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FINAL REPORT Baseline Survey and Establishing Benchmarks for Project FINAL REPORT Baseline survey and establishing benchmarks for project evaluation in selected key – MNCH indicators for UNICEF-KOICA MNCH project in 4 intervention zones Segen, Kefa and Bench Maji of SNNP and Jimma of Oromia regions Reference number: RFP-S&L-2016-9127376 Submitted to: UNICEF Ethiopia Submitted by: ABH SERVICES PLC, AN AFFILIATE OF JIMMA UNIVERSITY DUNS: 850459757 ADDRESS Bole Road, In front of The Millennium Hall Email: [email protected] Tel.: +251116186520 Web site: www.abhethiopia.com Addis Ababa, Ethiopia CONTACT PERSONS Primary Contact Additional Contact Name Dr. Markos Feleke Dr. Mengistu Tafesse Title CEO Technical Director Email [email protected] [email protected] Telephone +251-911-511610 +251-911-217919 Fax +251-11-6-186528 +251-11-6-186528 July 10, 2017 1 Table of Contents ............................................................................................................................................ 5 List of tables .......................................................................................................................................... 9 List of figures .............................................................................................................................................. 10 Acronyms .............................................................................................................................. 12 Executive Summary ................................................................................................................................... 18 1. Introduction ..................................................................................................................................... 19 2. Objectives ......................................................................................................................................... 20 3 Methods ..................................................................................................... 20 3.1 Study area and population ................................................................................... 20 3.2 Study design and study subjects/units ................................................................................... 21 3.3 Sample size and sampling techniques ................................................................................... 22 3.4 Data collection Techniques and tools ............................................................................................................... 24 3.5 Data quality control ............................................................................................. 24 3.6 Data management and analysis ................................................................................................................... 25 4 Ethical considerations 5. Results ........................................................................................................................................... 26 ................................... 26 5.1 Back ground characteristics of the participants of household survey 5.2 Findings related to Objective 1: Assess awareness and knowledge of mothers on high ................................................................ 28 impact MNCH services in the project intervention areas. 5.3 Findings related to Objective 2: Determine the level of utilization and associated factors of high impact maternal health services, newborn health services (including utilization of treatment for .. 30 newborns with sepsis at community level), and child health services during the first year of life. .......................................................................................... 30 5.3.1 Utilization of ANC services .............................................................................. 35 5.3.2 Utilization of delivery care services ........................................................................................... 40 5.3.3 Utilization of PNC services .......................................................................................... 42 5.3.4 Utilization of NBC services ................................................................................... 45 5.3.5 Utilization of child care services ............................. 48 5.3.6 Conclusion and recommendation on utilization of MNCH services 2 ’ 5.4 Findings related to Objective 3: Assess mothers perceived quality of high impact MNCH ......................................................................................... 48 services in the project intervention areas. .... 48 5.4.1 Quantitative findings from household survey related to quality of MNCH services ............................................ 53 5.4.2 Qualitative findings related to quality of MNCH services ........... 55 5.4.3 Conclusion and recommendation on the perceived quality of MNCH services 5.5 Findings related to Objective 4: Explore the demand for high impact MNCH services - ............................................ 55 ANC, SBA, ICCM, CBNC, Newborn Corner, NICU, and BEmONC. ................................. 55 5.5.1 Quantitative findings regarding the demand for MNCH services ................................... 58 5.5.2 Qualitative findings regarding the demand for MNCH services ......................... 58 5.5.3 Conclusion and recommendation on the demand for MNCH services 5.6 Findings related to Objective 5: Examine the actual referral linkage process and mechanisms in place for Maternal and newborn cases within the primary care units/delivery ............................................................................................................................................. 59 platform ........................................................... 59 5.6.1 Quantitative findings related to referral linkage ................................................ 61 5.6.2 Qualitative findings related to referral linkage process ................................. 62 5.6.3 Conclusion and recommendation on the referral linkage process 5.7 Findings related to Objectives 6,7, and 8: Availability and quality of high impact MNCH ............................................................................. 63 services, MNCH equipment, drugs and supplies. ......................................................................... 63 5.7.1 Results of health post (HP) assessment ..................................................................... 74 5.7.2 Results of health center (HC) assessment ...................................................................................... 98 5.7.3 Results of hospital assessment 5.7.4 Conclusions and recommendation on availability and quality of high impact MNCH ........................................................................ 119 services, MNCH equipment, drugs and supplies 5.8 Findings related to Objective 9: Identify critical challenges with regard to MNCH services ................................................................................ 123 utilization both from demand and supply side ................................................................................. 123 5.8.1 Challenges of lack of awareness ........................................................ 123 5.8.2 Challenges of accessibility of health institutions 5.8.3 Challenges of availability of MNCH services, equipments, drugs, and other supplies 124 .............................................. 124 5.8.4 Challenges of adequacy of rooms in health institutions 3 ........................................................... 125 5.8.5 Challenges related to maternity waiting rooms ......................................................... 125 5.8.6 Challenges of availability of skilled man power ..................................................................................... 125 5.8.7 Challenges of staff behaviour ................................................................... 126 5.8.8 Challenges related to culture and religion ...................................................................................... 126 5.8.9 Challenges within the family ................................................................. 126 5.8.10 Challenges related to water and electricity ..................................................................................... 127 5.8.11 Challenges of communication ........................................................................ 127 5.8.12 Challenges of recording and reporting ................................................................................ 127 5.8.13 Conclusion and recommendation ................................................................................................................................... 129 6 References 4 List of tables Table 1: Background characteristics of mothers who have under-one year infant in Segen, Kefa and ................................ 26 Bench Maji of SNNP Region, and Jimma Zone of Oromia Region, March 2017 Table 2: Awareness and knowledge of mothers on MNCH services in Segen, Kefa and Bench Maji of ........................................................ 29 SNNP Region, and Jimma Zone of Oromia Region, March 2017 Table 3: Utilization of ANC services by background characteristics in Segen, Kefa and Bench Maji of ............................................................................. 31 SNNP Region, and Jimma Zone of Oromia Region Table 4: Factors associated with ANC service utilization in Segen, Kefa and Bench Maji of SNNP ................................................................... 32 Region, and Jimma Zone
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