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Partnership for Maternal, Newborn and Child Health Project

KENYA, 2013
Health and Well-Being (HaW)
African Population and Health Research Center, , , , ,
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Identification

IDNO
APHRC-PAMANECH-2014-1.0
Title
Partnership for Maternal, Newborn and Child Health Project
Country
Name Country code
KENYA KEN
Abstract
Introduction;

Rapid urbanization in Kenya has resulted in growth of slums in urban centres, characterised by poverty, inadequate social services and poor health outcomes. The government's initiatives to improve access to quality health care for mothers and children are largely limited to public health facilities which are few and/or inaccessible in underserved areas like the slums. The 'Partnership for Maternal, Newborn and Child Health' (PAMANECH) project is being implemented in two Nairobi slums, Viwandani and Korogocho to assess the impact of strengthening public-private partnerships for the delivery of health care on the health of mothers, newborns and young children in two informal settlements in Kenya.

Methods and analysis;

A quasi-experimental study. Our approach is to support both private and public health providers and the community to enhance access to, and demand for quality health care services. Key activities include; infrastructural upgrade of selected Private Not-For-Profit health facilities operating in the two slums, building capacity for both health care providers and the Health Management Teams in Nairobi, facilitating provision of supportive supervision by the local health authorities and forming networks of Community Health Volunteers (CHVs) to create demand for the health services. To assess the impact of the intervention, the study is utilising multiple data sources using a combination of qualitative and quantitative methods. A baseline survey was conducted in 2013 and an end line survey will be conducted at least one year after full implementation of the intervention. Systematic monitoring and documentation of the intervention is on-going to strengthen the case for causal inference.

Ethics and dissemination.

Ethical approval for the study was obtained from the Kenya Medical Research Institute. Key messages from the results will be packaged and widely disseminated through workshops, conference presentations, reports, factsheets and academic publications to facilitate uptake by policy makers.

Version

Version Date
2013-10
Version Notes
Version 1.0 with anonymised baseline data and questionnaires

Scope

Keywords
Keyword
Public-Private Partnerships
Maternal
Newborn
Child Health
Slums
Kenya

Coverage

Geographic Coverage
Two Nairobi urban slums Korogocho and Viwandani
Unit of Analysis
Women of reproductive age and children under-five years
Universe
The direct beneficiaries of the project are women of reproductive age and children under the age of five years in the two informal settlements who make up 20% and 14% of the population, respectively. In addition, five health facilities are being upgraded and the health care providers in the selected PNFP and other public and private health facilities benefitting from training and skills upgrade. CHVs, the sCHMTs of the two sub-Counties where the study sites are located as well as the Nairobi County Health Management leadership are other direct beneficiaries. Residents of areas outside the NUDHSS as well as residents of the two slums who are male and/or older than 5 years but less than 15 years and/or older than 50 years are the indirect beneficiaries.

Producers and sponsors

Authoring entity/Primary investigators
Agency Name Affiliation
African Population and Health Research Center APHRC
Producers
Name Affiliation Role
Catherine Kyobutungi African Population and Health Research Center Primary Investigator
Pauline Bakibinga African Population and Health Research Center Co-Investigator
Eva Kamande African Population and Health Research Center Co-Investigator
Nicholas Ngomi African Population and Health Research Center Co-Investigator
Jane Osindo African Population and Health Research Center Co-Investigator
Thaddaeus Egondi African Population and Health Research Center Data analyst
Funding Agency/Sponsor
Name Role
Comic Relief, UK, through a Department for International Development (DFID) Funder
Other Identifications/Acknowledgments
Name Affiliation Role
Viwandani and Korogocho residents NHUDSS Support and participation in the research
Remare Ettarh, A.K. Ziraba, and Frederick Wekesa African Population and Health Research Center Developing study protocol
William & Flora Hewlett Foundation and the Swedish International Development Agency Core support to APHRC

Sampling

Sampling Procedure
Sampling procedure was for primary units. Random numbers were generated to select women of reproductive age (12 to 49 years) and children under 5 years from the most up-to-date Nairobi Urban Health and Demographic Surveillance System (NUHDSS) database. The sampling frame was restricted to those households that have individuals within the two study populations.
Deviations from the Sample Design
None
Response Rate
Total number of women interviewed were 849

Total number of interviews for children under 5 years were 975

Response rate: 100%
Weighting
No weighting

Data Collection

Dates of Data Collection (YYYY/MM/DD)
Start date End date
2013-09-01 2013-09-30
Mode of data collection
Face-to-face [f2f]
Supervision
Supervision was done by a supervision team that consisted of the project team research assistants and the field team leaders. Supervision was done in the following way;

1. Spot Checks

The team leaders would conduct spot check for each of the field workers in their team. The checks were done by random selection of completed interviews and during these checks the supervision team would visit the selected households to confirm whether they had been visited and interviewed by the field team. The research assistance would also randomly select completed interviews checks done by the team leaders to confirm that the data collected to confirm the same.

2. Sit ins

Were also done and this involved the supervision teams accompanying the field interviewers and “sitting in” during interviews.

The spot checks and 'sit ins” were done 3 times a week by the team leaders and twice a week by the research assistance.



To minimize errors and also prevent falsification, the team supervisors edited data collected. They only synchronized the completed data, those that had issues to be verified were brought to the attention of the field interviewer and if verification was required the field interviewer would revisit the respondent.

To minimize errors, each team leader had a maximum of 5 field interviewers.



To prevent data lose, data was backed up on the net book and external hard disc, although synchronization had numerous issues and some of our data may have been affected.
Type of Research Instrument
The women questionnaire was administered to women aged 12 - 49. The questionnaire included;

· Respondents background characteristics

· Care seeking behavior -Family planning services and knowledge, Ante Natal Care, Delivery, Post- Natal Care,

· Referral patterns

· Quality of health care facilities and interaction with Community Health Workers

· Child morbidity and Mortality

· Breastfeeding - Early initiation, breastfeeding knowledge, attitude and practice

· HIV and AIDs, and other STIs

The child questionnaire was for children under 5 years age and it was administered to parents or guardians of the children. This questionnaire included;

· Background characteristics of respondent,

· Care seeking behavior including vaccination,

· Child morbidity and mortality.

Both questionnaires were administered in Kiswahili.

Data Processing

Cleaning Operations
Data were colleted using Netbooks with inbuilt consistency checks and was synced to the central server at the office for back up. Project data analyst performed post-data collection consistency checks and labelling of variables.

Data access

Contact
Name Affiliation Email
Head Statistics and Survey Unit African Population and Health Research Center info@aphrc.org
Conditions
All non-APHRC staff seeking to use data generated at the Center must obtain written approval to use the data from the Director of Research. This form is developed to assess applications for data use and facilitate responsible sharing of data with external partners/collaborators/researchers. By entering into this agreement, the undersigned agrees to use these data only for the purpose for which they were obtained (as outlined on this form) and to abide by the conditions outlined below:

1. Data Ownership: The data remain the property of APHRC; any unauthorized reproduction and sharing of the data is strictly prohibited. The user will, therefore, not release nor permit others to use or release the data to any other person without the written authorization from the Center.

2. Purpose: The provided data must be used for the purpose specified in the Data Request Form; any other use not specified in the form must receive additional or separate authorization.

3. Respondent Identifiers: The Center is committed to protecting the identity of the respondents who provide information in its research. All analytical data sets (both qualitative and quantitative) released by the Data Unit MUST are stripped of respondent identifiers to protect the identity of the respondents. By accepting to use APHRC data, the user is pledging that he/she will not, under any circumstance, regenerate the identifiers or permit others to use the data to learn the identity of any individual, household or community included in any data set.

4. Confidentiality pledge: The user will not use nor permit others to use the data to report any information in the data sets that could identify, directly or by inference, individuals or households.

5. Reporting of errors or inconsistencies: The user will promptly notify the Head of the Statistics and Survey Unit any errors discovered in the data as soon as the errors are discovered.

6. Publications resulting from APHRC data: The Center requires external collaborators to work with APHRC staff on all publications resulting from its data. In order to facilitate this, lead authors should send a detailed concept note of the paper (including the background, rationale, data, analytical methods, and preliminary findings) to the Principle Investigator (or Theme Leader) for the project (with a copy to the Director of Research), who will circulate the abstract to concerned researchers for possible expression of interest in participating in the publication as co-authors. Any exception to the involvement of APHRC staff should be approved by the Director of Research, APHRC.

7. Security: The user will take responsibility for the security of the data by ensuring that the data are used and stored in a secure environment where access is password protected. This will ensure that non-authorized people should not have access to the data.

8. Loss of privilege to use data: In the event that APHRC determines that the data user is in violation of the conditions for using the data, or if the user wishes to cancel this agreement, the user will destroy the data files provided to him/her. APHRC retains the right to revoke this agreement or informs publishers to withhold publication of any work based wholly or in part on its data if the conditions for using the data are violated.

9. Acknowledgement: Any work/reports from this data must acknowledge APHRC as the source of these data. For example, the suggested acknowledgement for NUHDSS data is:

"This research uses livelihoods data collected under the longitudinal Nairobi Urban Health and Demographic Surveillance System (NUHDSS) since 2006. The NUHDSS is carried out by the African Population and Health Research Center in two slums settlements (Korogocho and Viwandani) in Nairobi City."

Additionally all funders, the study communities that provided the data, and staff who collected and analyzed or processed the data should be acknowledged.

10. Deposit of Reports/Papers: The user should submit electronic and paper copies of all publications generated using APHRC data to the Policy Engagement and Communications Department, with copies to the Director of Research.

11. Change of contact details: The user will promptly inform the Director of Research of any change in your personal details as contained on this data request form.
Citation requirement
African Population and Health Research Center, Partnership for Maternal, Newborn and Child Health Project, November 2014. APHRC, Nairobi, Kenya. doi:11239/176-2014-025-1.0

Metadata production

Document ID
APHRC-PAMANECH-2014-1.0
Producers
Name Abbreviation Affiliation Role
African Population and Health Research Center APHRC APHRC Metadata Producer
Date of Production
2014-11-21
Document version
Version 1.0