Evaluation of the feasibility, acceptability, and impact of Group Antenatal Care at the health post level on continuation in antenatal care and facility based delivery in Ethiopia using a cluster randomized stepped-wedge design: Study protocol [version 2; peer review: 1 approved, 2 approved with reservations, 1 not approved]
Background Adequate antenatal care (ANC) and facility-based delivery are linked to improved maternal and neonatal outcomes. Adequate antenatal care attendance and facility birth rates are increasing in Ethiopia but remain well below national goals and global recommendations. Group ANC (G-ANC), when...
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F1000 Research Ltd
2024-10-01
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| Online Access: | https://gatesopenresearch.org/articles/8-29/v2 |
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| author | Reena Sethi Rediet Fasil Walelegn W. Yallew Della Berhanu Yenealem Woldemariam Gayane Yenokyan Alemayehu Worku Dedefo Teshite Konjit Wolde Anne Hyre Stephanie Suhowatsky Lisa Noguchi |
| author_facet | Reena Sethi Rediet Fasil Walelegn W. Yallew Della Berhanu Yenealem Woldemariam Gayane Yenokyan Alemayehu Worku Dedefo Teshite Konjit Wolde Anne Hyre Stephanie Suhowatsky Lisa Noguchi |
| author_sort | Reena Sethi |
| collection | DOAJ |
| description | Background Adequate antenatal care (ANC) and facility-based delivery are linked to improved maternal and neonatal outcomes. Adequate antenatal care attendance and facility birth rates are increasing in Ethiopia but remain well below national goals and global recommendations. Group ANC (G-ANC), when implemented at higher level facilities, is associated with improved quality and experience of ANC, and increased ANC retention and facility-based delivery. The objectives of the study are to assess the feasibility, acceptability, and impact of G-ANC implemented at lower-level facilities (health posts) on ANC continuation and facility-based delivery. Methods G-ANC will first be piloted in five purposively selected health posts. The study will then use a stepped-wedge design in 36 health posts under six health centers, with randomization of the order of the start of the intervention done at the health center level (clusters). The design will include three time periods: first is a six-month control period with no G-ANC implementation, followed by another six months period where G-ANC will be introduced in half (n=18) of the study health posts, then final six months where G-ANC will be implemented in the remaining 18 health posts. Quantitative and qualitative data collection approaches will be used. The study has “pause and reflect” points designed to iterate on the intervention before rolling out to the next set of sites. Qualitative research will be conducted using in-depth interviews with pregnant women, health care workers, facility managers, and regional health managers. 770 women will be enrolled across all phases. Conclusions The study will inform decision makers locally and globally on whether G-ANC is a feasible service delivery model at the health post level. Effectiveness of G-ANC at increasing ANC retention and facility-based delivery will be reported, as well as its acceptability to pregnant women and Health Extension Workers. Registration NCT05054491, ClinicalTrials.gov (September 23rd 2021). |
| format | Article |
| id | doaj-art-bdeea6b6a4c24839acadecd76153eafe |
| institution | DOAJ |
| issn | 2572-4754 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | F1000 Research Ltd |
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| spelling | doaj-art-bdeea6b6a4c24839acadecd76153eafe2025-08-20T02:55:57ZengF1000 Research LtdGates Open Research2572-47542024-10-01810.12688/gatesopenres.15190.217691Evaluation of the feasibility, acceptability, and impact of Group Antenatal Care at the health post level on continuation in antenatal care and facility based delivery in Ethiopia using a cluster randomized stepped-wedge design: Study protocol [version 2; peer review: 1 approved, 2 approved with reservations, 1 not approved]Reena Sethi0https://orcid.org/0000-0003-3971-5401Rediet Fasil1https://orcid.org/0000-0001-5544-5777Walelegn W. Yallew2https://orcid.org/0000-0002-7332-5688Della Berhanu3Yenealem Woldemariam4Gayane Yenokyan5Alemayehu Worku6Dedefo Teshite7Konjit Wolde8https://orcid.org/0009-0006-6234-6455Anne Hyre9https://orcid.org/0000-0002-3474-0555Stephanie Suhowatsky10https://orcid.org/0000-0002-1825-1145Lisa Noguchi11Jhpiego, Baltimore, MD, 21231, USAAddis Continental Institute of Public Health, Addis Ababa, EthiopiaAddis Continental Institute of Public Health, Addis Ababa, EthiopiaJhpiego Ethiopia, Assia Ababa, EthiopiaJhpiego Ethiopia, Assia Ababa, EthiopiaJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USAAddis Continental Institute of Public Health, Addis Ababa, EthiopiaJhpiego Ethiopia, Assia Ababa, EthiopiaJhpiego Ethiopia, Assia Ababa, EthiopiaJhpiego, Baltimore, MD, 21231, USAJhpiego, Baltimore, MD, 21231, USAJhpiego, Baltimore, MD, 21231, USABackground Adequate antenatal care (ANC) and facility-based delivery are linked to improved maternal and neonatal outcomes. Adequate antenatal care attendance and facility birth rates are increasing in Ethiopia but remain well below national goals and global recommendations. Group ANC (G-ANC), when implemented at higher level facilities, is associated with improved quality and experience of ANC, and increased ANC retention and facility-based delivery. The objectives of the study are to assess the feasibility, acceptability, and impact of G-ANC implemented at lower-level facilities (health posts) on ANC continuation and facility-based delivery. Methods G-ANC will first be piloted in five purposively selected health posts. The study will then use a stepped-wedge design in 36 health posts under six health centers, with randomization of the order of the start of the intervention done at the health center level (clusters). The design will include three time periods: first is a six-month control period with no G-ANC implementation, followed by another six months period where G-ANC will be introduced in half (n=18) of the study health posts, then final six months where G-ANC will be implemented in the remaining 18 health posts. Quantitative and qualitative data collection approaches will be used. The study has “pause and reflect” points designed to iterate on the intervention before rolling out to the next set of sites. Qualitative research will be conducted using in-depth interviews with pregnant women, health care workers, facility managers, and regional health managers. 770 women will be enrolled across all phases. Conclusions The study will inform decision makers locally and globally on whether G-ANC is a feasible service delivery model at the health post level. Effectiveness of G-ANC at increasing ANC retention and facility-based delivery will be reported, as well as its acceptability to pregnant women and Health Extension Workers. Registration NCT05054491, ClinicalTrials.gov (September 23rd 2021).https://gatesopenresearch.org/articles/8-29/v2Health post antenatal care group antenatal care health extension worker Ethiopia maternal outcomeseng |
| spellingShingle | Reena Sethi Rediet Fasil Walelegn W. Yallew Della Berhanu Yenealem Woldemariam Gayane Yenokyan Alemayehu Worku Dedefo Teshite Konjit Wolde Anne Hyre Stephanie Suhowatsky Lisa Noguchi Evaluation of the feasibility, acceptability, and impact of Group Antenatal Care at the health post level on continuation in antenatal care and facility based delivery in Ethiopia using a cluster randomized stepped-wedge design: Study protocol [version 2; peer review: 1 approved, 2 approved with reservations, 1 not approved] Gates Open Research Health post antenatal care group antenatal care health extension worker Ethiopia maternal outcomes eng |
| title | Evaluation of the feasibility, acceptability, and impact of Group Antenatal Care at the health post level on continuation in antenatal care and facility based delivery in Ethiopia using a cluster randomized stepped-wedge design: Study protocol [version 2; peer review: 1 approved, 2 approved with reservations, 1 not approved] |
| title_full | Evaluation of the feasibility, acceptability, and impact of Group Antenatal Care at the health post level on continuation in antenatal care and facility based delivery in Ethiopia using a cluster randomized stepped-wedge design: Study protocol [version 2; peer review: 1 approved, 2 approved with reservations, 1 not approved] |
| title_fullStr | Evaluation of the feasibility, acceptability, and impact of Group Antenatal Care at the health post level on continuation in antenatal care and facility based delivery in Ethiopia using a cluster randomized stepped-wedge design: Study protocol [version 2; peer review: 1 approved, 2 approved with reservations, 1 not approved] |
| title_full_unstemmed | Evaluation of the feasibility, acceptability, and impact of Group Antenatal Care at the health post level on continuation in antenatal care and facility based delivery in Ethiopia using a cluster randomized stepped-wedge design: Study protocol [version 2; peer review: 1 approved, 2 approved with reservations, 1 not approved] |
| title_short | Evaluation of the feasibility, acceptability, and impact of Group Antenatal Care at the health post level on continuation in antenatal care and facility based delivery in Ethiopia using a cluster randomized stepped-wedge design: Study protocol [version 2; peer review: 1 approved, 2 approved with reservations, 1 not approved] |
| title_sort | evaluation of the feasibility acceptability and impact of group antenatal care at the health post level on continuation in antenatal care and facility based delivery in ethiopia using a cluster randomized stepped wedge design study protocol version 2 peer review 1 approved 2 approved with reservations 1 not approved |
| topic | Health post antenatal care group antenatal care health extension worker Ethiopia maternal outcomes eng |
| url | https://gatesopenresearch.org/articles/8-29/v2 |
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