Improving maternal and newborn health care delivery in rural Amhara and Oromiya regions of Ethiopia through the maternal and newborn health in Ethiopia partnership

The study aimed to address the challenges faced by rural communities in Ethiopia in accessing skilled maternal and newborn health care services. The rural residence and limited access to providers and health services contribute to poor maternal and newborn survival rates. The Maternal Health in Ethiopia Partnership (MaNHEP) developed a community-based model to improve maternal and newborn health care delivery in these regions.
1. Three-pronged intervention: MaNHEP implemented a comprehensive intervention strategy that included community- and facility-based maternal and newborn health training, continuous quality improvement, and behavior change communications.
2. Significant improvements in care provision: The study found significant improvements in the capacity and confidence of health extension workers, community health development agents, and traditional birth attendants to provide maternal and newborn health care. This led to a sense of being part of a maternal and newborn health care team.
3. Increased awareness and trust: Women showed increased awareness and trust in the ability of the health care team members to provide maternal and newborn health care. They also reported receiving more complete care and increased utilization of skilled providers and health extension workers for antenatal and postnatal care.
4. Successful local solutions: The project communities adopted successful local solutions for pregnancy identification, antenatal care registration, labor-birth notification, and postnatal follow-up.
5. Improved perinatal outcomes: The study showed improved perinatal outcomes, as indicated by the increased number of days between perinatal deaths over the duration of the project.
1. Scale-up of the model: The MaNHEP model has shown adaptability and potential scalability. It is recommended to integrate this model into the Ethiopian Ministry of Health’s Primary Health Care Unit and Health Extension Program structures.
2. Strengthening of health care workforce: To ensure the successful implementation of the model, it is recommended to invest in training and capacity building of health extension workers, community health development agents, and traditional birth attendants.
3. Continued quality improvement: The continuous quality improvement approach should be sustained to maintain and further improve the quality of maternal and newborn health care services.
4. Behavior change communication: Ongoing behavior change communication efforts should be prioritized to ensure sustained awareness and utilization of skilled providers and health extension workers for antenatal and postnatal care.
1. Ethiopian Ministry of Health: Responsible for integrating the MaNHEP model into the Primary Health Care Unit and Health Extension Program structures.
2. Health extension workers: Provide primary health care services, including maternal and newborn health care, at the community level.
3. Community health development agents: Support health extension workers in delivering health care services and implementing community-based interventions.
4. Traditional birth attendants: Play a role in providing maternal and newborn health care in rural communities.
5. Quality improvement teams: Responsible for monitoring and improving the quality of maternal and newborn health care services.
1. Training and capacity building: Budget for training programs and workshops to enhance the skills and knowledge of health extension workers, community health development agents, and traditional birth attendants.
2. Program integration: Allocate resources for integrating the MaNHEP model into the existing Primary Health Care Unit and Health Extension Program structures.
3. Continuous quality improvement: Set aside funds for monitoring and evaluation activities, quality improvement initiatives, and data collection.
4. Behavior change communication: Allocate a budget for developing and implementing behavior change communication strategies, including materials and campaigns.