Improving facility delivery and postpartum care coverage through facility and community based intervention in the post-Ebola context in rural Guinea

Despite efforts to reduce maternal mortality in Guinea, the proportions of facility deliveries and postpartum care remain low, especially in rural areas. Yet, most maternal deaths occur in the intra-partum and the immediate postpartum periods. In addition, the 2013-2015 EVD outbreak has inhibited communities’ motivation to use health services, due to the worsened mistrust in the government health system. In the postEVD era, the Maferinyah Centre in collaboration with the ITM, within the context of the FA4 project, has begun a new Mother and Child Cohort in Forécariah district to evaluate baseline indicators of maternal and child health in order to guide interventions. The present doctoral research is within the context of the FA4 and aims to contribute to improving quality of maternal care and increasing facility delivery and postpartum care coverage in the rural district of Forécariah, using a participatory co-designed intervention that combines facility-based and community-based activities. This will be a sequential explanatory mixed-methods study with three phases. The first phase will consist of two strands: a quantitative one to analyse ongoing cohort data to provide baseline indicators for the intervention, and a qualitative one to explore perceptions and quality of maternal care and identify suggestions that will be integrated as intervention components to improve the situation. In a second phase, the chosen intervention will be implemented at health facility at community levels. We anticipate equipping selected health facilities and training health providers to ensure quality maternal care. We also anticipate training and equipping community resource members with videos downloaded on Android ipads to increase awareness of women on maternal care, through home visits. The proposed intervention will be continuously monitored and evaluated (using both qualitative and quantitative methods) and improved based on feedback loops from the on-going research. Finally, a qualitative and quantitative assessment of the intervention strategy and effectiveness will be conducted (endline). This process will result in improved health facility delivery and postpartum care coverage in Forécariah district, rural Guinea. This research is the first of its kind in Guinea.

Trefwoorden:B680-volksgezondheid