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Assessing the Impact of a Community Outreach Model

A trainer explains major warning signs of a dangerous pregnancy to a group of villagers in Jigawa State, Nigeria

Research Overview

The Strengthening the Midwife Service Scheme with Community Focused Interventions Project was initiated in Jigawa State, Nigeria in 2011. The aim of this project is to evaluate three strategies to reduce maternal and neonatal mortality and morbidity by using a randomized controlled trial. One of these interventions is the Community Resource Person (CoRPs) program in which local women are trained to provide door-to-door education to pregnant women and their families. The CoRPs program was initiated in December 2012. TRAction is supporting a case study to describe recognition and care-seeking behaviors, and to determine whether the CoRPs program has resulted in improvements in recognition and appropriate care seeking.

 

Project Location

Nigeria: Jigawa State

Research Objectives

The aim of this study is to describe recognition and care-seeking behaviors and determine the impact of the CoRPs program. Research questions include:

  • What was the process of illness recognition and care seeking for mothers and newborns?
  • What was the sequence of actions for care seeking?
  • How did the CoRPs intervention impact care seeking?
  • What is the role of husbands in the decision-making process?
  • How does risk perception influence the decision-making process?

Study Approach

This case study will use both qualitative and quantitative methods to assess the impact of the CoRPs program in improving recognition and care seeking behaviors. Data will be collected from the study areas where the CoRPs intervention is being implemented and also in the study’s control group areas. Qualitative data will be collected via illness narratives, in-depth interviews and focus groups with women and families who have experienced complications, as well as with husbands, community leaders and CoRPs. Cases of maternal post-partum hemorrhage, neonatal illness, maternal deaths, and neonatal deaths will be assessed in each study arm. Quantitative data will provide background information on the local context, including a socio-economic and geographic profile of the study area, maternal and neonatal mortality rates, the proportion of women receiving appropriate prenatal care, and the proportion who deliver in a hospital with a skilled birth attendant. In addition, information will be gathered on the quality of the services provided at these facilities. A baseline survey comprising 15% of randomly sampled households in the study communities was completed in June 2012. A total of 7,000 women participated in the survey. End-line data collection is expected to take place beginning in December 2015.

Research into Action

This case study will examine how a community health outreach model influences decision-making and care seeking related to maternal and newborn complications. Findings will be shared with Nigerian stakeholders in the government, health and academic institutions, as well as local leaders in the project communities. TRAction will synthesize the findings from this and four other recognition studies in order to facilitate understanding of community-oriented approaches for improving recognition and care seeking. Experience from this study and other TRAction projects will be used to inform the development of interventions that address maternal and newborn health in low and middle income countries.

Research Partners

 

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