Home-Based Life-Saving Skills in Matlab, Bangladesh: A Program/Process Evaluation

Maternal mortality and morbidity continues to be a major public health problem around the world. For women who deliver in low-resource settings, delays exist in seeking care, arriving at a referral site, and obtaining life-saving obstetric care from trained providers.

In 2007, Home-Based Life-Saving Skills (HBLSS) was implemented in the International Centre for Diarrheal Disease Research, Bangladesh (ICDDR,B) service area of Matlab, located in the District of Chandpur, Bangladesh. HBLSS is a community-based program developed by the American College of Nurse-Midwives (ACNM) Department of Global Outreach with the aim of reducing the number of maternal and newborn deaths in areas where homebirth is common. ICDDR,B has been collecting demographic and health surveillance data for the past four decades and has recently developed a comprehensive Maternal Newborn and Child program of which HBLSS was implemented one component.

In April, 2008, a program/process evaluation of the HBLSS program will be completed. The purpose of this research study is to evaluate the implementation and progress of HBLSS in Matlab, Bangladesh over the past year.

Research Questions:

1) From the perspective of HBLSS coordinators, master trainers, guides, and community participants, what is the value of the HBLSS program in the Matlab community and what can be done to improve it?

2) How many women and homebirth team members have received HBLSS education in the past year?

3) Does data suggest any change in health care utilization or pregnancy outcomes since the implementation of HBLSS?

Qualitative research methods will be utilized in this evaluation including focus group discussions and key informant interviews. Data will also be gathered on the dissemination of HBLSS education. In addition, early outcome data will be collected on pregnancy complications and utilization of hospital and community health centers for deliveries.

The presentaiton will include a discussion of research results, lessons learned, and recommendations for future implementation. The information gained from the evaluation will be used to improve the HBLSS program in Matlab and in future sites, with the aim of improving the health of women and babies around the world.