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BackgroundMaternal and neonatal mortality remain elevated in low and middle income countries, and progress is slower than needed to achieve the Sustainable Development Goals. Existing strategies appear to be insufficient. One proposed alternative strategy, Service Delivery Redesign for Maternal and Neonatal Health (SDR), centers on strengthening higher level health facilities to provide rapid, definitive care in case of delivery and post-natal complications, and then promoting delivery in these hospitals, rather than in primary care facilities. However to date, SDR has not been piloted or evaluated.MethodsWe will use a prospective, non-randomized stepped-wedge design to evaluate the effectiveness and implementation of Service Delivery Redesign for Maternal and Neonatal Health in Kakamega County, Kenya.DiscussionThis protocol describes a hybrid effectiveness/implementation evaluation study with an adaptive design. The impact evaluation ("effectiveness") study focuses on maternal and newborn health outcomes, and will be accompanied by an implementation evaluation focused on program reach, adoption, and fidelity.

Original publication

DOI

10.1186/s12889-022-13578-y

Type

Journal

BMC public health

Publication Date

09/2022

Volume

22

Addresses

Harvard T.H. Chan School of Public Health, Boston, MA, USA. kcroke@hsph.harvard.edu.

Keywords

Humans, Prospective Studies, Infant, Newborn, Health Facilities, Kenya, Infant Health, Implementation Science