Efficacy of Community Factors in the Implementation of Community-Based Interventions to Improve Antenatal Care: Lessons from IMCHA Programme, Tanzania

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Abstract Background: Efforts to improve antenatal care have been heightened to reduce global maternal deaths. In resource-limited settings, community-based interventions play a pivotal role in improving antenatal care services. However, effective implementation of community-based interventions is influenced by prevailing community-related factors. Drawing from the community-based interventions implemented in Iringa Region in Tanzania, this paper underscores how community factors influenced implementation and ultimate improvement of antenatal care services.Methods: A qualitative case study design involving interviews (n=86) and focus group discussions (n=6). Data was collected in Kilolo and Mufindi districts in Iringa Region and analysed thematically. Results: The community readiness to adopt the interventions and effective local administrative systems were the key factors that influenced the implementation of the community-based interventions. Stakeholders’ engagement and the local health system support were also pivotal for improving antenatal care services. However, physical environment, bullying of implementers of interventions and family-related challenges constrained the implementation of the interventions.Conclusion: The performance of community-based interventions was highly determined by the community-related factors. In-depth understanding and adequate management of community engagement are important during the planning, development and implementation of the interventions. Inadequate community engagement may lead to community members reluctance to adopt and implement community-based interventions.

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