Background: Since 2008, Participatory Action for Rural Development Innovation (PARI) Development Trust, with the
support of Enfants du Monde, has been implementing a maternal and newborn health (MNH) program based on
the World Health Organization’s (WHO) framework for Working with Individuals, Families and Communities (IFC) to
improve MNH in Netrokona district, Bangladesh. This program aims to empower women and families and increase
utilization of quality health services, thereby helping women realize their rights related to maternal health. Birth
preparedness and complication readiness and working with traditional birth attendants (TBAs) to exercise a new
role in MNH and have formed key interventions of this program. The purpose of this study was to explore how the
program has contributed to changing social norms and practices surrounding MNH at midpoint.
Methods: This study relied primarily on qualitative data collection. Two focus group discussions (FGDs) were
conducted with women who were pregnant or had recently given birth and one FGD with each of the following
groups: husbands, family members, TBAs, and health workers. In-depth interviews were conducted with women
who were pregnant or had recently given birth, family members of these women, health care providers, TBAs and
community health workers in selected intervention areas.
Results: Since implementation of interventions informants report an increase in planning for birth and complications
and a shift in preference toward skilled care at birth. However, women still prefer to receive services at home. TBAs
report encouraging women to access skilled care for both routine and emergency services. While community
members’ understanding of rights related to maternal health remains limited, they report increased women’s
participation in household decision- making processes, an important indicator of the realization of rights.
Conclusion: Results suggest that community-level interventions aiming to affect change in social norms and practices
surrounding MNH can influence knowledge and practices even after a short period of time. Further evaluations will be
required to quantify the degree to which these changes are having an impact on health services utilization