Effect of USAID-funded obstetric ultrasound service interventions on maternal and perinatal health outcomes at primary healthcare facilities in Ethiopia: a propensity score matching analysis.

Yitbarek, K; Tuji, A; Alemayehu, YK; Tadesse, D; Tadele, A; Tsegaye, S; Abera, Y; Abrar, M; Ibrahim, A; Esmael, S; Belete, M; Mohammed, A; Shekabdulahi, M; Olani, H; Selamu, A; Medhin, G; Gerbaba, MJ

Effect of USAID-funded obstetric ultrasound service interventions on maternal and perinatal health outcomes at primary healthcare facilities in Ethiopia: a propensity score matching analysis.

Yitbarek, K Tuji, A Alemayehu, YK Tadesse, D Tadele, A Tsegaye, S Abera, Y Abrar, M Ibrahim, A Esmael, S Belete, M Mohammed, A Shekabdulahi, M Olani, H Selamu, A Medhin, G Gerbaba, MJ

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Publisher:: BMJ
Publication Type:: Journal Article
Citation:: BMJ Open, 2022, 12, (10), pp. e065351
Issue Date:: 2022-10-11

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Field	Value	Language
dc.contributor.author	Yitbarek, K
dc.contributor.author	Tuji, A
dc.contributor.author	Alemayehu, YK
dc.contributor.author	Tadesse, D
dc.contributor.author	Tadele, A
dc.contributor.author	Tsegaye, S
dc.contributor.author	Abera, Y
dc.contributor.author	Abrar, M
dc.contributor.author	Ibrahim, A
dc.contributor.author	Esmael, S
dc.contributor.author	Belete, M
dc.contributor.author	Mohammed, A
dc.contributor.author	Shekabdulahi, M
dc.contributor.author	Olani, H
dc.contributor.author	Selamu, A
dc.contributor.author	Medhin, G
dc.contributor.author	Gerbaba, MJ
dc.date.accessioned	2023-05-22T00:59:25Z
dc.date.available	2023-05-22T00:59:25Z
dc.date.issued	2022-10-11
dc.identifier.citation	BMJ Open, 2022, 12, (10), pp. e065351
dc.identifier.issn	2044-6055
dc.identifier.issn	2044-6055
dc.identifier.uri	http://hdl.handle.net/10453/170392
dc.description.abstract	OBJECTIVE: A dimensional shift in the health service delivery in the primary healthcare setting is required to raise maternal and child well-being. This study aimed to evaluate the effect of US Agency for International Development-funded obstetric ultrasound service on maternal and perinatal health outcomes at Ethiopia's primary healthcare facilities. DESIGN: We employed a quasi-experimental study design. SETTING: The study was conducted in primary health centres located in four regions of Ethiopia. PARTICIPANTS: We used 2 years' data of 1568 mothers from 13 intervention and 13 control primary health centres. Data were obtained from Vscan, antenatal care (ANC), delivery and postnatal care registers. INTERVENTION: Use of portable obstetric ultrasound service during pregnancy. OUTCOME MEASURES: The primary outcome variables include complete four ANC visits, referral during ANC, delivery in a health facility and having postnatal care and continuum of care. The secondary outcome variable was perinatal death. RESULTS: With the kernel matching approach, we have found that having four or more ANC visits was decreased after the intervention (average treatment effect (ATE): -0.20; 95% CI: -0.23 to -0.09), and the rest of the indicators, including referral during ANC (ATE: 0.01; 95% CI: 0.15 to 0.34), institutional delivery (ATE: 0.24; 95% CI: 0.15 to 0.34) and postnatal care (ATE: 0.26; 95% CI: 0.10 to 0.37), were significantly raised because of the intervention. Similarly, we have found that perinatal death dropped considerably due to the intervention. CONCLUSION: The findings show a consistent increase in maternal health service use because of the introduction of obstetric ultrasound services at the primary health centre level. Furthermore, early detection of complications and following referral for specialty care were found to be high. The consistent rise in maternal health service use indicators calls for additional trial to test the effect of obstetric ultrasound service in other locations of the country. Furthermore, evaluating the predictive values, sensitivity and specificity of the obstetric ultrasound service is important.
dc.format	Electronic
dc.language	eng
dc.publisher	BMJ
dc.relation.ispartof	BMJ Open
dc.relation.isbasedon	10.1136/bmjopen-2022-065351
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1103 Clinical Sciences, 1117 Public Health and Health Services, 1199 Other Medical and Health Sciences
dc.subject.mesh	Delivery, Obstetric
dc.subject.mesh	Ethiopia
dc.subject.mesh	Female
dc.subject.mesh	Health Facilities
dc.subject.mesh	Humans
dc.subject.mesh	Maternal Health Services
dc.subject.mesh	Outcome Assessment, Health Care
dc.subject.mesh	Perinatal Death
dc.subject.mesh	Pregnancy
dc.subject.mesh	Prenatal Care
dc.subject.mesh	Primary Health Care
dc.subject.mesh	Propensity Score
dc.subject.mesh	Ultrasonography, Prenatal
dc.subject.mesh	United States
dc.subject.mesh	United States Agency for International Development
dc.subject.mesh	Humans
dc.subject.mesh	Ultrasonography, Prenatal
dc.subject.mesh	Prenatal Care
dc.subject.mesh	Delivery, Obstetric
dc.subject.mesh	Pregnancy
dc.subject.mesh	Health Facilities
dc.subject.mesh	Maternal Health Services
dc.subject.mesh	Primary Health Care
dc.subject.mesh	Ethiopia
dc.subject.mesh	United States
dc.subject.mesh	Female
dc.subject.mesh	United States Agency for International Development
dc.subject.mesh	Propensity Score
dc.subject.mesh	Perinatal Death
dc.subject.mesh	Outcome Assessment, Health Care
dc.subject.mesh	Delivery, Obstetric
dc.subject.mesh	Ethiopia
dc.subject.mesh	Female
dc.subject.mesh	Health Facilities
dc.subject.mesh	Humans
dc.subject.mesh	Maternal Health Services
dc.subject.mesh	Outcome Assessment, Health Care
dc.subject.mesh	Perinatal Death
dc.subject.mesh	Pregnancy
dc.subject.mesh	Prenatal Care
dc.subject.mesh	Primary Health Care
dc.subject.mesh	Propensity Score
dc.subject.mesh	Ultrasonography, Prenatal
dc.subject.mesh	United States
dc.subject.mesh	United States Agency for International Development
dc.title	Effect of USAID-funded obstetric ultrasound service interventions on maternal and perinatal health outcomes at primary healthcare facilities in Ethiopia: a propensity score matching analysis.
dc.type	Journal Article
utslib.citation.volume	12
utslib.location.activity	England
utslib.for	1103 Clinical Sciences
utslib.for	1117 Public Health and Health Services
utslib.for	1199 Other Medical and Health Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	open_access	*
dc.date.updated	2023-05-22T00:59:23Z
pubs.issue	10
pubs.publication-status	Published online
pubs.volume	12
utslib.citation.issue	10

Abstract:

OBJECTIVE: A dimensional shift in the health service delivery in the primary healthcare setting is required to raise maternal and child well-being. This study aimed to evaluate the effect of US Agency for International Development-funded obstetric ultrasound service on maternal and perinatal health outcomes at Ethiopia's primary healthcare facilities. DESIGN: We employed a quasi-experimental study design. SETTING: The study was conducted in primary health centres located in four regions of Ethiopia. PARTICIPANTS: We used 2 years' data of 1568 mothers from 13 intervention and 13 control primary health centres. Data were obtained from Vscan, antenatal care (ANC), delivery and postnatal care registers. INTERVENTION: Use of portable obstetric ultrasound service during pregnancy. OUTCOME MEASURES: The primary outcome variables include complete four ANC visits, referral during ANC, delivery in a health facility and having postnatal care and continuum of care. The secondary outcome variable was perinatal death. RESULTS: With the kernel matching approach, we have found that having four or more ANC visits was decreased after the intervention (average treatment effect (ATE): -0.20; 95% CI: -0.23 to -0.09), and the rest of the indicators, including referral during ANC (ATE: 0.01; 95% CI: 0.15 to 0.34), institutional delivery (ATE: 0.24; 95% CI: 0.15 to 0.34) and postnatal care (ATE: 0.26; 95% CI: 0.10 to 0.37), were significantly raised because of the intervention. Similarly, we have found that perinatal death dropped considerably due to the intervention. CONCLUSION: The findings show a consistent increase in maternal health service use because of the introduction of obstetric ultrasound services at the primary health centre level. Furthermore, early detection of complications and following referral for specialty care were found to be high. The consistent rise in maternal health service use indicators calls for additional trial to test the effect of obstetric ultrasound service in other locations of the country. Furthermore, evaluating the predictive values, sensitivity and specificity of the obstetric ultrasound service is important.

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http://hdl.handle.net/10453/170392