Reproductive Health Working Group > Antenatal care in low ...

Development of a strategy for improved Antenatal Care in low income settings - experiences from Jimma town health facilities, Ethiopia

Project period: 2008-2011 

Project team:

• PhD student Sarah Fredsted Villadsen
• Professor Henrik Friis, Dept Human Nutrition, KU-LIFE, Denmark
• MD/PhD Vibeke Rasch, Institute of International Health, Immunology, and Microbiology, Denmark
• Assistant Professor Dereje Negussie, Dept of Gynaecology and Obstetrics, Jimma University, Ethiopia.

Partner institution: Jimma University, Ethiopia 

Project description:

Background: Pregnancy and child birth are major health challenges, and reduction in maternal mortality is one of the Millennium Development Goals. Despite being high on the political agenda, little progress have been made, and in developing countries complications during pregnancy and childbirth are leading causes of disability and death among women in reproductive age. In Ethiopia the maternal and infant mortality are among the highest in the world. Many studies have investigated barriers for not using antenatal care (ANC) and delivery services as well as poor health outcomes of mother and child, but little is known about what interventions implemented within the frames of public financed health facilities in low income countries, could have positive effect on mother and child health. Evaluation of interventions for improved maternal and infant health and survival in public financed health care systems are thus needed.

Aim: To develop a participatory strategy to improve utilization and quality of ANC services in a low income setting.

Methodology: This study will be conducted with an interdisciplinary approach combining quantitative and qualitative methods. A local situation analysis of the ANC and delivery service will be conducted by study of routine data, field observation and qualitative interviews. By participatory methods ideas for improved service will be sought among the health staff responsible for the maternal and neonatal health. Further, the needs, experiences and wishes regarding the health system of the mothers with newborns will be analysed through qualitative interviews. On behalf of these input an intervention will be designed and implemented. Indicators of the study outcomes will be measured before and after intervention in routine data from the health facilities combined with a community based survey. The data will be collected in several study sites to evaluate the change in outcomes in settings with and without intervention.

Project budget: DKK 2,5 mill as part of a larger research collaboration with Jimma University, Ethiopia.