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Citation_information

Type Journal Article - BMJ Open
Title Marriage-based pilot clean household fuel intervention in India for improved pregnancy outcomes
Author(s)
Volume 10
Issue 10
Publication (Day/Month/Year) 2020
Page numbers e044127
URL https://bmjopen.bmj.com/content/10/10/e044127
Abstract
Introduction Health interventions often target pregnant
women and their unborn children. Interventions in rural
India targeting pregnant women, however, often do not
cover the critical early windows of susceptibility during the
first trimester and parts of the second trimester. This pilot
seeks to determine if targeting newlyweds could protect
entire pregnancies with a clean stove and fuel intervention.
Methods We recruited 50 newlywed couples who use
biomass as a cooking fuel into a clean cooking intervention
that included a liquefied petroleum gas (LPG) stove, two
gas cylinders, a table to place the stove on and health
education. We first evaluated whether community health
workers in this region could identify and recruit couples
at marriage. We quantified how many additional days
of pregnancy could be covered by an intervention if we
recruited at marriage versus recruiting after detection of
pregnancy.
Results On average, we identified and visited newlywed
couples within 40 (SD 21) days of marriage. Of the 50
couples recruited, 25 pregnancies and 18 deliveries
were identified during this 1-year study. Due to
challenges securing fuel from the LPG supply system,
not all couples received their intervention prior to
pregnancy. Regardless, couples recruited in the marriage
arm had substantially more days with the intervention
than couples recruited into a similar arm recruited at
pregnancy (211 SD 46 vs 120 SD 45). At scale, a stove
intervention targeting new marriages would cover
about twice as many weeks of first pregnancies as an
intervention recruiting after detection of pregnancy.
Conclusions We were able to recruit in early marriage
using existing community health workers. Households
recruited early in marriage had more days with clean
fuel coverage than those recruited at pregnancy. Our
findings indicate that recruitment at marriage is feasible
and warrants further exploration for stove and other
interventions targeting pregnancy-related outcomes.
Ajay Pillarisetti, Sudipto Roy , Nadia Diamond-Smith , Makarand Ghorpade , Arun Dhongade , Kalpana Balakrishnan , Sankar Sambandam , Rutuja Patil , David I Levine , Sanjay Juvekar , and Kirk R Smith. "Marriage-based pilot clean household fuel intervention in India for improved pregnancy outcomes." BMJ Open 10, no. 10 (2020): e044127.
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