A&T Ethiopia Maternal Nutrition Endline Survey 2021: Nurse-Midwife

Alive & Thrive (A&T) is an initiative that supports the scaling up of nutrition interventions to save lives, prevent illnesses, and contribute to healthy growth and development through improved maternal nutrition, breastfeeding, and complementary feeding practices. In Ethiopia, A&T integrated a package of maternal nutrition interventions into existing ANC services delivered through government health facilities (interpersonal counseling on diet quality during pregnancy, counseling on iron-folic acid (IFA) supplementation, adequate weight-gain monitoring, counseling on early breastfeeding practices, and systems strengthening through training and supportive supervision) and community platforms (home visits, Pregnant Women Conferences/Mother Support groups, and community gatherings) that align with the latest global evidence. This dataset is part of a survey that was conducted to gather endline data for the impact evaluation of the interventions. The overall study objective was to determine the feasibility of integrating locally relevant maternal nutrition interventions into existing ANC services and determine the impact on diet quality and utilization of nutrition interventions during pregnancy. Research questions include: 1) What is the program impact on maternal practices: (1) consumption of diversified foods during pregnancy; (2) consumption of IFA supplements during pregnancy; and (3) early breastfeeding practices? 2) Can the coverage and utilization of key maternal nutrition interventions during ANC be improved through system strengthening approaches? 3) What factors influenced the integration and strengthening of maternal nutrition interventions into the government ANC service delivery platform? The evaluation used a two-arm cluster-randomized, non-masked trial design, consisting of two cross-sectional surveys at baseline and endline. The unit of randomization is the health center and associated health posts in the catchment area. The endline survey was conducted in August-September 2021 by Addis Continental Institute of Public Health (ACIPH), the in-country research collaborator for the survey. The endline survey included the following: 1) Pregnant women questionnaire, 2) Recently delivered women questionnaire, 3) Health Extension Worker (HEW) questionnaire, 4), Nurse-midwife questionnaire, 5) Health facility observation checklist, and 6) ANC observation checklist and exit interview. The nurse-midwife interviews were conducted using pretested, structured questionnaires. Information was collected on work responsibilities, time commitments and workload, capacity, knowledge, motivation, supervision, and ANC service provision at the health center.健康存续计划（Alive & Thrive，A&T）是一项旨在通过优化孕产妇营养、母乳喂养及辅食喂养实践，推广营养干预措施以挽救生命、预防疾病并促进健康成长与发育的倡议。在埃塞俄比亚，A&T将一系列孕产妇营养干预措施整合至现有政府卫生机构提供的产前保健（Antenatal Care，ANC）服务中，包括针对孕期饮食质量的人际咨询、铁叶酸（iron-folic acid，简称IFA）补充咨询、规范体重增长监测、早期母乳喂养实践咨询，以及通过培训与支持性督导强化服务体系；同时将相关举措整合至符合最新全球证据的社区平台，涵盖家庭访视、孕妇会议/母亲支持小组及社区集会。本数据集是为收集上述干预措施影响评估的终线数据而开展的调查的一部分。本研究的总体目标为：评估将符合当地实际的孕产妇营养干预措施整合至现有ANC服务的可行性，以及其对孕期饮食质量与营养干预措施使用率的影响。研究问题如下：1） 本项目对孕产妇行为产生了哪些影响：（1）孕期多样化食物摄入情况；（2）孕期铁叶酸补充剂摄入情况；（3）早期母乳喂养实践？2） 通过体系强化路径，能否提升ANC期间关键孕产妇营养干预措施的覆盖率与使用率？3） 哪些因素影响了孕产妇营养干预措施整合并强化至政府ANC服务提供平台的过程？本次评估采用双臂整群随机非盲试验设计，包含基线与终线两次横断面调查。随机化单元为服务覆盖区域内的卫生中心及其附属卫生所。本次终线调查于2021年8-9月由埃塞俄比亚本土研究合作方——埃塞俄比亚大陆公共卫生研究院（Addis Continental Institute of Public Health，简称ACIPH）开展。本次终线调查涵盖以下内容：1） 孕妇问卷；2） 近期分娩妇女问卷；3） 卫生推广员（Health Extension Worker，简称HEW）问卷；4） 护士-助产士问卷；5） 卫生设施观察清单；6） ANC观察清单与出口访谈。护士-助产士访谈采用经过预测试的结构化问卷开展，收集的信息涵盖工作职责、时间投入与工作量、能力水平、知识储备、工作动机、督导情况，以及卫生中心的ANC服务提供情况。