A multi-site, non-randomized study of the feasibility and acceptability of a family-led postnatal care model in the Ada District, Ethiopia

Abstract

Background: Postnatal care is a critical intervention to reduce newborn and maternal mortality in high-mortality settings. However, it is underutilized in many countries. Family-led postnatal care (FPNC) is an innovative postnatal care service delivery model that leverages self-care principles to address key barriers identified in the Ethiopian context, including women’s preference to stay home in the first week after delivery and receive support from trusted family members. Utilizing an improved discharge process, coupled with user-friendly monitoring devices made available as a home care kit kept with preferred community custodians, this self-care model for postnatal care will be evaluated as a potential solution to very low coverage of postnatal care in the first week of life.  Methods: The study will use mixed sequential methods: quantitative pre-intervention and post-intervention survey and phenomenological qualitative study. Four health centers in Ada Districtof Oromia, Ethiopia will be purposively selected. A pre-intervention survey will measure coverage and content of postnatal checks and care-seeking behavior. Health centers will then implement family led postnatal care. Once FPNC is initiated, post-intervention quantitative data will be collected. Approximately 218 postnatal women are to be included in the quantitative survey.  Qualitative interviews with approximately 20 mothers, 20 partners, 20 families, eight health managers, 12 postnatal discharge counselors, 20 health extension workers, and eight home care kit custodians will be conducted. A quantitative measurement of sustainability six months after the endline will also be assessed. Conclusions: Optimally, the study will contribute evidence to inform decision makers locally and globally on whether FPNC is a feasible and acceptable service delivery model for postnatal care, and whether it improves women’s empowerment and/or increases men’s support and connection to women and newborns in the early postnatal period.