Vulnerability Project

“Our project is based on the assumption that accurate and comprehensive assessment of
vulnerability in maternal service uptake can help identify vulnerable pregnant women with the lowest likelihood of accessing necessary health services, which will subsequently help generate evidence and provide guidance on effective policies and interventions. Therefore, identifying the most vulnerable pregnant women and engaging them in program development would enhance the applicability, viability, and effectiveness of an intervention.

Adopting user-oriented strategies, our study attempts to render vulnerable pregnant women an opportunity to take ownership of their problems and participate in generating solutions with the study team to cater to their unique needs, challenges, and hopes.” (Kang et al, 2024)

About the Project

The Vulnerability Project aims to develop and test the efficacy and
acceptability of interventions to promote institutional delivery, ANC visits, and nutritional
supplementation among highly vulnerable pregnant women in Ethiopia.

In Phase 1, HCD solutions were finalized in January 2024 and implemented until May 2024. Our objective in Phase 2 is to refine the solutions to optimize scalability and ownership in the health system, in turn to ensure service uptake among pregnant women.

Objectives

The study objectives across the two phases are:

  1. To assess whether changes in institutional delivery and ANC visits among women from
    baseline to end-line in the intervention arm are significantly greater than corresponding changes in the control arm.
  2. To explore how social and behavioral factors, including social norms, gender norms, women’s empowerment, and spousal dynamics, are associated with maternal health service uptake.
  3. To understand the extent to which the intervention meets key implementation research
    outcomes, including fidelity, acceptability, feasibility, scalability, and sustainability, among pregnant women and health workers in the intervention arm.

Team

Johns Hopkins University Center for Communications Programs (Ethiopia and U.S.
offices), CROWN

Link to protocol paper: Developing and evaluating human-centered design solutions for enhancing maternal health service utilization among vulnerable pregnant women in Oromia, Ethiopia: Study protocol for a quasi-experimental study (publication coming soon!)