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Published in: Trials 1/2019

Open Access 01-12-2019 | Study protocol

Effectiveness of upgraded maternity waiting homes and local leader training in improving institutional births among women in the Jimma zone, Ethiopia: study protocol for a cluster-randomized controlled trial

Authors: Jaameeta Kurji, Manisha A. Kulkarni, Lakew Abebe Gebretsadik, Muluemebet Abera Wordofa, Sudhakar Morankar, Kunuz Haji Bedru, Gebeyehu Bulcha, Kednapa Thavorn, Ronald Labonte, Monica Taljaard

Published in: Trials | Issue 1/2019

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Abstract

Background

Ethiopia is one of the ten countries in the world that together account for almost 60% of all maternal deaths. Recent reductions in maternal mortality have been seen, yet just 26% of women who gave birth in Ethiopia in 2016 reported doing so at a health facility. Maternity waiting homes (MWHs) have been introduced to overcome geographical and financial barriers to institutional births but there is no conclusive evidence as to their effectiveness. We aim to evaluate the effects of upgraded MWHs and local leader training in increasing institutional births in the Jimma zone of Ethiopia.

Methods

A parallel, three-arm, stratified, cluster-randomized controlled trial design is being employed to evaluate intervention effects on institutional births, which is the primary outcome. Trial arms are: (1) upgraded MWH + religious/community leader training; (2) leader training alone; and (3) standard care. Twenty-four primary health care unit catchment areas (clusters) have been randomized and 3840 women of reproductive age who had a pregnancy outcome (livebirth, stillbirth or abortion) are being randomly recruited for each survey round. Outcome assessments will be made using repeat cross-sectional surveys at baseline and 24 months postintervention. An intention to treat approach will be used and the primary outcome analysed using generalized linear mixed models with a random effect for cluster and time. A cost-effectiveness analysis will also be conducted from a societal perspective.

Discussion

This is one of the first trials to evaluate the effectiveness of upgraded MWHs and will provide much needed evidence to policy makers about aspects of functionality and the community engagement required as they scale-up this programme in Ethiopia.

Trial registration

ClinicalTrial.gov, NCT03299491. Retrospectively registered on 3 October 2017.
Appendix
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Metadata
Title
Effectiveness of upgraded maternity waiting homes and local leader training in improving institutional births among women in the Jimma zone, Ethiopia: study protocol for a cluster-randomized controlled trial
Authors
Jaameeta Kurji
Manisha A. Kulkarni
Lakew Abebe Gebretsadik
Muluemebet Abera Wordofa
Sudhakar Morankar
Kunuz Haji Bedru
Gebeyehu Bulcha
Kednapa Thavorn
Ronald Labonte
Monica Taljaard
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Trials / Issue 1/2019
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-019-3755-z

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