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Ethiopia

Based at the Ethiopia Public Health Institute in Addis Ababa, the IDEAS team worked in four of Ethiopia’s ten regions - Amhara, Oromia, Southern Nations, Nationalities and Peoples and Tigray - to provide a rich source of data for funders, governments and non-governmental organisations working in maternal and newborn health in Ethiopia.

Working with our measurement, learning and evaluation partners and using multidisciplinary research methods, our findings on what works, why and how aims to close the gap in implementation research on how to get life-saving interventions to families at scale.

In Ethiopia, the IDEAS project worked across a range of research areas.

Supporting local decision-making

To enhance the capacity of health systems, quality data needs to be generated and used at the local level for timely course correction, improved health outcomes and the long-term sustainability of health initiatives. Following an Ethiopian feasibility study in 2012 and the experiences of a prototype phase in the state of West Bengal State in India, we developed an intervention to support data-driven decision-making at district level in Ethiopia, supported implementation over a period of 21 months, and used a cluster-randomised controlled evaluation in 24 districts (woreda) in North Shewa zone, which showed strong evidence of improved health information system performance and data-driven decision-making.

 

Understanding quality improvement

Building on our previous work to understand behaviour change at household level in Ethiopia, IDEAS used novel qualitative and quantitative approaches to understand health worker behaviours that drive quality improvement in the provision and utilisation of maternal and newborn health services.

One initiative supporting understanding quality improvement is the Quality of Care Network research (QCN). IDEAS collaborated with a multi-country research project titled: “How does a multi-country, multilateral network focused on specific health care improvements evolve and what shapes its ability to achieve its goals?” (‘QCN project’).  The parent project is led by the UCL Institute for Global Health. Working with the Ethiopian Public Health Institute (EPHI), IDEAS focused on the experience of Ethiopia as part of this larger body of research.

Fostering innovation sustainability

We studied how to scale-up and sustain maternal and newborn health innovations in Ethiopia, northeast Nigeria and Uttar Pradesh in India. We defined ‘scale-up’ as the adoption of donor-funded health innovations beyond original programme districts, and ‘sustainability’ as the longer-term implementation of donor-funded innovations that have been scaled-up.

Community-Based Newborn Care

Community-Based Newborn Care (CBNC) is an Ethiopian national initiative launched in 2013. It brings life-saving care to mothers and newborns at the community level within the Ethiopian health system. IDEAS collaborated with the Ethiopian Federal Ministry of Health and JaRco Consulting to evaluate the CBNC programme through a series of quantitative surveys and qualitative assessments over five years.

 

Published content

Report
Dissemination activity and impact of maternal and newborn health projects in Ethiopia, India and Nigeria

Report on the dissemination activity and impact of Bill & Melinda Gates Foundation implementation projects.


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Ethiopia
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India
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Nigeria
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Research findings
Journal article
Measurement of delayed bathing and early initiation of breastfeeding: a cross-sectional survey exploring experiences of data collectors in Ethiopia

This paper recommends that the inclusion of standard probes or follow-on questions to the existing survey tools assessing delayed bathing and early initiation of breastfeeding. Data collectors also require further guidance in using appropriate probes to gather accurate maternal responses.


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Ethiopia
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Improving measurement
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Evaluation methods
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Research findings
News
Household, frontline worker and facility follow-up surveys begin in Ethiopia and Nigeria

The endline data, to be collected in April and May 2015, will be compared with baseline data collected in 2012, and any changes in healthcare...


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Ethiopia
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Nigeria
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Understanding quality improvement
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Evaluation methods
Journal article
A qualitative study exploring newborn care behaviours after home births in rural Ethiopia: implications for adoption of essential interventions for saving newborn lives.

An investigation of the sequence of immediate newborn care practices and associated beliefs following home deliveries in rural communities in Ethiopia.


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Ethiopia
Report
Community Based Newborn Care Baseline (CBNC) Survey Report Ethiopia, October 2014

Report on the baseline survey findings for the evaluation of the Ethiopian Government's Community Based Newborn Care package


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Ethiopia
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Community-based newborn care
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Implementation projects
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Research findings
Journal article
‘Scaling-up is a craft not a science’: Catalysing scale-up of health innovations in Ethiopia, India and Nigeria

A study of the scale-up of health innovations in Ethiopia, Nigeria and India, showing that multiple steps are required, including: planning; advocacy; using evidence; involving government; partnership, together with time, money and coordination, and the commitment of implementers, donors and government.


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Ethiopia
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India
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Nigeria
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Scale-up
Journal article
How do health extension workers in Ethiopia allocate their time?

Despite dividing their time between many activities, a major component of health extension workers work includes reproductive, maternal, newborn, and child health activities, showing they have an important role in improving maternal and newborn health in Ethiopia.


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Ethiopia
Journal article
Measurement of breastfeeding initiation: Ethiopian mothers’ perception about survey questions assessing early initiation of breastfeeding

An assessment of Ethiopian mothers' perception about the question assessing early initiation. Standard probes or follow on questions are required to avoid subjective interpretation of the indicator.


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Ethiopia
Report
Evidence to improve maternal and newborn health: The IDEAS Project

Leaflet giving an overview of the IDEAS project, it's aims and evaluation methods


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Ethiopia
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India
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Nigeria