Background: Reducing maternal mortality and improving child health outcomes are global priorities stated by the United Nations. Ethiopia, despite recent improvements, has one of the highest rates of maternal mortality globally (nearly 700 deaths/100 000 live births), and performs poorly in terms of maternal and child health (MCH) service use. The Safe Motherhood Project, a randomised cluster intervention trial led by Jimma University and the University of Ottawa, explores the implementation and scale-up of MCH initiatives in Jimma, Ethiopia.
Objectives: A needs-assessment activity was conducted to gather evidence to inform the design of a community-based information, education and communication (IEC) intervention. This research aimed to better understand perceptions of health and illness, cultural and religious beliefs relevant to MCH, and preferences about MCH IEC activities.
Methods: Qualitative data were collected at 6 rural sites in Jimma Zone through focus groups with community members, and interviews with health workers, the development army and religious leaders. 36 transcripts were translated into English, coded and analysed.
Results: Major themes included: MCH experiences; MCH traditions and beliefs; roles in promoting MCH; and MCH information sources. Participants mentioned various factors contributing to healthy pregnancies (e.g. workload, diets, hygiene) and signs of unhealthy pregnancies (e.g. nausea, vomiting, bleeding). Problems were thought to be caused by excessive exertion during pregnancy, failure to use health services and/or the will of God. Participants described harmful traditional practices and beliefs (e.g. removing baby teeth, swallowing butter, consulting traditional birth attendants), which are now done in a hidden way. Participants elaborated on the responsibilities and contributions of various groups in promoting MCH: husbands, family/community members, religious leaders, health workers, development army, and government.
Conclusions: Based on the findings, IEC modules for health workers, development army and religious leaders were developed to reinforce healthy concepts and encourage strategies to overcome barriers.