The maternal and newborn health eCohort to track longitudinal care quality: study protocol and survey development

Catherine Arsenault, Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Katherine Wright, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Tefera Taddele, Health System Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
Ashenif Tadele, Health System Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
Anagaw Derseh Mebratie, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Firew Tiruneh Tiyare, Health System Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
Rose J. Kosgei, Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya.
Jacinta Nzinga, Health Economics Research Unit, KEMRI Wellcome Trust Research Program, Nairobi, Kenya.
Bethany Holt, Blavatnik Institute of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
Irene Mugenya, Health Economics Research Unit, KEMRI Wellcome Trust Research Program, Nairobi, Kenya.
Emma Clarke-Deelder, Department of Epidemiology and Public Health, Swiss Tropical & Public Health Institute, Allschwil, Switzerland.
Adiam Nega, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Dorairaj Prabhakaran, Public Health Foundation of India, Gurgaon, India.
Sailesh Mohan, Public Health Foundation of India, Gurgaon, India.
Nompumelelo Gloria Mfeka-Nkabinde, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
Londiwe Mthethwa, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
Damen Haile Mariam, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Gebeyaw Molla, Health System Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
Theodros Getachew, Health System Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
Prashant Jarhyan, Public Health Foundation of India, Gurugram, Haryana, India.
Monica Chaudhry, Public Health Foundation of India, Gurugram, Haryana, India.
Munir Kassa, Ministry of Health of Ethiopia, Addis Ababa, Ethiopia.
Margaret E. Kruk, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Document Type

Journal Article

Publication Date

12-31-2024

Journal

Global health action

Volume

17

Issue

1

DOI

10.1080/16549716.2024.2392352

Keywords

Health system quality; evidence-based care; implementation science; maternal and newborn health; quality of care

Abstract

The MNH eCohort was developed to fill gaps in maternal and newborn health (MNH) care quality measurement. In this paper, we describe the survey development process, recruitment strategy, data collection procedures, survey content and plans for analysis of the data generated by the study. We also compare the survey content to that of existing multi-country tools on MNH care quality. The eCohort is a longitudinal mixed-mode (in-person and phone) survey that will recruit women in health facilities at their first antenatal care (ANC) visit. Women will be followed via phone survey until 10-12 weeks postpartum. User-reported information will be complemented with data from physical health assessments at baseline and endline, extraction from MNH cards, and a brief facility survey. The final MNH eCohort instrument is centered around six key domains of high-quality health systems including competent care (content of ANC, delivery, and postnatal care for the mother and newborn), competent systems (prevention and detection, timely care, continuity, integration), user experience, health outcomes, confidence in the health system, and economic outcomes. The eCohort combines the maternal and newborn experience and, due to its longitudinal nature, will allow for quality assessment according to specific risks that evolve throughout the pregnancy and postpartum period. Detailed information on medical and obstetric history and current health status of respondents and newborns will allow us to determine whether women and newborns at risk are receiving needed care. The MNH eCohort will answer novel questions to guide health system improvements and to fill data gaps in implementing countries.

Department

Global Health

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