We move together
A realist evaluation of the Safe Motherhood Action Groups in Eastern Province, Zambia
Bibliographic Data
| ID | 21881110 |
|---|---|
| Authors | Sara Dada (0000-0003-3910-1856, University College Dublin), Aoife De Brún (0000-0003-0124-0893, University College Dublin), Nachela Chelwa (National HIV/AIDS/STI/TB Council), Natasha Okpara (National HIV/AIDS/STI/TB Council), Mirriam Zulu (University of Zambia), Bellington Vwalika (0000-0001-5548-8187, University of Zambia), Brynne Gilmore (0000-0003-4496-9254, University College Dublin) |
| Year | 2025 |
| Volume | 10 |
| Issue | 4 |
| Pages | e015961 |
| Publication date | 2025-04-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | BMJ Global Health (JOURNAL) |
| Journal identifiers | ISSN: 2059-7908 • E-ISSN: 2059-7908 |
| Publisher | BMJ (PUBLISHER • GB) |
| DOI | 10.1136/bmjgh-2024-015961 |
| PMID | 40262856 |
| OpenAlex | W4409661386 |
| Language | EN |
| Citations received | 3 |
| References cited | 37 |
INTRODUCTION: In Zambia, where less than half of pregnant women complete the continuum of care for maternal health, community engagement initiatives like the Safe Motherhood Action Groups (SMAGs) are used to mobilise communities and support maternal and newborn health (MNH) care-seeking. However, there is a lack of documented evidence on communication in community engagement and its implementation across diverse settings. This study examines how communication in community engagement influences MNH care-seeking in Zambia's Eastern Province. METHODS: This realist evaluation used two iterative multi-method case studies to evaluate the SMAG programmes at Chibolya Urban Health Clinic and Jerusalem Rural Health Clinic. Data were collected from facility metrics, in-depth interviews, realist photovoice discussions, focus-group discussions and observations. Participants, including SMAGs (n=10), local leaders (n=2), pregnant women (n=10), community members (n=20), healthcare providers (n=4) and Ministry of Health stakeholders (n=4) were purposively sampled. RESULTS: Seven programme theories, informed by 50 context-mechanism-outcome configurations, were refined and organised to explain how the SMAG programme in Zambia works when communities are actively involved, messaging is relevant and relatable, SMAGs are trusted, SMAGs are familiar, the programme and facility are well-coordinated, the community perceives benefits from the messaging and SMAGs are motivated. CONCLUSION: This realist evaluation offers research, practice and policy recommendations to enhance communication in community engagement for MNH, with potential applicability to other health domains. It emphasises trust and strong community-programme relationships as key drivers of effective and sustainable community engagement
Action research · Community engagement · Community health · Economic growth · Focus group · Geography · Health care · Photovoice · Political science · Public health · Public relations · Sociology · Global Health and Surgery · Global Maternal and Child Health · Health Policy Implementation Science · Medicine · Nursing · Psychology
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Theoretical and Practical Implications of Communication in Community Engagement for Maternal and Newborn Health
Reflections from Planning and Conducting Data Collection for a Realist Evaluation in Zambia
Community participation
An Integrative Model of Organizational Trust
What’s in a name? Unpacking ‘Community Blank ’ terminology in reproductive, maternal, newborn and child health
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Understanding communication in community engagement for maternal and newborn health programmes in low- and middle-income countries
Conducting focus groups in realist evaluation
Retroductive theorizing in Pawson and Tilley's applied scientific realism
The craft of interviewing in realist evaluation
Using Photographs to Capture Women's Experiences of Chemotherapy
The Process and Effects of Mass Communication
Successful Recruitment to Qualitative Research
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Data Analysis and Synthesis Within a Realist Evaluation
Using the realist interview approach to maintain theoretical awareness in realist studies
| Unique citing works | 3 |
|---|---|
| Citations per year | 3 |
| Citation span | 2025 - 2026 (2) |
| Citation velocity | current |
| Highly cited | No |
| Citation types | Neutral: 3 |