Updates from Ethiopia

Updates from the field: Ethiopia

After the Convening workshop, the Ethiopian CROWN team held an internal meeting involving the project senior management that identified main takeaways of the workshop and discussed on how to incorporate the lessons obtained from the workshop. From these learnings, the following changes were made:

• Evaluation plan: Standardization of measurements of IFA adherence, gender norms, application of the Pathways segmentation tools were the major focus areas in the revision of evaluation plan.
• IFA adherence measurement: a mix of methods including self-report questionnaire, pill count & scale measurements were proposed. The tool is still under review to further refine it and to share with other CROWN partners.
• Social and gender norms:  Questions on both injunctive and descriptive social and gender norms were adapted in view of the Ethiopia context and included in the baseline and midline survey questionnaires.
• Vulnerability Screening tool: The PATHWAYS team developed the Ethiopia Vulnerability Segmentation typing tool based on the EDHS data. Accordingly, the Ethiopia CROWN team identified and adapted those variables that significantly predicting woman’s risk of not using maternal and child health services (ANC Institutional delivery and IFA) in the PATHWAYS and developed a screening tool that will be utilized to screen vulnerable women to participate in the design sprint workshop and to enroll panel study participants of evaluation purpose. The vulnerability screening tool will be automated using mobile app supported with a query that aggregate the scores and enable the team to identify pregnant women based on their vulnerability driving factors.
• HCD Plan: The Ethiopia CROWN team made significant changes on their HCD plan. The original plan was only two rounds of workshops, and that would include diverse stakeholders in the workshop including community and services providers together. However, the revised plan has six workshops with homogeneous design team members in each workshop.

Current Status:

• Completed 3-days HCD facilitators and notetakers training from May 1-3. The training covered basics on HCD and how to facilitate effective HCD design workshops. Sixteen facilitators and notetakers who have at least bachelor’s degree participated in the training that included hands on practical exercise on the basic HCD steps.
• Completed two rounds of HCD design workshops that engaged eight different design teams from the community and service providers in each; and an internal workshop that engaged CROWN staff, facilitators and notetakers only, which was done  between the first and third workshops. Four teams were working on the one design challenge focusing on how to support pregnant women to improve ANC attendance, and the other four teams were focusing on how to support pregnant women to deliver at health facility.

What’s next:

HCD prototype solutions: The Ethiopia CROWN team will continue conducting the remaining HCD workshops before the end of June 2023.

Evaluation: The Ethiopia CROWN team will secure IRB clearance from JHSPH and local IRBs and prepare for baseline data collection before end of 2023. Furthermore, the team will finalize adherence measurements and will share them with other CROWN implementing partners.