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Is the Maternal and Child Health (MCH) handbook effective in improving health-related behavior? Evidence from Palestine

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Abstract

Objective: This study examines the effect of the Maternal and Child Health (MCH) handbook – a home-based health record – on women's knowledge and behavior in the Jericho and Ramallah Governorates of Palestine. Methods: This study uses a repeated, cross-sectional data set in which pre- and post-intervention situations are incorporated on two groups: those exposed and those not exposed to the MCH handbook. We employed a difference-in-difference regression analysis utilizing a pre-tested knowledge, attitude, and practice survey of women at 24 MCH ‘treatment’ centers (N=260, 270, pre-/post-) in comparison with the women at 6 MCH centers (N=70, 70, pre-/post-) where the MCH handbook was not released. A trained facilitator conducted a series of focus group discussions with 42 women who were the clients of MCH services and 25 health providers, both from the intervention area, to confirm the results obtained from the quantitative study. Findings: Knowledge related to MCH such as the importance of exclusive breastfeeding and how to cope with the risks of rupture of membranes during pregnancy increased among MCH handbook users, especially among less-educated women. The MCH handbook may be an effective tool for communication with health providers and husbands, for both highly educated and less-educated women during their first pregnancy. Our results suggest that although less-educated women rarely read the handbook themselves at home, they became familiar with health information and options related to MCH through personalized guidance that was provided by health providers at health facilities utilizing MCH handbook. Conclusion: The MCH handbook may be an effective tool to improve (i) communication between the client and the health provider and (ii) women's knowledge- and health-seeking behaviors related to maternal, newborn, and child health.

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Authors and Affiliations

  1. Japan International Cooperation Agency (JICA), Human Development Department, Japan International Cooperation Agency (JICA), Tokyo, Japan

    Akiko Hagiwara

  2. Faculty of Economics, Ryukoku University, 67 Tsukamoto-cho, Fukakusa, Fushimi-ku, Kyoto, 612-8577, Japan

    Mika Ueyama

  3. Ministry of Health, National Authority of Palestine, Primary Health Care and Public Health Directorate Ramallah,

    Asad Ramlawi

  4. Faculty of Economics, University of Tokyo and JICA Research Institute, Tokyo, Japan

    Yasuyuki Sawada

Authors
  1. Akiko Hagiwara
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  2. Mika Ueyama
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  3. Asad Ramlawi
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  4. Yasuyuki Sawada
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Additional information

An evaluation by Japan's assistance program revealed the great benefit of having a handbook or manual to help mothers (and fathers) learn good maternal and child health practices.

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Hagiwara, A., Ueyama, M., Ramlawi, A. et al. Is the Maternal and Child Health (MCH) handbook effective in improving health-related behavior? Evidence from Palestine. J Public Health Pol 34, 31–45 (2013). https://doi.org/10.1057/jphp.2012.56

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