In Addis Ababa, Ethiopia, many women give birth at hospitals, while few seek maternal health care services at health centers, creating stresses on the health system to meet women’s needs.
In 2012, the Federal Ministry of Health took steps to strengthen the city’s health care system, not only to meet current needs, but also to prepare for future demand. The new guidelines split Addis Ababa into eight hospital-health center referral networks, each with one tertiary hospital and 7 to 10 nearby health centers, with the goal of ensuring optimal use of limited health care resources.
To better understand health system barriers and how the new referral networks could improve access to and quality of obstetric care in Ethiopia, the Maternal Health Task Force (MHTF) and Addis Continental Institute of Public Health (ACIPH) worked closely with the Federal Ministry of Health to conduct an implementation research study in one catchment area. The MHTF and ACIPH partnered with St. Paul’s Millennium Medical College and the Institute for Clinical Effectiveness and Health Policy in Buenos Aires, Argentina to design, implement, monitor and evaluate a package of interventions, including:
- Comprehensive, basic emergency obstetric and newborn care (BEmONC) training
- Post-training mentorship
- Emergency obstetric drills
- Exchanges between midwives at the hospital and catchment health centers
- Team-based supportive supervision at hospitals and health centers
St. Paul’s Millennium Medical College tested the package of interventions within its network with technical assistance from ACIPH and the MHTF. The project was rigorously evaluated using baseline and endline surveys, case studies and other qualitative methods. A complementary study used qualitative methods to understand mothers’ perceptions of the quality of obstetric care in Addis Ababa and the factors that influence their decisions to delivery at a facility or at home. The results of the study will be used to inform future health care policy in Addis Ababa.
Read the findings resulting from this research:
A qualitative study on factors that influence women’s choice of delivery in health facilities in Addis Ababa, Ethiopia
BMC Pregnancy and Childbirth | October 2016
Barriers to Providing Quality Emergency Obstetric Care in Addis Ababa, Ethiopia: Healthcare providers’ perspectives on training, referrals and supervision, a mixed methods study
BMC Pregnancy and Childbirth | March 2015
To learn more about the successes of this project, visit the MHTF blog: