NCT07133321

The Effectiveness of Multi-pronged Interventions to Improve Institutional Delivery in South Ethiopia

• Status: Enrolling By Invitation
• Phase: N/A
• Study type: Interventional
• Enrollment: 1,680 (estimated)
• Sponsor: Prof Yves Jacquemyn · Academic / Other
• Sex: Male
• Age: —
• Healthy volunteers: Not accepted

Summary

This study aims to improve the health and safety of mothers during pregnancy and childbirth by working closely with their husbands. In many communities in Ethiopia, husbands play an important role in decisions about where women give birth. The study involves educating husbands in group sessions to help them understand how to support their wives during pregnancy, prepare for childbirth, recognize danger signs, and encourage giving birth in health centers where skilled care is available. At the same time, some health workers receive training to improve their ability to handle childbirth emergencies and provide respectful, culturally sensitive care. Communities are divided into groups that receive either husband education, health worker training, both, or no additional support. The study will see which approach helps more women deliver safely in health centers and receive care after birth. By involving husbands and improving health worker skills, this study hopes to support mothers better and improve outcomes for families.

Detailed description

This study is conducted in Southern Ethiopia to improve the utilization of maternal health services, helping more women access safe childbirth and postnatal care. Many women face challenges in using health facilities for delivery, which can increase risks for mothers and babies. The study tests two key interventions that support mothers by involving both their families and health workers. 1. Husband Group Education: Since husbands often influence decisions about childbirth, this intervention provides group education sessions for husbands. These sessions focus on: Supporting their wives during pregnancy and childbirth. Preparing for birth and recognizing danger signs. Encouraging facility-based delivery where skilled care is available. Promoting shared decision-making and responsibility sharing between husbands and wives around pregnancy and childbirth. By increasing husbands' knowledge and encouraging joint responsibility, the study aims to improve the use of maternal health services by women. 2. Health Worker Training on Helping mother survive integrated RMC: This intervention improves health workers' skills at local health facilities in Southern Ethiopia to: Manage common childbirth emergencies. Provide timely referrals and emergency care. Deliver culturally sensitive and woman-centered care. Enhance overall quality of care, making health facilities more effective and trusted. The study uses a cluster randomized controlled trial design with four groups to compare the effects of these interventions: Husband group education only, Health worker training only, Both husband education and health worker training, No intervention (control group). The primary goal is to identify which intervention best increases the number of women who give birth at health facilities and receive postnatal care. Secondary goals include improving husbands' knowledge and attitudes about birth preparedness, gender roles, and shared responsibilities, as well as enhancing health workers' knowledge and skills. Overall, this study seeks to find effective ways to increase maternal health service utilization by fostering husband involvement and strengthening health system readiness, contributing to safer childbirth and healthier families in Southern Ethiopia

Conditions

• Maternal Health
• Gender

Interventions

Type	Name	Description
BEHAVIORAL	Husband Group Health education.	The community-based husband group health education will target expectant fathers with pregnant partners. It will focus on reshaping gender-related attitudes and beliefs, promoting caregiving best practices, preventing violence against women, and improving men's involvement in maternal health. The intervention will comprise group sessions with 20 participants each, conducted over three sessions lasting 2.5 hours each, with a 15-day interval between sessions. The sessions will cover key topics, including recognizing obstetric danger signs, preparing for childbirth, fostering men's engagement in maternal health, advocating nonviolence and shared responsibility, and encouraging joint decision-making.
BEHAVIORAL	Helping Mothers Survive + RMC	The "Helping Mothers Survive" training is designed by Jhpiego, an affiliate of Johns Hopkins University, in collaboration with global health partners, including the World Health Organization (WHO), Laerdal Global Health, and the International Confederation of Midwives (ICM) for healthcare professionals involved in childbirth care focusing on saving lives at birth in low-resource settings. This on-site training will use realistic simulations to enhance skills in identifying and managing key causes of maternal mortality, such as postpartum hemorrhage and preeclampsia, starting with essential labor care. The program employs the MamaNatalie birthing simulator, a low-tech realistic tool for hands-on practice developed by Laerdal Global Health. MamaNatalie features a model uterus with a neonate, placenta, and umbilical cord, enabling simulations of postpartum hemorrhage, breech delivery, vacuum-assisted birth, and normal labor.

Timeline

• Start date: 2025-07-27
• Primary completion: 2026-04-15
• Completion: 2026-04-15
• First posted: 2025-08-21
• Last updated: 2025-08-21

Locations

1 site across 1 country: Ethiopia