Design and evaluation of a community participatory, birth preparedness project in Cambodia

Objective: to evaluate a pilot project, which used a community participatory approach to introduce birth preparedness in rural Cambodia. Design: a feasibility and out come evaluation. This included observation, interview, document analysis and costing. Setting: the project was undertaken in 15 villages linked to five health centres in Kampong Chhnang, Cambodia. Participants: key management personnel, local midwives, village leaders, village volunteers and village members who had participated in the programme. Findings: community engagement was not only feasible but was also a successful and cost-effective way to introduce birth preparedness. A high degree of satisfaction was reported by the health staff and the community. Over the year in which the project was undertaken, there was a 22% increase in antenatal care, a 32% increase in the number of women delivered by a midwife, and a 281% increase in referrals to hospital. Implications for practice: discussion about birth preparedness should occur not only with pregnant women but also with the communities that support them. Communities that are poor and isolated are responsive to the health needs of their women as they give birth, and articulate their needs when given the opportunity. Interacting with health staff in a way in which there is shared in formation can lead to greater utilisation of the health services that they provide. (C) 2008 Elsevier Ltd. All rights reserved.