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Design, Implement, Measure

We are a gateway to internationally recognised expertise. From our unique skills base, we provide technical assistance (TA) to clients and partners who are looking to make sustainable improvements to health systems worldwide.

The Centre for Maternal and Newborn Health has designed, developed and implemented a variety of innovative maternal and newborn health interventions and programmes that ‘catalyse’ increased availability and improved quality of care available at health facility level in middle and low-income settings and uses a rigorous evaluation methodology to document effectiveness of complex interventions and programs; these are used to facilitate the translation of evidence into practice.

DESIGN

CMNH has developed three new approaches to increase the availability and improve the quality of care available at health facility level:

  • Designing and delivering a skills and drills EmONC training package that comprises a short (max 6 days) multi-disciplinary training (nurses, midwives, doctors and specialists train as a team), training critical numbers (80% or more) of health care workers providing maternity care in or close to  health care facilities and using expert volunteers to build in-country capacity  
  • Designing and delivering a Making it Happen with data workshop package (1 day) that helps health care providers to better collect, understand and use routine data on maternal and newborn healthcare provision and health outcomes   
  • Designing and delivering a comprehensive workshop package (4 days) to strengthen quality improvement methodologies (maternal and perinatal death audit and standards based audit) at health care facility level. 

These packages are adaptable to the country setting and are available under an LSTM licence agreement. For more information please contact us. 

Research OUTPUTS

CMNH Emergency Obstetric & Newborn Care Training has developed/contributed to the development of the following manuals 

  • Making it Happen with Data
  • Quality Improvement
  • Care of Equipment
  • On the Job Training Manual (Sierra Leone)
  • Expanded EmONC Training Manual (Kenya)
  • Skills Lab for RMNCH+A Services Training Manual (India) 

IMPLEMENT

Global Coordinating Centre

CMNH serves as the global coordinating centre for EmONC, working in close partnership with the Ministry of Health in each participating country, the UN technical agencies and professional organisations.

It covers a number of very different research-related activities that range from a M&E team focused on the aggregation, management, and analysis of data from multiple sites, to a study-wide centre responsible for overseeing all aspects of a multi-country activity, including the development of proposals for new countries, the quality assurance of implementation, the development of Standard Operating Procedures, the coordination of data collection, and the overall governance of activities across all participating countries. 

Operations Research

With advances in health research, many studies have been conducted to identify best practice and/ or assess effectiveness of known health care interventions in health care. Most health care interventions are implemented as care packages in real world settings in a specific social and geographic context, making evaluation more complex. More recently the term operations research has been used for this type of research….identifying what care packages work in a real life setting and why.

CMNH has led on a range of operations research programmes, including:

The impact of the Making it Happen Programme on maternal and newborn mortality and morbidity. A comprehensive, innovative 5-level M&E framework to evaluate the effectiveness of EmONC training was developed by CMNH.  This is used to evaluate the impact of the MiH interventions in 11 African and Asian countries (Sierra Leone, Ghana, Nigeria, Malawi, Tanzania, Kenya, South Africa, Bangladesh, India, Pakistan and Republic of South Africa).  Data was collected at baseline and then at 3-monthly intervals, up to 12 months post intervention. Results from health care facilities were 80% or more of maternity care providers have been trained were included in the analysis.

Impact of Ebola on maternal & newborn health in Sierra Leone 

Assessment of quality of care indicators on maternal and newborn care at facility level.  In order to ensure care offered to mothers and babies across the globe is of sufficiently high quality, developing and maintaining quality standards is necessary. These standards need to be measurable and therefore indicators to assess the quality of care play a critical role in the process.  After consultation with a wide range of international stakeholders and experts in quality improvement and measurement of quality of care, a core set of indicators was proposed at global level to improve measurement of quality of care at facility level.

The CMNH was tasked by the World Health Organization with assessing the indicators proposed to measure quality of care in maternal and newborn care.  Data for the analysis was collected through facility assessment surveys done as part of the CMNH led Making it Happen programme across nine African and Asian countries and an additional evaluation in Sierra Leone (altogether 1,039 facilities).  CMNH was tasked to suggest additional information required to measure the indicators in real-life settings and to develop methodological recommendations on testing the feasibility of the proposed indicators. 

Maternal Morbidity.  

MEASURE

The CMNH has wide experience in the evaluation of complex programmes in Maternal & Newborn Health.  Examples of our work include:

Independent evaluation of the Maternal, neonatal and child health week (MNCHW) in Nigeria.  

Evaluation of the programme “Improving Maternal and newborn health in Nkhotakota district, Malawi.  The evaluation provides an in-depth understanding of the differences that the project has made in care seeking behaviours and in the quality and availability of maternal and newborn health (MNH) services.  At inception, CMNH provided technical assistance and quality assurance in the design of the project monitoring systems and tools, and in the collection and analysis of project monitoring data.  CMNH is now assessing both the implementation process, analysing the activities implemented by the project and the key measurable outputs of the activities, and the plausible effect of the project activities on key maternal and newborn outcomes. 

Independent evaluation of the Health Transition Fund (HTF) in Zimbabwe. 

Design, Implement, Measure