13 December 2016

Ethiopia: Innovative Intervention Reducing Maternal Mortality

Health development army contributes to maternal mortality reduction.

Ethiopian maternal health researcher Hagos Godefay at Umeå University in Sweden has created a locally feasible method to estimate maternal mortality rates with a bottom-up measurement approach.

Providing insights into the effectiveness of local interventions to reduce maternal mortality, the approach would be important for health sector planning and decision-making.

The researcher with the Department of Public Health and Clinical Medicine, Epidemiology and Global Health Unit conducted a research on efforts to reduce maternal mortality in Tigray State. He has set out to quantify overall mortality levels, identify specific causes and evaluate local interventions.

By using methods that can also be scaled at national level, Hagos results provide a strong empirical basis for decision-making by State Health Bureau.

"We see encouraging results of improved reproductive health and reduced pregnancy-related deaths in Tigray. A key reason for this has been the creation of small local women's groups of volunteers who act as ambassadors for the benefits of utilizing the existing health services," says Hagos.

The state government has created the Health Development Army, an initiative that seeks to integrate and strengthen the link between the community, politicians and the health sector. The overall goals are improved sustainability of health programmes and community empowerment.

To achieve these goals, the initiative brings together community action, as represented by Women's Development Groups, and the commitment of state political leadership and the health sector itself, represented by the health workforce.

A key aspect of the Health Development Army is the focus on community and social mobilization in Women's Development Groups. The initiative encourages women in neighbouring households to volunteer and organize in "1-to-5 networks" which then form larger networks of 25-30 members.

The groups set out to create demand for and increase utilization of existing maternal health services. This is in part accomplished by tackling behavioural barriers and potentially unhealthy traditional practices through community dialogue. The groups also encourage facility-based delivery by preparing cultural porridge and Ethiopian coffee for postnatal mothers at health facilities.

"The goal is to reinforce positive behaviours and locally initiated good practices by celebrating women's achievements. Creating a conducive environment, where women living in the rural areas can meet and discuss together based on their own agenda, can make a big difference in reducing maternal mortality. This has been one of the more challenging goals, but achieving it demonstrates that women can work together to save the lives of other women," he said.

In research findings published earlier this year in the Journal of Global Health, Hagos and his colleagues showed that transport and communication innovations in Tigray and other rural areas of Ethiopia correlated with appreciably reduced maternal mortality. The study showed that a national programme providing free-of-charge ambulances, which can be ordered on a 24/7 basis via mobile phones, coincided with a reduction of maternal mortality rates by about 50 per cent.

"Despite noticeable achievements in Tigray, major challenges remain in many settings in terms of both measuring and reducing maternal mortality effectively," concludes Hagos, according to medicalxpress.com.

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