Improvement of Maternal-Child Health (MCH) through a Community-Oriented MCH Project in Ethiopia

Purpose: This study aimed to explore the effects of a community-oriented maternal-child health (MCH) project in Ethiopia initiated and supported by Korea International Cooperation Agency (KOICA).

Methods: One group pre-post design was used. The project was intervened in a rural area, Kihen of the Tigray regional state in north Ethiopia. The inclusion criteria of the study were women aged 15 to 49 who were married and resided in Kihen. The number of the women participated in the study was 927 for pre-test and 409 for post-test. A complete baseline survey was done for pre-test because the mother project needed to understand the project target area in the beginning. For post-test, we used a stratified random sampling method. Data for the pre-test were collected from October to December in 2012, and the post-test data from June to July in 2014. Our trained research assistants visited each woman’s home and interviewed them using a structured questionnaire which was adapted from a safe motherhood population-based survey questionnaire developed by JHPIEGO (2004). The 2-year MCH project in Ethiopia consisted of on-the-job trainings for nurses and midwives at health centers, education for heath extension workers, community health education, and radio broadcasting of MCH/FP-related information.

Results: A descriptive statistics, chi-square test and paired t-test were used for data analysis. There were significant increases of the women’s knowledge on serious health problems during pregnancy (t=-7.33, p<.001), labor and childbirth (t=-6.88, p<.001), 1^st 7days after childbirth (t=-8.94, p<.001), and early childhood (t=-3.90, p<.001) at the completion of the project. The women’s perceptions of father involvement in prenatal visit (t=-10.97, p<.001), and childbirth (t=5.80, p<.001) were also significantly positively increased. The number of women currently using a family planning method was significantly increased from 31.3% to 91.3% (χ²=404.10, p<.001). The institutional birth rate was also significantly increased from 10.4% to 91.9% (χ²=307.29, p<.001).

Conclusion: Consistent with the national health policy of Ethiopia, our project was effective to improve the women’s knowledge and perceptions of MCH and their MCH practices. Our study results suggest that capacity development of nursing staffs and community health education are necessary to change knowledge and perceptions on health of community residents and ultimately to improve MCH in a developing country.