Relationship between implementing interpersonal communication and mass education campaigns in emergency settings and use of reproductive healthcare services: evidence from Darfur, Sudan
Open accessAbstract
Objectives: (1) To examine changes in women's awareness and utilisation of reproductive healthcare services in emergency settings following provision of interpersonal communication (IPC) and mass education campaigns, and (2) to describe factors associated with reproductive healthcare service use in internally displaced person (IDP) camps. Setting: Three camps containing 88 984 IDPs in Darfur, Sudan. Participants: 640 women aged 15−49 who had experienced pregnancy in the camp during the previous 2 years were enrolled in each of two independent cross-sectional surveys 26 months apart. Interventions: IPC and mass education campaigns where community health workers disseminated information by home/shelter visits, clinic sessions, public meetings and other means to raise awareness and promote reproductive healthcare service use. Primary outcome measures: Awareness of the existence of antenatal care (ANC) and tetanus toxoid (TT) vaccination services, reception of ANC and TT vaccination, place of delivery and use of postnatal care (PNC). Results: The percentage of women who received home visits, and attended in-clinic sessions and public meetings increased from 61.6% to 86.7%, from 43.0% to 68.8%, and from 3.8% to 39.8%, respectively, between the initial and follow-up surveys. More women were aware of ANC (OR 18.6, 95% CI 13.1 to 26.5) and TT vaccination (OR 3.2, 95% CI 2.4 to 4.4) in the follow-up than the initial survey, after multivariable adjustment. More women received ≥3 ANC visits (OR 8.8, 95% CI 6.4 to 12.0) and ≥3 doses of TT (OR 2.5, 95% CI 1.9 to 3.3), delivered at a healthcare facility (OR 5.4, 95% CI 4.0 to 7.4) and received a PNC visit (OR 5.5, 95% CI 4.0 to 7.7) in the follow-up than in the initial survey, after multivariable adjustment. Conclusions: Awareness about and utilisation of reproductive healthcare services were higher in the follow-up survey. An integrated IPC and mass education campaign is effective for improving women's reproductive health in emergency settings.
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In low-income countries and fragile and conflict areas, pregnant women's formal education significantly predicted adequate ANC utilization.
“In low-income countries and fragile and conflict areas, pregnant women’s formal education [6, 11–15] and their partner’s education [13, 14, 16] significantly predicted adequate utilization of ANC.”
From Predictors of antenatal care utilization among the Rohingya population in the refugee camps of Cox's Bazar, Bangladesh (2025) · cites this paper as [15]
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“In low-income countries and fragile and conflict areas, pregnant women’s formal education [6, 11–15] and their partner’s education [13, 14, 16] significantly predicted adequate utilization of ANC.”
- Authors
- Adam, I. F., Nakamura, K., Kizuki, M., Al Rifai, R., & Vanching, U.
- Affiliations
- Tokyo Medical and Dental University (JP)
- Department of International Health and Medicine, Division of Public Health, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Corresponding author
- Nakamura, Keiko
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2015-09
- Volume
- 5
- Issue
- 9
- Pages
- e008285
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC4577869
- OpenAlex
- W2172277631
- Cited by
- 24
- References
- 0
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 3 · 2023: 1 · 2022: 4 · 2021: 1 · 2020: 4 · 2019: 2 · 2018: 3
- FWCI
- 1.00
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Japan Society for the Promotion of Science (26305022)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Health Professions › General Health Professions › Health and Conflict Studies
- Keywords
- interpersonal communication, internally displaced persons, emergency situations, prenatal care, tetanus vaccination, postpartum care, place of delivery, community health workers, home visits, women's health awareness, access to maternal health services, Darfur conflict
- MeSH terms
- Adult, Ambulatory Care Facilities, Communication, Community Health Services, Cross-Sectional Studies, Female, Health Services Accessibility, Humans, Health Knowledge, Attitudes, Practice, Patient Acceptance of Health Care, Pregnancy, Prenatal Care, Sudan, Reproductive Health Services
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