Abstract
BackgroundEthiopia is one of the ten countries in the world that together account for almost 60% of all maternal deaths. Recent reductions in maternal mortality have been seen, yet just 26% of women who gave birth in Ethiopia in 2016 reported doing so at a health facility. Maternity waiting homes (MWHs) have been introduced to overcome geographical and financial barriers to institutional births but there is no conclusive evidence as to their effectiveness. We aim to evaluate the effects of upgraded MWHs and local leader training in increasing institutional births in the Jimma zone of Ethiopia.MethodsA parallel, three-arm, stratified, cluster-randomized controlled trial design is being employed to evaluate intervention effects on institutional births, which is the primary outcome. Trial arms are: (1) upgraded MWH + religious/community leader training; (2) leader training alone; and (3) standard care. Twenty-four primary health care unit catchment areas (clusters) have been randomized and 3840 women of reproductive age who had a pregnancy outcome (livebirth, stillbirth or abortion) are being randomly recruited for each survey round. Outcome assessments will be made using repeat cross-sectional surveys at baseline and 24 months postintervention. An intention to treat approach will be used and the primary outcome analysed using generalized linear mixed models with a random effect for cluster and time. A cost-effectiveness analysis will also be conducted from a societal perspective.DiscussionThis is one of the first trials to evaluate the effectiveness of upgraded MWHs and will provide much needed evidence to policy makers about aspects of functionality and the community engagement required as they scale-up this programme in Ethiopia.Trial registrationClinicalTrial.gov, NCT03299491. Retrospectively registered on 3 October 2017.
Highlights
Ethiopia is one of the ten countries in the world that together account for almost 60% of all maternal deaths
These districts were selected from among the 18 districts located in the Jimma zone because: 1) they had the largest available populations; 2) Maternity waiting home (MWH) were present at health centres; and 3) they did not have any active maternal and child health interventions at the time
The supplies provided were selected based on a review of existing literature, a rapidneeds assessment conducted at baseline, and input from the Jimma Zone Health Office (JZHO)
Summary
Ethiopia is one of the ten countries in the world that together account for almost 60% of all maternal deaths. Recent reductions in maternal mortality have been seen, yet just 26% of women who gave birth in Ethiopia in 2016 reported doing so at a health facility. We aim to evaluate the effects of upgraded MWHs and local leader training in increasing institutional births in the Jimma zone of Ethiopia. The recently established Sustainable Development Goals reaffirm a global commitment to reducing maternal mortality [1]. Significant progress was made in reducing maternal mortality worldwide during the Millennium Development Goal period from 1990 to 2015; levels remain unacceptably high and large regional disparities exist. The majority of maternal deaths are preventable if women have timely access to good-quality maternal health-care services. In Ethiopia, only 26% of women who gave birth in 2016 reported doing so at a health facility [3]. Obstetric services are provided at the health centre and hospital level but are not available at community-based health posts
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
