Exploring opportunities to enhance effectiveness of mobile health and nutrition strategy for providing health and nutrition services amongst pastoralists in Somali region, Ethiopia

Oladeji, Olusola; Oladeji, Bibilola D.; Omer, Mohammed Eltahier Abdalla; Farah, Abdifatah Elmi; Ameda, Ida M; Gera, Rajeev; Ismail, Abibakar Sheikaden; Ayanle, Mohamed; Nixon, Opiyo; Diriye, Hadis M

doi:10.4102/phcfm.v13i1.2723

Cited by 9 publications

(19 citation statements)

References 16 publications

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“…The odds of under-five mortality were higher for residents of Afar and Somali regions compared to the Tigray region. This coincides among other things, with Somali and Afar regions having the first and second lowest coverage of children with all basic as well as second and first prevalence respectively [ 35 , 36 ]. Additionally, the Somali region was one of the regions that were in the primary cluster from our spatial scan statistics analysis where under-five mortality is more likely to occur.…”

Section: Discussionmentioning

confidence: 65%

Geographic variation and factors associated with under-five mortality in Ethiopia. A spatial and multilevel analysis of Ethiopian mini demographic and health survey 2019

Tessema

Mulat²,

Gebrehewet³

2022

PLoS ONE

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Background The distribution of under-five mortality (U5M) worldwide is uneven and the burden is higher in Sub-Saharan African countries, which account for more than 53% of the global under-five mortality. In Ethiopia, though U5M decreased substantially between 1990 and 2019, it remains excessively high and unevenly distributed. Therefore, this study aimed to assess geographic variation and factors associated with under-five mortality (U5M) in Ethiopia. Methods We sourced data from the most recent nationally representative 2019 Ethiopian Mini-Demographic and Health Survey for this study. A sample size of 5,695 total births was considered. Descriptive, analytical analysis and spatial analysis were conducted using STATA version 16. Both multilevel and spatial analyses were employed to ascertain the factors associated with U5M in Ethiopia. Results The U5M was 5.9% with a 95% CI 5.4% to 6.6%. Based on the multivariable multilevel logistic regression model results, the following characteristics were associated with under-five mortality: family size (AOR = 0.92, 95% CI: 0.84,0.99), number of under-five children in the family (AOR = 0.17, 95% CI: 0.14, 0.21), multiple birth (AOR = 14.4, 95% CI: 8.5, 24.3), children who were breastfed for less than 6 months (AOR = 5.04, 95% CI: 3.81, 6.67), people whose main roof is palm (AOR = 0.57, 95% CI: 0.34, 0.96), under-five children who are the sixth or more child to be born (AOR = 2.46, 95% CI: 1.49, 4.06), institutional delivery (AOR = 0.57, 95% CI: 0.41, 0.81), resident of Somali and Afar region (AOR = 3.46, 95% CI: 1.58, 7.55) and (AOR = 2.54, 95% CI: 1.10, 5.85), respectively. Spatial analysis revealed that hot spot areas of under-five mortality were located in the Dire Dawa and Somali regions. Conclusion Under-five mortality in Ethiopia is high and unacceptable when compared to the 2030 sustainable development target, which aims for 25 per 1000 live births. Breastfeeding for less than 6 months, twin births, institutional delivery and high-risk areas of under-five mortality (Somali and Dire Dawa) are modifiable risk factors. Therefore, maternal and community education on the advantages of breastfeeding and institutional delivery is highly recommended. Women who deliver twins should be given special attention. An effective strategy should be designed for intervention in under-five mortality hot spot areas such as Somali and Dire Dawa.

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Section: Discussionmentioning

confidence: 65%

Geographic variation and factors associated with under-five mortality in Ethiopia. A spatial and multilevel analysis of Ethiopian mini demographic and health survey 2019

Tessema

Mulat²,

Gebrehewet³

2022

PLoS ONE

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“…The finding is consistent with another study which showed that MHNT program is documented as a convenient approach of health service delivery in the pastoral areas of Ethiopia. 19 In another study it has been also reported that the opinion of the society about the usefulness of the MHNT approach is entirely encouraging. 18…”

Section: Discussionmentioning

confidence: 91%

“…This finding corroborates with a study by Olaji et al which reported that movement restrictions affected the successful implementation of MHNT programs in pastoral areas. 19 This implies that the pastoral lifestyle and their movement pattern should be considered for appropriate design and implementation of effective MHNT strategy in the local context.…”

Section: Discussionmentioning

confidence: 99%

“…18 Similarly, another study reported that MHNT programs are relevant to increase health service access based on the growing demands of the society. 8 , 19 A study from Afghanistan also showed that sustained and scheduled MHNT program implementation resulted in better performance on maternal and child health. 5 Likewise in Nigeria, dedicated mobile teams increase service access for remote settings.…”

Section: Discussionmentioning

confidence: 99%

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Mobile Health and Nutrition Team Service Implementation in Somali and Afar Regions of Ethiopia: A Qualitative Implementation Science Study

Wolka¹,

Alemu²,

Gobana³

et al. 2022

JMDH

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Background: Ethiopia has been implementing Mobile Health and Nutrition Teams (MHNTs) to improve the accessibility of essential healthcare services for unreached populations with poor infrastructure to ensure health for all target by Universal health coverage (UHC). However, the current implementation status of this MNHT is not assessed. Objective: This study aimed to capture the current implementation status of the MHNT from the program managers, supporting partners and decision makers at each level of the health system structure in Afar and Somali regions. Methods: We conducted qualitative study with phenomenological study design. The data was collected from RHB MHNT coordinator, woreda health office MHNT coordinator, MHNT leader and representatives from implementing partners. The interview guides were developed using the CFIR framework. Results: Out of the 17 respondents, 13 responded all the standard service packages a MHNT is expected to deliver (76.5%). Overall, the KIIs mentioned that the MHNTs are effective in ensuring access and quality of health services. MHNT strategy has high demand and acceptability by the community and the service providers. The main barrier to program implementation is the gap in service integration within and across sectors. Inadequate staffing of the MHNT, gaps in ensuring proper professional mix, frequent turnover of contract health workers, and skill gaps hamper effective and sustainable implementation of the program. Conclusion: MHNT establishment, effectiveness, acceptability and sustainably in the implementing woredas of Afar and Somali Regions is very promising. The culture of MHNT documentation and reporting needs some improvement. Besides, community engagement and government ownership are good drivers for sustainability of MHNT. Standardizing and adding additional professionals with capacity building is crucial to ensuring service quality. Furthermore, community mobilization and woreda leadership commitment boosting will be needed for granting sustainability. Finally, national scale up of this alternative strategy is recommended through standardized implementation modality.

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“…Over the past decade, the WHO open-source AccessMod software has often been used to model geographic accessibility coverage of various types of health services (11)(12)(13)(14)(15). To analyze the accessibility coverage of a country or region, AccessMod applies a least-cost path algorithm to compute the routes with the shortest travel time between any location and the nearest health service, for example an EmONC facility (10,16).…”

Section: Knowledge Elicitation Travel Scenario Workhopsmentioning

confidence: 99%

Travel scenario workshops for geographical accessibility modeling of health services: A transdisciplinary evaluation study

Molenaar

Hierink²,

Brun³

et al. 2023

Front. Public Health

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IntroductionLimited geographical access to quality Emergency Obstetric and Newborn Care (EmONC) is a major driver of high maternal mortality. Geographic access to EmONC facilities is identified by the global community as a critical issue for reducing maternal mortality and is proposed as a global indicator by the Ending Preventable Maternal Mortality (EPMM) initiative. Geographic accessibility models can provide insight into the population that lacks adequate access and on the optimal distribution of facilities and resources. Travel scenarios (i.e., modes and speed of transport) used to compute geographical access to healthcare are a key input to these models and should approximate reality as much as possible. This study explores strategies to optimize and harmonize knowledge elicitation practices for developing travel scenarios.MethodsKnowledge elicitation practices for travel scenario workshops (TSW) were studied in 14 African and South-Asian countries where the United Nations Population Fund supported ministries of health and governments in strengthening networks of EmONC facilities. This was done through a mixed methods evaluation study following a transdisciplinary approach, applying the four phases of the Interactive Learning and Action methodology: exploration, in-depth, integration, and prioritization and action planning. Data was collected in November 2020–June 2021 and involved scoping activities, stakeholder identification, semi-structured interviews (N = 9), an evaluation survey (N = 31), and two co-creating focus group discussions (N = 8).ResultsEstimating realistic travel speeds and limited time for the workshop were considered as the largest barriers. The identified opportunities were inclusively prioritized, whereby preparation; a favorable composition of attendees; validation practices; and evaluation were anticipated to be the most promising improvement strategies, explaining their central place on the co-developed initial standard operating procedure (SOP) for future TSWs. Mostly extensive preparation—both on the side of the organization and the attendees—was anticipated to address nearly all of the identified TSW challenges.ConclusionThis study showed that the different identified stakeholders had contradicting, complementing and overlapping ideas about strategies to optimize and harmonize TSWs. Yet, an initial SOP was inclusively developed, emphasizing practices for before, during and after each TSW. This SOP is not only relevant in the context of the UNFPA EmONC development approach, but also for monitoring the newly launched EPMM indicator and even in the broader field of geographic accessibility modeling.

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Exploring opportunities to enhance effectiveness of mobile health and nutrition strategy for providing health and nutrition services amongst pastoralists in Somali region, Ethiopia

Cited by 9 publications

References 16 publications

Geographic variation and factors associated with under-five mortality in Ethiopia. A spatial and multilevel analysis of Ethiopian mini demographic and health survey 2019

Geographic variation and factors associated with under-five mortality in Ethiopia. A spatial and multilevel analysis of Ethiopian mini demographic and health survey 2019

Mobile Health and Nutrition Team Service Implementation in Somali and Afar Regions of Ethiopia: A Qualitative Implementation Science Study

Travel scenario workshops for geographical accessibility modeling of health services: A transdisciplinary evaluation study

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