Online Program

Evidence based scaling-up an innovative community-based maternal and newborn health strategy in Ethiopia

Monday, November 4, 2013 : 5:00 p.m. - 5:15 p.m.

Wuleta Betemariam, MA, MPH, The Last Ten Kilometers Project, JSI Research & Training Institute, Inc., Addis Ababa, Ethiopia
Ali Mehryar Karim, PhD, Last 10 Kilometers Project, JSI Research & Training Institute, Inc., Addis Ababa, Ethiopia
Nebiyu Getachew, MA, The Last Ten Kilometers Project, JSI Research & Training Institute, Inc., Addis Ababa, Ethiopia
The health extension program (HEP) is Ethiopia's major vehicle to reach its health related MDGs. Since 2008 the Last Ten Kilometers (L10K) project has been implementing and testing innovative community-based strategies in 115 districts covering a population of about 14 million people, to enhance the capacity of the front-line health workers (FHWs) of the HEP to improve maternal and newborn health (M&NH) care behavior. As an innovative strategy the community-based data for decision-making (CBDDM) is being implemented in 14 L10K districts covering a population of about 1.6 million to enhance its primary objective. CBDDM fosters partnership between the grassroots public administration, HEP FHWs, community institutes, and community members to implement a community-based surveillance system to track pregnant mothers and ensure utilization of the M&NH services provided by HEP.

Difference-in-difference analysis using multilevel mixed-effects regressions of data from baseline (December 2008) and midterm (December 2010) surveys indicated that increase in M&NH coverage was statistical significantly higher in the CBDDM areas compared to other L10K areas where CBBDM was not implemented. Face value analysis of data obtained from 4,217 supportive supervisory visits during the period January to December 2012 indicated that increase in skilled delivery and early postnatal care has continued to be higher in the CBDDM areas. Latter findings support the decision to spread CBDDM to all the 115 L10K districts which was based on the earlier findings. Data from L10K supportive supervision will inform the effectiveness of the scaling-up strategy. CBDDM can be potentially adapted by community-based programs elsewhere.

Learning Areas:

Biostatistics, economics
Conduct evaluation related to programs, research, and other areas of practice
Provision of health care to the public
Public health or related research

Learning Objectives:
Demonstrates how an innovative community-based strategy improved maternal and newborn health care practices in Ethiopia and how the strategy was scaled-up based on evidence.

Keyword(s): Community Programs, Practice-Based Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I do not have any conflict of interest
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.