Project to reduce maternal mortality in ethiopia

UNIVERSITÉ LIBRE DE BRUXELLES

SCHOOL OF PUBLIC HEALTH

MC in public health methodology programOperational research and planning

Accessing skilled delivery for Ethiopian rural women. A project proposed by:

Azmeraw Tayelgn AMARE (Bahir Dar University, Ethiopia)

Advisor:

Professor Patrick Martiny (Université libre De Bruxelles)

April, 201204/10/23 Community midwives for Ethiopia 1

Presentation outline

Needs-offer-demands frame

Unsatisfactory issue and intervention(Managerial

blocks)

Goal, objective and results

Indicators

Main activities

Gantt Chart

Team: persons involved04/10/23 Community midwives for Ethiopia 2

Needs-offer-demands frame

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•low access and poor quality skilled delivery

•Rural women had low demand and utilization of institutional delivery

Low demandThere is need

Low offer

Unsatisfactory issue:

low access to skilled delivery for rural Ethiopian women Only 4.1% of rural mothers were delivered at health care facility (EDHS, 2011)

In 2011 the maternal mortality rate in Ethiopia is 676 per 100,000 live births (EDHS, 2011).

The lack of functioning maternal health care facilities is severe in rural parts of the country.

Definition of the intervention• Introduction of a Community midwives with access

to ambulance for emergency referral4

1. Unsatisfactory issue and intervention

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Managerial blocks

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Next slidesNext slides

Managerial blocks1. Leadership & Governance• No maternal health policies• Little  coordination of maternal health care activities• Low political commitment to maternal health care

2. Resources

Infrastructure & Supplies• Poor infrastructure in the rural areas• Low access of the health care system• No electricity• Lack of roads or poor condition of roads• Lack of emergency transportation• Shortages of supplies, i.e. emergency medicines• Lack of equipment for obstetric care

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Managerial blocks con…

Human Resources

• Shortage of of healthcare personnel(midwives)

• Poorly trained health workers with punitive attitude

• Lack of community support

• Gender insensitivity of healthcare providers

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Managerial blocks con…Knowledge &Information• There are inadequate and inaccurate data to

evaluate maternal health care• There is no continuous maternal health care

monitoring system• Rural mothers do not access to communication.• Most of the rural women are illiterate

Finances • There are global maternal health care funds

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Managerial blocks con…

3. Organization and  delivery of  health care 

• The maternal health care facilities are poor in

quality and poorly utilized

• The first line health care unit is poorly structured

and less equipped to provide the appropriate care.

• Weak referral system which includes poor

transportation and poor communication

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Managerial blocks con…4. Population Interaction  with population • There is less demand of using the health care

system• Low participation of the community• Women are less informed about their health needs• Local, community and religious leaders are

influential to bring social change

5. Values & Principles• Women have the right to health care• Women have the right to autonomy and security • But the health care system poorly focus on the

participation of clients.04/10/23 Community midwives for Ethiopia 10

Managerial blocks con…

6. Context• There are international organizations working for

improving maternal health care• The international policies and goals gave priority

to maternal health care• Improving maternal health is one of the

millennium development goals• International political, environmental realities

support maternal health care• There is increased donor funding for maternal

health care

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Goal: Improving maternal health condition of

Ethiopia

Outcome: Reducing maternal mortality rate in the

country

Results: Increased proportion of rural mothers

whose delivery will be assisted by skilled birth

attendants

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2. Goal, objective and results

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Goal At the end of 2016, the maternal morbidity and

mortality in the Ethiopia will be reduced by half. Outcome At the end of 2016, the maternal mortality rate in the

country will be about 338 per 100,000 live births.Results At the end of 2016, more than 50% of deliveries will

be attended by community midwives At the end of 2016, more than 70% of rural mothers

delivery will be attended by skilled birth attendant At the end of 2016, about 5% of mothers will be

referred to hospitals for emergency intervention13

3. Indicators

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4. Main activitiesActivity 1:Training of community midwives

To communicate with universities and colleges Design teaching curriculum To select the trainee Training Assignment of trained midwives

Activity 2:To buy and make ambulances ready for emergency transport to district hospitals.

Activity 3: To equip the health posts with basic emergency obstetric care equipments

Activity 4:To organize mother-help task force in each kebele for supporting pregnant women in emergency situations.04/10/23 14Community midwives for Ethiopia

Mains activities con...Activity 5:To teach households/families to

recognize the importance of skilled birth deliveryActivity 6:To train and empower religious and

community leaders to work with community midwives

Activity 7:To organize informational campaigns to heighten community awareness of the benefits of seeking skilled care

Activity 8:To evaluate the program every year and at the end of the project

Activity 9:To provide continuous education, on job training and positive supervision/support for the midwives

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5. GANTT CHART

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YearActivities 2012 2013 2014 2015 2016

Activity 1

Activity 2

Activity 3

Activity 4

Activity 5

Activity 6

Activity 7

Activity 8

Activity 9

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National Safe motherhood team

• The team consists of head of MCH department from the

ministry of health, women representatives from ministry of

women, representatives from colleges and Universities,

experts from Ethiopian obstetrics and gynecology association

and from Ethiopian midwifery association.

Regional Safe motherhood team

• The team consists of head of MCH department from regional

health bureau, representatives from regional health science

colleges and consultant physicians from the regional

hospitals. 17

6. Team: persons involved

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Team: persons involved

Committee at the district level

• Head of the wereda health office, Head of the

district hospital, and head of the health center.

Committee at the kebele(Community) level

• Active and operational team which consists of

kebele leaders, community midwives, and

representatives from the community (community

leaders or religious leaders)

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Thank you!!!

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