene","year":"2016","journal-title":"Reproductive Health"},{"key":"pgph.0001106.ref007","volume-title":"Situa\u00e7\u00e3o mundial da inf\u00e2ncia 2009: Sa\u00fade Materna e Neonata. 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