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Understanding the impact of neighborhood characteristics is crucial given its multigenerational impact. However, there is low availability of validated instruments measuring neighborhood dimensions, particularly in pregnant women, and a lack of cross-country validation of neighborhood-related scales. In this study, we used data from the [masked] study to assess the conceptual and measurement equivalence of the community domains of neighborhood cohesion, intergenerational closure, and neighborhood and social disorder, testing for measurement invariance across eight low- and middle-income countries (LMICs). Following this, we examined patterns of associations with prenatal maternal stress, well-being, and depressive symptoms through the use of nomological networks. We found that the conceptual and measurement equivalence of the neighborhood domains were good across the eight LMICs, although some adjustments had to be made to improve the model fit in two of the sites. Moreover, our results suggest that, in general, higher levels of neighborhood and social disorder, and lower levels of cohesion and intergenerational closure in the community were similarly associated with adverse maternal outcomes across the included sites. The results of this study emphasize the importance of exploring the community context when assessing maternal well-being and supports the need to advocate for community-based interventions that promote safer physical and social environments within maternal programs.

Identification and reporting of vital events such as births and deaths remain a challenge within communities in low- and middle-income countries (LMICs). LMICs are recently experiencing high mobile phone penetration. This study, therefore, explored the feasibility of Community Key Informants (CKIs) using mobile phone technology to improve reporting of vital events at the community level. Sixty CKIs were purposively sampled from the Kintampo Health and Demographic Surveillance System (KHDSS) setting based on mobile phone ownership. CKIs were grouped into an intervention and a control group. The intervention arm was provided with mobile phone air time to report vital events that occurred in their communities. The control group used the routine system of reporting in the KHDSS. The number of vital events reported by CKIs increased at the end line compared to baseline: (pregnancy: 40.25% to 72.80%; birth: 56.52% to 69.80%; deaths: 33.33% to 68.60%). The time interval between event identification and reporting was much shorter for the intervention group at the end line compared to baseline: (Intervention: 95.06 days to 31.35 days, Control: 87.54 days to 80.57 days). This study demonstrated the feasibility of CKIs using a mobile phone in reporting vital events more timely and effectively.