Principal Investigators: Dr Renaud Becquet and Prof. Richard Ngbale
The purpose is to assess whether the implementation of an innovative system based on the integration of Traditional Birth Attendants (TBAs) into the health system with strengthened collaboration between TBAs and health facilities, supported by a phone application to register pregnant women, makes it possible to identify those at high risk of obstetric complications and improve delivery rates of high-risk pregnancies in the health facilities included in this study. The study will also allow us to have a clearer picture of the number of pregnancies in the community. A process evaluation will be conducted to understand how and why the intervention worked or not.
Improving maternal and neonatal mortality indicators remains a challenge in CAR. Traditional birth attendants play an important role due to the lack of qualified staff. We will assess whether strengthening their capacity through an innovative approach and formal collaboration with health facilities may constitute a lever for improving the situation.
At the national Ministry of Health level, it is expected this study will highlight the role that TBAs can play in improving maternal health in a context like CAR with a weak access to health structures. Existing policies open the door to further collaboration with TBAs in the health system and this study has the objective to assist authorities in pursuing this way by integrating such new evidence in upcoming community health strategy and policy.
At the regional and district levels, health authorities are expected to continue the collaboration with TBAs, even after the completion of the project. Beyond the technology element of the study through the development of the mHealth application, the collaboration efforts between TBAs and the health system could continue after the study completion.
At the international level, results will feed the existing body of evidence. The phone application will be made open source for other actors to use it and improve it.
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