Maternal healthcare markets Evaluation Team – ‘MET’ (2012-2017)

MET is a cross-faculty multidisciplinary group led by Dr Caroline Lynch and Dr Catherine Goodman, currently working on an evaluation of the MSD for Mothers (MfM) initiative. The 10-year, $500 million initiative focuses on averting deaths due to postpartum haemorrhage and hypertensive diseases of pregnancy and reducing unintended pregnancies via family planning.

MSD has contracted MET as an independent external evaluator for several MfM-supported programmes. These include social franchises for maternal healthcare in India and Uganda, an innovative supply chain for family planning in Senegal and initiatives to standardise approaches to address obstetric emergencies in the US.

Data quality survey team

Data quality survey team in Senegal

The team is currently working on six projects:

Social franchising case studies: MfM is supporting three social franchising models—the Matrika project in Uttar Pradesh, the Merrygold model in Rajasthan, and the ProFam model in Uganda. The programmes share some common elements, but differ in details and key features. We are using a mixed-methods approach to examine the similarities and differences in the design and implementation of these models.

Impact evaluation of the Matrika project: The Matrika project seeks to establish a social franchise network, improve linkages between private health providers and the public sector, and improve community awareness and demand for maternal health services. The evaluation draws on quantitative and qualitative methods to show the impact of Matrika on the quality and coverage of health services along the continuum of care for reproductive, maternal and newborn health.

Nature of competition: MfM-funded interventions have a strong focus on strategies involving the private sector. These interventions take place within the context of markets where private for-profit providers compete for patients. Anticipating and interpreting the effects of these interventions requires an understanding of the nature of competition in these markets. We aim to develop this understanding by studying the market for maternal health services in Uttar Pradesh.

Jenerose Waiswa is an enrolled midwife and owner of St. Maama Tereza Clinic Domiciliary a Profam partner in Nsenkwa, Wakiso District, Uganda. She regularly conducts talks with clients about different options for birth control. Profam helps subsidize the products she provides in her clinic so that they can be affordable to lower to middle income Ugandans. An IUD costs 3,000 Uganda Shillings or the equivalent of $1.25 US dollars for the IUD and insertion. June 26, 2012. Copyright © Vanessa Vick 2012

Photo credit: PACE-Uganda (KK Big Sky)

Promoting contraceptive use through evaluation and evidence (PROCEED): We are evaluating the effect of the Informed Push Model (IPM) on the availability of family planning stock in health facilities in Senegal. We are also examining the effect of the intervention on Modern Contraceptive Prevalence Rates among women of reproductive age. Our multi-dimensional approach considers the key elements of IPM, how it was implemented and how it changed. We aim to understand its acceptability within all levels of the health system and to determine the cost and cost-effectiveness of the model.

Routine data for accountability (DATA): We are collecting a set of Harmonised Indicators (HIs) from MfM-funded programmes in India, Senegal, Uganda and the United States. The aim is to collect data that can be used to ensure that projects are comparable to the greatest extent possible. The data will be used to measure the health impacts of each programme, either directly through the HIs, or via mathematical modelling.

Secondary data analysis for generating new evidence (SAGE): We are using Demographic and Health Surveys (DHS) to gain insights into the patterns, transitions and choices women in low- and middle-income countries make in accessing reproductive and maternal healthcare services.

For more information, please visit the MET website.

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