Implementation strategies for adapting global tools, knowledge, and practices in local communities

The Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) project employed integrated approaches to provide women and newborns with a package of evidence-based maternal and newborn health (MNH) care practices whose timely and consistent provision during birth and the early postnatal period was understood to improve MNH outcomes. Increased delivery of this package was accomplished by participatory community maternal and newborn health training for frontline health workers, women and families as well as a core quality improvement (QI) strategy. The improvement strategy sought to provide the necessary skills and a structure for providers and women, families, and community members to co-develop ways to ensure that MNH care reached women and their newborns “in time, every time”. Community members, health center and woreda (district) health office staff who served as QI team members and coaches were surveyed on perceptions of district culture and leadership for improvement activities before and after the project, motivation for participation in improvement work, and self-assessed capacity for improvement work, using 5-point likert scales, with 5 indicating greater capacity. Average scores were 3.7 out of 5 and above, reflecting the respondents' agreement that they have gained the necessary level of capacity in the improvement skills. Additionally, significant increases from before and after the MaNHEP project were documented. Based on the result from this study it is clear that MaNHEP was successful in creating lead woredas that will be able to continue improvements in maternal and newborn health within their woredas.