A successful project – or just good timing? Measuring interventions and their impact on health outcomes

published 24 September 2018

Ethiopia has made impressive gains improving mother and child health indicators in the past decades, but how can we know for certain who or what really made the difference?

Attributing changes in health outcomes to specific interventions or projects is tricky. Oftentimes coincidental factors, such as the construction of a new highway linking communities to a health facility, could have improved the communities’ health indicators just as much, as a project employing newly trained health workers.

A series of papers published in a BMC Pregnancy and Childbirth Supplement all examine community engagement projects implemented in support of the Federal Ministry of Health of Ethiopia. The research looked into how these may have contributed to recent improvements in maternal and child health in Ethiopia.

The papers examine the complexity of attributing specific real-life inputs to improvements in outcomes, and take a closer look at evaluation methods and approaches which generate robust evidence but also reflect the real-life conditions in which they are used.

The first paper examines possible correlations between the development of Ethiopia’s Women’s Development Army and improvements in mother and child health outcomes. The authors were able to use survey data from over 12,000 women in over 400 communities correlating the density of the active intervention with relevant outcomes.

The second paper examines the effects of using Community-Based Data for Decision-Making on maternal and child health care practices. Before-and-after survey data from 177 communities were used to examine correlations between CBDDM strength and health care practices.

The third paper examines the effects of a Participatory Community Quality Improvement strategy on mother and child health care behaviour. Using a similar approach to the second paper, the authors examine the effects of PCQI over and above an emergency obstetric service intervention in certain communities.

The fourth paper examines potential effects of a specific intervention, the Family Conversation, which is a structured dialogue between a health worker, a pregnant woman and key members of the woman’s immediate family and household