Community-based newborn care (CBNC) in Ethiopia is a national package that aims to improve newborn survival through the Health Extension Programme. This will involve implementing a newborn care package along the continuum of care from pregnancy to post-birth through community frontline workers, including improving sepsis management (care for and treatment of a newborn with a potentially deadly bacterial blood infection).
IDEAS has been asked by the Ethiopian Government to carry out the evaluation of CBNC. The evaluation will show the extent to which sepsis management through the Health Extension Programme in Ethiopia is scaled-up, and the extent to which evidence-based life-saving behaviours and interventions at household level are improved as a result of CBNC.
Evaluation of Community-based newborn care
The objective of the CBNC evaluation is to gather, analyse and synthesise evidence to determine whether and how community-based newborn care leads to increased coverage of critical life-saving interventions along the continuum of care, reflecting the nine maternal and newborn components.
- What is the effect of CBNC on coverage of key maternal and newborn health interventions along the continuum of care at the health post, health centre and household levels?
- What is the process by which beliefs, attitudes and care-seeking for newborn illness are addressed by CBNC at the household level?
- What are the CBNC processes through which Health Extension Workers and the Health Development Army deliver the community-based newborn care package?
- What is the quality of CBNC services provided by Health Extension Workers at the Primary Health Care Unit level?
Evaluation of CBNC will show the extent to which sepsis management through the health extension programme in Ethiopia is scaled-up, and the extent to which evidence-based life-saving behaviours and interventions at household level are improved as a result of CBNC.
The evaluation will include baseline (before CBNC starts) and endline (once CBNC has finished) surveys to find out if health behaviours have changed and more life-saving interventions are reaching women and babies at a household level. The surveys will be done in areas where CBNC has been implemented and areas where CBNC has not been implemented and compare them. We will also do a midline survey to examine whether public health care units have the capacity to supply adequate care that will save the lives of women and babies.
Qualitative studies: interviews with health care providers and families
We will conduct two qualitative studies comprising structured interviews with health care providers and families. The studies aim to provide an in-depth understanding of health care provider and family perspectives, and the adaptive behaviours needed for CBNC.
We will track contextual factors, such as socioeconomic status of woreda (districts), in order to fully understand trends we may see in the analysis of results, e.g. if CBNC hasn’t worked in one area it may be because of contextual factors, such as a drought, that adversely affected the health of women and newborn babies.
Dr Bilal Avan, Lead Investigator
Dr Tanya Marchant, Lead Investigator
Mr Tsegahun Tessema, based at our measurement and evaluation partner, JaRCo Consulting
The CBNC evaluation is overseen by the IDEAS Principal Investigator, Dr Joanna Schellenberg