The effect of community health worker-led education on women's health and treatment-seeking: A cluster randomised trial and nested process evaluation in Gujarat, India.

摘要: Background A community-based health insurance scheme operated by the Self-Employed Women's Association in Gujarat, India reported that leading reasons for inpatient hospitalisation claims its members were diarrhoea, fever and hysterectomy - latter at average age of 37. This pattern raised concern regarding potentially unnecessary amongst low-income women. Methods cluster randomised trial mixed methods process evaluation designed to evaluate whether how a community worker-led education intervention insured uninsured adult women could reduce claims, as well morbidity, related hysterectomy. The 18-month consisted workers providing preventive care information group setting 14 randomly selected clusters, while continued with regular activities comparison clusters. Claims data collected from an administrative database, four household surveys conducted cohort 1934 Results 30% 18% attending sessions. There was no evidence effect on primary outcome, (risk ratio (RR) = 1.03; 95% confidence interval (CI) 0.81, 1.30) or secondary outcomes women, (RR 1.05; CI 0.58, 1.90) morbidity 1.09; 0.87, 1.38) three conditions. suggested participants retained knowledge sessions, but barriers behaviour change not overcome. Conclusions We detected this decrease Strategies capitalise workers' role knowledge, those address social determinants frequency such water sanitation infrastructure access gynaecological emerged areas strengthen future interventions.