A&T Ethiopia Maternal Nutrition Baseline Survey 2019: 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 antenatal care (ANC) services delivered through government health facilities (counselling on diet quality during pregnancy, distribution and promotion of Iron Folic Acid (IFA) supplementation, weight gain monitoring, counselling 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 baseline 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 baseline survey was conducted in October-November 2019 by Addis Continental Institute of Public Health (ACIPH), the in-country research collaborator for the survey. The baseline survey included the following: 1) Pregnant women questionnaire, 2) Recently delivered women questionnaire, 3) Health Extension Worker (HEW) questionnaire, 4), Nurse-midwife questionnaire, and 5) Health facility observation checklist. 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.生存与繁荣（Alive & Thrive，简称A&T）是一项旨在通过改善孕产妇营养、母乳喂养及辅食喂养实践，推动营养干预措施规模化落地，以挽救生命、预防疾病、助力健康成长与发育的倡议。在埃塞俄比亚，A&T将一套孕产妇营养干预方案整合至现有由政府卫生机构提供的产前保健（Antenatal Care，简称ANC）服务中，具体包括孕期饮食质量咨询、铁叶酸（Iron Folic Acid，简称IFA）补充剂的发放与推广、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能力；同时将相关举措整合至社区平台，包括家庭访视、孕妇会议/母亲支持小组及社区集会，所有举措均符合最新全球循证医学证据。本数据集是为该干预措施的影响评估收集基线数据所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。研究问题包括：1）该项目对孕产妇实践产生了哪些影响：(1) 孕期多样化食物摄入情况；(2) 孕期铁叶酸补充剂服用情况；(3) 早期母乳喂养实践？2）能否通过系统强化手段提升ANC期间关键孕产妇营养干预措施的覆盖率与使用率？3）哪些因素推动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？本次评估采用双臂整群随机、非设盲试验设计，包含基线与终线两次横断面调查。随机化单位为服务覆盖区域内的卫生中心及关联卫生所。基线调查于2019年10—11月由本调查的本土研究合作方——埃塞俄比亚大陆公共卫生研究所（Addis Continental Institute of Public Health，简称ACIPH）开展。基线调查涵盖以下内容：1）孕妇问卷；2）近期分娩妇女问卷；3）健康拓展工作者（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。护士-助产士访谈采用经过预试验的结构化问卷开展，收集的信息包括工作职责、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。