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Another limitation is the lack of a comparison area.
In Bangladesh, a before after design was used with a comparison area.
Dallas was used as a comparison area because although it was not damaged by the hurricanes, experts had originally expected it to be hit by Hurricane Rita.
Since October 1977, half of the surveillance area has been exposed to Maternal and Child Health and Family Planning (MCH-FP/ICDDR,B service area) services while the other half is a comparison area (15, 13).
These studies assessed the impact of BCC channels on women's knowledge of services required during pregnancy, during delivery, after delivery and when caring for children, in a project area and a comparison area.
The analyses for this part of the project will centre on regression models, testing for a differential impact associated with living in an intervention area (relative to a comparison area).
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Lastly, even though a before/after analysis without a separate comparison area does not provide definitive scientific evidence, it is difficult to explain the often dramatic increases in maternal death reporting and investigation with MAPEDIR other than as a direct result of the MAPEDIR process.
In 2004 2009, we conducted an exposure study in two neighborhoods bordering an oil refinery in Richmond, California, and a rural neighborhood in Bolinas, California, that served as a regional comparison area (Brody et al. 2009).
However, an adjacent comparison area subsequently experienced a similar decrease in mortality, and the improvement in mortality rates in both areas was later largely ascribed to women's self-referral to accessible hospital emergency obstetric care[ 24].
Rural and remote areas had higher median values and a greater scatter of clinical peripherality indices among their practices than an urban comparison area.
By contrast, the Care Group program experiences do not have the benefit of systematic mortality documentation, and although they used pre-post designs with important service utilization and household practice endpoints in all the documented instances generally they did not use designs tracking pre-post changes in an equivalent comparison area.
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