Project to reduce maternal mortality in ethiopia


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Project to reduce maternal mortality in ethiopia

  1. 1. UNIVERSITÉ LIBRE DE BRUXELLES SCHOOL OF PUBLIC HEALTH MC in public health methodology program O p e r a t io n a l r e s e a r c h a n d p la n n in g 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)04/12/12 Community midwives for Ethiopia 1 April, 2012
  2. 2. Presentation outline3 Needs-offer-demands frame3 Unsatisfactory issue and intervention(Managerial blocks)3 Goal, objective and results3 Indicators3 Main activities3 Gantt Chart3 Team: persons involved 04/12/12 Community midwives for Ethiopia 2
  3. 3. Needs-offer-demands frame •Rural women had low demand and utilization of institutional delivery Low demand There is need Low offer •low access and poor quality skilled delivery04/12/12 Community midwives for Ethiopia 3
  4. 4. 1. Unsatisfactory issue and intervention 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 referral 04/12/12 Community midwives for Ethiopia 4
  5. 5. Managerial blocks Next slides04/12/12 Community midwives for Ethiopia 5
  6. 6. Managerial blocks1. Leadership & Governance• No maternal health policies• Little coordination of maternal health care activities• Low political commitment to maternal health care2. ResourcesInfrastructure & 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 04/12/12 Community midwives for Ethiopia 6
  7. 7. 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 04/12/12 Community midwives for Ethiopia 7
  8. 8. 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 illiterateFinances• There are global maternal health care funds 04/12/12 Community midwives for Ethiopia 8
  9. 9. 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 04/12/12 Community midwives for Ethiopia 9
  10. 10. 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 change5. 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. 04/12/12 Community midwives for Ethiopia 10
  11. 11. 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 care04/12/12 Community midwives for Ethiopia 11
  12. 12. 2. Goal, objective and results 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 04/12/12 Community midwives for Ethiopia 12
  13. 13.  Goal 3. Indicators 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 intervention 04/12/12 Community midwives for Ethiopia 13
  14. 14. 4. Main activities© Activity 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. midwives for Ethiopia 04/12/12 Community 14
  15. 15. Mains activities con...© Activity 5:To teach households/families to recognize the importance of skilled birth delivery© Activity 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 04/12/12 Community midwives for Ethiopia 15
  16. 16. 5. GANTT CHART YearActivities 2012 2013 2014 2015 2016Activity 1Activity 2Activity 3Activity 4Activity 5Activity 6Activity 7Activity 8Activity 9 04/12/12 Community midwives for Ethiopia 16
  17. 17. 6. Team: persons involvedNational 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 04/12/12 Community midwives for Ethiopia 17 hospitals.
  18. 18. Team: persons involvedCommittee 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) 04/12/12 Community midwives for Ethiopia 18
  19. 19. u ! !! y o n k h a T04/12/12 Community midwives for Ethiopia 19