Birth Setting, Maternal Health
Conditions
Keywords
Coffee ceremony, Hospital-based deliveries, Maternal health, Ethiopia
Brief summary
This study evaluates if organizing a postpartum traditional Ethiopian coffee ceremony will provide an incentive for our antenatal care patients to eventually deliver in our hospital. Patients are randomized to either receiving, or not receiving, a postpartum coffee ceremony for them and their relatives.
Detailed description
Ethiopia has one of the highest maternal mortality rates in the world, with an estimated maternal mortality ratio of 497 per 100,000 live births. Cultural factors contribute to the underutilization of maternal health services. In 2014, only 20% of our antenatal care patients delivered in our hospital. In order to increase health facility-based delivery rates, government-funded hospitals and health centers facilitate traditional Ethiopian coffee ceremonies after delivery. We hypothesized that organizing postpartum coffee ceremonies would motivate our antenatal care patients to deliver in our hospital and would thus increase the hospital-based delivery rate.
Interventions
BEHAVIORALPostpartum coffee ceremony
The promise of a postpartum coffee ceremony
Sponsors
Gambo General Rural Hospital
University of Missouri, Kansas City
Vanderbilt University Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Masking description
No masking
Eligibility
Sex/Gender
FEMALE
Healthy volunteers
No
Inclusion criteria
* Pregnant patient * First visit to antenatal care clinic
Exclusion criteria
* Non-viable pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hospital-based Delivery Rate | Up to 9 months | Percentage of antenatal care patients that deliver in the hospital |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Health Center or Health Post-delivery Rate | Up to 9 months | Percentage of antenatal care patients that deliver in an associated health center or health post |
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Coffee Ceremony Antenatal care patients will be told on their first antenatal care visit that a postpartum coffee ceremony will be organized for them and up to 4 relatives | 237 |
| NO Coffee Ceremony Antenatal care patients will be told that they will NOT receive a postpartum coffee ceremony, as is the current status quo | 167 |
| Total | 404 |
Baseline characteristics
| Characteristic | Coffee Ceremony | NO Coffee Ceremony | Total |
|---|---|---|---|
| Age, Continuous | 24.7 years STANDARD_DEVIATION 5.3 | 25.5 years STANDARD_DEVIATION 5.5 | 25 years STANDARD_DEVIATION 5.4 |
| Antenatal care visits | 1.75 visits STANDARD_DEVIATION 1 | 1.73 visits STANDARD_DEVIATION 1 | 1.74 visits STANDARD_DEVIATION 1 |
| Cost of transportation | 6.2 Ethiopian birr STANDARD_DEVIATION 10.3 | 6.9 Ethiopian birr STANDARD_DEVIATION 13.3 | 6.5 Ethiopian birr STANDARD_DEVIATION 11.6 |
| Education grade | 5 grades STANDARD_DEVIATION 3.9 | 5.3 grades STANDARD_DEVIATION 3.9 | 5.1 grades STANDARD_DEVIATION 3.9 |
| Race/Ethnicity, Customized Missing | 1 participants | 4 participants | 5 participants |
| Race/Ethnicity, Customized Oromo | 226 participants | 155 participants | 381 participants |
| Race/Ethnicity, Customized Other | 27 participants | 26 participants | 53 participants |
| Religion Missing | 2 Participants | 3 Participants | 5 Participants |
| Religion Muslim | 198 Participants | 137 Participants | 335 Participants |
| Religion Other | 37 Participants | 27 Participants | 64 Participants |
| Sex: Female, Male Female | 237 Participants | 167 Participants | 404 Participants |
| Sex: Female, Male Male | 0 Participants | 0 Participants | 0 Participants |
| Travel time to hospital | 100.7 minutes STANDARD_DEVIATION 53 | 103.5 minutes STANDARD_DEVIATION 52.2 | 101.9 minutes STANDARD_DEVIATION 52.6 |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 237 | 0 / 167 |
| serious Total, serious adverse events | 0 / 237 | 0 / 167 |
Outcome results
Primary
Hospital-based Delivery Rate
Percentage of antenatal care patients that deliver in the hospital
Time frame: Up to 9 months
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Coffee Ceremony | Hospital-based Delivery Rate | 76 Participants |
| NO Coffee Ceremony | Hospital-based Delivery Rate | 53 Participants |
Secondary
Health Center or Health Post-delivery Rate
Percentage of antenatal care patients that deliver in an associated health center or health post
Time frame: Up to 9 months