Table 3.

Summary of Themes Organized by Study

Authors & Year	Increased Knowledge/Awareness	Impact on Health Outcomes	Integral Components to CM Strategy
Babalola et al. (2006)	• Increased perceived self efficacy to not perform FGC • Decreased personal approval of FGC • Increased perceived social support for ending FGC • Increased personal advocacy for eliminating FGC	• Results used to inform policy abolishing FGC	• Implemented at hamlet, local government authority, and state level • Involved traditional leaders, local government officials, school groups, women’s groups, and pre-existing social forums • Use of mass media; regular newspaper columns, radio call in shows, public forums on FGC.
Babalola et al. (2001)	• CM showed a twofold increase in knowledge of FP methods. • CM increased dialogue about contraception, sexually transmitted infections (STIs) and HIV, child survival. • CM is an effective method of behavior change.	• Increases in use of clinic based health services, modern FP. • Higher impact seen in one of the districts in comparison to the other.	• Use of pre-existing Njangi groups/ meetings • Meetings with local stakeholders for project advocacy & sharing ownership
Boone et al. (2016)	• Caregivers in intervention group had improved knowledge and care seeking behavior.	• Intervention group had decreased maternal deaths • Under 5 mortality did not decrease. • House-holds in intervention group had decreased morbidity and higher under-standing of how to treat morbidities	• Local leaders involved in process • Standard country protocols used in training community health workers and traditional birth attendants • Villages selected the traditional birth attendants to be involved in project
Colbourn et al. (2013)	• Women’s groups implemented a variety of strategies to address maternal & child health, likely raising awareness in the community (although not measured).	• Increase in facility delivery after policy change. • CM + quality improvement reduced neonatal mortality. • CM alone reduced perinatal mortality. • No impact on maternal mortality.	• Village volunteers selected by research team and local chiefs. • CM with simultaneous facility quality improvement had the most impact.
Colbourn et al. (2015)	• Article assessed cost effectiveness only	• Community intervention more effective and less expensive than facility intervention. • Community intervention combined with facility intervention most cost effective.	• Article assessed cost effectiveness only.
Ejembi et al. (2014)	• 99.7% of women reported acceptability of misoprostol (would recommend to a friend/family member) • Community dialogues identified two methods by which community members could identify 500 ml of blood loss (rubber cup/moda or 2 yards of commonly used cotton fabric soaked)	• Project results informed health policy in Nigeria, then scaled up across the country.	• Community drug keepers identified by community members and leaders. • Traditional birth attendants (TBAs) can be trained/supervised and are a critical part of the team. • Intervention tailored to cultural norms of purdah, which results in high number of homebirths and need for emergency care in the community.
Ekirapa Kiracho et al. (2017)	• Primiparas, women of lower wealth quintiles, and with less formal education benefitted from having community healthworkers visit them at home to deliver health messages related to ANC and safe newborn practices. • Women with health worker visit more likely to attend ANC in first trimester. • Women with four ANC visits were 42% more likely to deliver at a facility. • Women who saved money for maternal health at least two times more likely to have facility delivery.	• Increase in ANC visits • Increase in safer newborn practices	• District and community level stakeholders identified the methods to be used and controlled implementation and adaptation of strategies as needed.
Gullo et al. (2017)	• Intervention builds capacity of community members and healthcare providers. • Increased satisfaction with reproductive health services. • 57% increase in use of modern contraceptives.	• Intervention increased community health worker prenatal home visits by 20%, and postnatal home visits increased by 6%. • Modern contraceptive use increased by 57%. • Women’s satisfaction with reproductive health services increased.	• Improved relationships between community health workers and the community. • Improved training/support for community health workers.
Guyon et al. (2009)	• CM intervention key in developing supporting policy environment & development of national guidelines.	• Increased and improved practices around breastfeeding.	• Multiple local partners used consistent, harmonized approach to ensure delivery of consistent messages.
Lori et al. (2013)	• Not assessed, however intervention inherently increased the awareness of what TBAs training/skills are to midwives and vice versa.	• Communities with a MWH had lower rates of maternal/ perinatal death. • Increase in team births in control and intervention sites.	• Integration of care by traditional birth attendants and midwives. • Sharing and partnering with government: MWH included in Liberia’s accelerated action plan to reduce neonatal and maternal mortality.
Mburu et al. (2012)	• Networks of people living with HIV can increase awareness/reach those who are unable to be reached by the healthcare system. • Encourages male participation.	• Not measured; though this approach is implied to decrease vertical transmission of HIV.	• Networks of peer support were effective. • Inclusion of income generating activities may strengthen sustainability.
Mseu et al. (2014)	• Increased awareness of need for ANC and breastfeeding, but lack of retention.	• Increase in ANC visits, education level correlated with total number of ANC visits	• Despite increased awareness, cultural myths impacted uptake/action. • Local context explored through qualitative data collection.
Muzyamba et al. (2017)	• Causal links exist for empirical evidence linking CM to better health outcomes for HIV negative women. This is lacking for HIV positive women.	• Reductions in maternal depression, reduced rates of hemorrhage, reduced neonatal and maternal mortality reported in CM studies.	• Biomedical model undermines local competencies.
Prata et al. (2012)	• CM delivered messages reached 80–90% of women, with a high retention of knowledge post intervention.	• Direct health outcomes not measured. • 83% of women interviewed postpartum identified that hemorrhage could be fatal. • 97–99% of postpartum women interviewed knew about the use of misoprostol to prevent deaths from hemorrhage.	• CM showed that TBA or person helping with the birth could provide education about safe use of misoprostol. • Women identified TBAs as the most important source of information regarding misoprostol 41% of the time. • Community members identified culturally appropriate ways to measure blood loss and spread intervention information.
Rosato et al. (2012)	• Not assessed directly, although CM enacted through women’s groups is designed to increase awareness/knowledge and build capacity around solving health problems.	• Not assessed in this manuscript, although CM intervention was directed at decreasing maternal & neonatal mortality.	• Women’s groups designed and implemented on average 8 different strategies.
Undie et al. (2014)	• Raised awareness of FP methods. • Raised awareness about early pregnancy bleeding.	• Increased proportion of women who reported early pregnancy bleeding.	• Supported by Kenya’s Ministry of Health and its Community Management Strategy • Supported by Naivasha District Health Management Team • Trained healthcare providers at existing clinics and dispensaries
Wagman et al. (2015)	• This was not directly measured, although the intervention was directed at changing attitudes, behaviors, and social norms related to IPV.	• Physical and sexual intimate partner violence as well as rape decreased in intervention group at second follow up. • Differences in emotional intimate partner violence were not significant. • Male reports of perpetrating intimate partner violence were not significantly affected by the intervention.	• Implemented intervention within a pre-existing community clusters for a previous family planning trial.
Wekesah et al. (2016)	• 3 studies indicated that CM increased the level of health information related to danger signs and risk factors in pregnancy, first ANC visits, health facility use, and deliveries.	• Non-drug interventions directly or indirectly improved quality of maternal health and morbidity/ mortality outcomes.	• Comprehensive interventions that work to strengthen across sectors of existing healthcare systems (at the community and health facility level) along with supportive policy environments can improve care and reduce mortality.
Zamawe et al. (2016)	• CM intervention raised awareness related to maternal & neonatal health and safe delivery, although this was not directly measured.	• Women’s groups improved uptake of contraceptives by 26% for both women who were in the groups as well as non-members in the community.	• Intervention supported by pre-existing MaiMwana project and Malawi Ministry of Health

Abbreviations: ANC = antenatal care; CHW = community health worker; CM = community mobilization; FP = family planning; HIV = Human Immunodeficiency Virus; IPV = intimate partner violence; MWH = maternity waiting home