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Table 3 Interventions for increasing facility births in sub-Saharan Africa

From: Interventions to increase facility births and provision of postpartum care in sub-Saharan Africa: a scoping review

Authors, year, Country Community level intervention Health system level intervention Intervention effect
Target Package Mode Actors Time period Target package Mode Actors Frequency
Altaye et al., 2018, Ethiopia [37] Pregnant women & family decision makers Awareness-raising: ANCs, nutrition & birth preparedness Conversation, distribution of booklets CHWs Twice during pregnancy       63% (N = 688) in the intervention group versus 56% (N = 3502) in the comparison (p = 0.011)
August et al., 2016, Tanzania [27] Pregnant women Awareness raising: ANC, birth preparedness, postpartum danger signs Individual home sessions using pictorial cards CHWs At least four times during pregnancy?       75.6% (N = 603) to 90.2% (671) in the intervention group versus 76.1% (N = 591) to 79.6% (N = 588) in the comparison group [no p-value reported]. Difference in difference: 11.5% points increase (p = 0.123)
Turan et al., 2011, Eritrea [35] Women and men Awareness raising: ANC, birth preparedness, birth danger signs Group sessions Maternal health volunteers Once a week       3% (N = 7) to 47% (N = 58) in intervention group versus 4% (N = 9) to 15% (N = 31) in the comparison group; p = 0.003
Mbonye et al., 2007, Uganda [25] Pregnant women Awareness raising: malaria, ANC, administration of malaria preventive treatment Home visits TBAs, drug vendors, CHWs, peer mobilizers Twice       From 34.3% (N = 276) before the intervention to 41.5% (N = 434) after the intervention, p = 0.02
Ommeh et al., 2019, Kenya [23] Pregnant women Ambulance voucher for delivery Enrollment Community health volunteers Once Pregnant women, ambulance drivers Ambulance voucher for delivery Enrollment during ANC & training [Not reported] Once In Suguta area: 98% (N = 52) after the intervention versus 30% (N = 16) before the intervention
In Barsaloi area: 100% (N = 33) after the intervention versus 30% (N = 10) before the intervention
Massavon et al., 2017, Uganda [26] Pregnant women Awareness raising about the voucher program Radio and stakeholders meetings Community volunteers, health providers [Not reported] Pregnant women Transport voucher for delivery Distribution during ANC [Not reported] [Not reported] 20% [N not reported] to 80% in the intervention group versus 44% [N not reported] to 61% [N not reported] in the comparison group that is a difference in difference of 43% higher in intervention group
Masavon et al., 2017, Uganda [26] Pregnant women Awareness raising about the baby kit Radio and stakeholders meetings Community volunteers, health providers [Not reported] Pregnant women Baby kits (plastic basin, soap, polythene bag, ½ kg of sugar, a piece of cotton cloth for wrapping the baby) Distribution during ANC [Not reported] [Not reported] 47% [N not reported] to 58% [N not reported] in the intervention group versus 90% [N not reported] to 71%[N not reported] in the comparison group that is a difference in difference of 30% higher in intervention group
Wang et al., 2016, Zambia [30] Pregnant women Promotion about the baby kit [Not reported] Community volunteers [Not reported] Pregnant women Baby kit (cloth, baby diaper, blanket) Promotion during ANC; distribution after delivering in health facility Health providers [Not reported for promotion]; Once (for distribution) 36.3% (N = 359) in the intervention group versus 26% (N = 304) in the comparison group (AOR: 1.63; P-value < 0.01, 95% CI: 1.29; 2.06)
Mwaniki et al., 2015, Kenya [24] Pregnant women Tracing and accompanying women to health facility for delivery Household visits TBAs, CHWs Routinely Pregnant women Pregnancy screening; ANC follow up; payment for services in installments; reduction of waiting time, iron & ARVs available, enhancement of patient privacy; dialogue with community During routine activities Health providers Routinely 52% (N = 259) after intervention versus 33% (N = 164) before the intervention, p = 0.012
Obare et al., 2013, Kenya [22] Pregnant women Voucher for maternal health expenses Identification of women through a poverty grading tool Distributors from a voucher management agency Once Pregnant women Provision of standard quality services Routine services Health providers Routinely 63% (N = 453) in the intervention group versus 37% (N = 118) in the comparison group; OR:2.1 (95% CI: 1.5 – 3.1)
Satti et al., 2012, Lesotho [31] Pregnant women Awareness raising on facility-based care; identification and accompaniment of women to the health center and back home after delivery Community gatherings (awareness raising); household visits (identification) NGO Partners in Health, maternal health workers Once a month Pregnant women HIV testing & treatment, nutrition support to babies, baby kits for women delivering in health facility; maternal waiting house Routine services NGO Partners in Health, health providers, maternal health workers Routinely 16 women on average delivering each month in the 2nd year of the intervention, compare to 12 women in the 1st year of the intervention and 4 women in the year preceding the intervention
Sangho et al., 2010, Mali [32] TBAs, pregnant women Training on delivery and resuscitation, equipment for TBAs (gloves, plastic sheets, bleach, soap, compresses) identification and awareness raising of pregnant women Session (training), [Not reported for the others] CHWs, women’s associations, [Not reported for the others] Once for training and equipment, [Not reported for awareness raising] Health providers, pregnant Training on delivery and resuscitation, equipment, care provision Session (training), routine services (care) Health providers for care, [Not reported for training] Once for training and equipment, routinely for care Dialakoroba: 93% (N = 243) after the intervention versus 86% (N = 324) before the intervention (p = 0.005)
Safébougoula: 90% (N = 271) after the intervention versus 80% (N = 304) before the intervention ( p = 0.0005)
Wilunda et al., 2016, Ethiopia [34] CHWs, village leaders, community Strengthening sensitization capacity; promotion of free maternal services Radio broadcasts for promotion, [Not reported for the others] [Not reported] [Not reported] Local health system managers, hospital, health centers, pregnant women Improving infrastructures, information system, meeting coordination, monitoring; removal of user fees, equipment of maternity wards, training and supervision of CHWs, free ambulance services, care provision Standard checklists for supervision, routine services for care, [Not reported for the others] Doctors with Africa, hospital staff (training), health providers (care) Routinely for care, [Not reported for the others] 60% [N not reported] during the intervention compared to 27% [N not reported] before the intervention; AOR: 5.04 (2.53–10.06)
  1. AOR adjusted odd ratio, OR odd ratio
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Reproductive Health

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