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New Study Assesses Maternal and Newborn Health Interventions in Ethiopia: Health Service Coverage is Increasing, but Quality of Care Needs to be Improved

Data from a new study, the Performance Monitoring and Accountability 2020 Maternal and Newborn Health survey (PMA-MNH), show that coverage levels for key maternal and newborn health services are increasing, however comprehensive coverage and quality of health services remains low in Southern Nations, Nationalities and Peoples’ region (SNNPR). PMA-MNH is a longitudinal household survey designed to collect information on knowledge, practice, and coverage of maternal and neonatal health service utilization over time. Data were collected in SNNPR (one of the nine regions in Ethiopia) from August 2016 to July 2017. Following the initial household screening of nearly 10,000 households, 329 women six or more months pregnant were identified; three follow-up interviews were conducted 7-days, 6-weeks, and 6-months after delivery.

Ethiopia has achieved remarkable success in reducing under-five and maternal mortality in recent decades, but still has very high neonatal mortality rates (29 deaths per 1,000 live births) and maternal mortality ratios (412 deaths per 100,000 live births). In recent years, the government of Ethiopia has invested heavily in improving the coverage of effective maternal and newborn interventions, but, as the results from this study show, the quality of maternal and newborn care still needs attention.

Researchers found:

-83% of women received at least one antenatal care (ANC) during pregnancy, however only 53% of the women said they had four or more ANC visits.

-Only a quarter of the women had their blood pressure measured and gave urine and blood samples as part of a regular ANC visit (all three services should be delivered to be considered a comprehensive visit).

-Approximately one in two women (53%) delivered their baby in a facility; of women who delivered at home, 8% said they did so because they had poor prior experiences at a health facility.

-Only about 25% of infants had received a newborn check up by six-weeks post-delivery, and less than 15% of mothers had received a maternal health check by that time.

-Most women (88%) resumed sexual activity by the six-month interview, however only about 44% reported using family planning.

“Although we found increasing numbers of women receiving services throughout pregnancy and the postpartum period, there is a concern that over time the low quality or incomplete services offered will discourage women from using the health system,” explains Dr. Solomon Shiferaw Principal Investigator for the PMA2020 program in Ethiopia. “The Ministry of Health and public health community must continue to make investments to improve quality of these crucial healthcare services.”

Researchers at Addis Ababa University’s School of Public Health at the College of Health Sciences (AAU/SPH/CHS) disseminated these results at an event on October 24, 2017 in Addis Ababa, Ethiopia. Drs. Solomon Shiferaw, Assefa Seme, Linnea Zimmerman, and Saiffudin Ahmed presented these and other key findings from the study to Ministry of Health officials, program implementers, regional health planners, and other key stakeholders. 


PMA2020 uses innovative mobile technology to support low-cost, rap­id-turnaround surveys to monitor key health indicators in 11 countries. The program is implemented by local universities and research organi­zations, deploying a cadre of female resident data collectors trained in mobile-assisted data collection. PMA2020/Ethiopia is led by Addis Ababa University’s School of Public Health at the College of Health Sciences (AAU/SPH/CHS), in collaboration with regional universities, the Federal Ministry of Health, and Central Statistical Agency. Overall direction and support is provided by the Bill & Melinda Gates Institute for Population and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health and funded by the Bill & Melinda Gates Foundation.

For this longitudinal study, the team used the 44 enumeration areas that were used in the first four rounds of the PMA2020 core survey and a complete census was conducted to identify all women six or more months pregnant. Eligible women were contacted and consented and enrolled in the longitudinal study. The final sample included 329 eligible women.

Read the results brief.

For more information visit

Thursday, November 16, 2017