Abstract
BackgroundRates of maternal and perinatal mortality remain high in developing countries despite the existence of effective interventions. Efforts to strengthen evidence-based approaches to improve health in these settings are partly hindered by restricted access to the best available evidence, limited training in evidence-based practice and concerns about the relevance of existing evidence. South East Asia - Optimising Reproductive and Child Health in Developing Countries (SEA-ORCHID) was a five-year project that aimed to determine whether a multifaceted intervention designed to strengthen the capacity for research synthesis, evidence-based care and knowledge implementation improved clinical practice and led to better health outcomes for mothers and babies. This paper describes the development and design of the SEA-ORCHID intervention plan using a logical framework approach.MethodsSEA-ORCHID used a before-and-after design to evaluate the impact of a multifaceted tailored intervention at nine sites across Thailand, Malaysia, Philippines and Indonesia, supported by three centres in Australia. We used a logical framework approach to systematically prepare and summarise the project plan in a clear and logical way. The development and design of the SEA-ORCHID project was based around the three components of a logical framework (problem analysis, project plan and evaluation strategy).ResultsThe SEA-ORCHID logical framework defined the project's goal and purpose (To improve the health of mothers and babies in South East Asia and To improve clinical practice in reproductive health in South East Asia), and outlined a series of project objectives and activities designed to achieve these. The logical framework also established outcome and process measures appropriate to each level of the project plan, and guided project work in each of the participating countries and hospitals.ConclusionsDevelopment of a logical framework in the SEA-ORCHID project enabled a reasoned, logical approach to the project design that ensured the project activities would achieve the desired outcomes and that the evaluation plan would assess both the process and outcome of the project. The logical framework was also valuable over the course of the project to facilitate communication, assess progress and build a shared understanding of the project activities, purpose and goal.
Highlights
Rates of maternal and perinatal mortality remain high in developing countries despite the existence of effective interventions
The burden of death and injury falls disproportionately on low and middle income countries, as is indicated by the lifetime risk of maternal death in South East Asia which is one in 130 compared to one in 7,300 in developed regions [2]. Much of this burden could be prevented if interventions which have been demonstrated by research to be effective and feasible were implemented at scale [3]
We describe the methods and results of the first stage
Summary
Rates of maternal and perinatal mortality remain high in developing countries despite the existence of effective interventions. The burden of death and injury falls disproportionately on low and middle income countries, as is indicated by the lifetime risk of maternal death in South East Asia which is one in 130 compared to one in 7,300 in developed regions [2]. Much of this burden could be prevented if interventions which have been demonstrated by research to be effective and feasible were implemented at scale [3]. This is a concern given that increasing the generation and use of research in health care are essential steps in improving health systems and achieving better health, in low-income settings [7,8,9]
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