Evaluation of the Maternal and Child Survival Program (MCSP) in Mozambique Using Mixed Methods
Condition: Knowledge, Attitudes, Practice; Gender Issues
Study type: Interventional

Summary: 
      This study evaluates changes in knowledge, attitudes, practices and coverage of key
      reproductive, maternal, newborn, and child health (RMNCH) areas, including malaria, family
      planning (FP), nutrition, water, sanitation and hygiene (WASH), and gender equity among the
      population in Nampula and Sofala provinces targeted by the Maternal and Child Survival
      Program (MCSP) in Mozambique.
    

Detailed description: 
      The specific objectives of the study are to:

        1. Assess changes in knowledge, attitudes, practices and coverage (KAPC) of high-impact
           interventions related to MNCH (antenatal care, delivery, post-partum/natal care, and
           sick child care), immunization, family planning and reproductive health, nutrition, WASH
           and malaria among mothers and fathers of children age 0-23 months in MCSP supported
           areas;

        2. Evaluate the effectiveness of male engagement interventions that encourage couples
           communication at increasing antenatal care (ANC) attendance, joint birth preparedness
           and complication readiness (BPCR) plans, institutional birth, and use of modern FP;

        3. Determine the feasibility and acceptability of male engagement interventions on RMNCH
           services for clients and providers;

        4. Explore how decisions between couples are made and what may influence their decisions
           about seeking RMNCH services; and

        5. Explore the experiences of women who were referred to a health facility for themselves
           or their child for obstetric, newborn or child health complications, and examine the
           factors contributing to whether and how those referrals were completed in Nampula
           Province.

      This study is a final program evaluation that will use a mixed methods approach, including
      both quantitative and qualitative data collection.

      Quantitative data will be collected through a cross-sectional KAPC household survey of
      mothers and fathers of children age 0-23 months, replicating the same KAPC questionnaire that
      was conducted at baseline in 2016 in the same geographic areas. Questions were harmonized
      with the DHS and MICS where appropriate. Findings from the endline KAPC survey will be
      compared to findings from the baseline survey to assess changes over time in the primary
      outcomes of interest.

      Qualitative data will be collected through focus group discussions (FGDs) and in-depth
      interviews (IDIs) with clients (mothers and fathers of children age 0-23 months) and health
      providers in MCSP-supported areas. The qualitative component will be conducted to help us
      gain a more in-depth understanding of the influence of male engagement interventions on
      couples' decision-making and care-seeking related to RMNCH as well as the barriers and
      facilitators that affected the experience of identified women who were referred to health
      facilities for obstetric or newborn complications. We will explore both client and provider
      experiences with gender-equitable male engagement practices, as well as individual client
      referral narratives related to obstetric or newborn complications.
    

Intervention name(s): Health promotion and provision of RMNCH services
Intervention type(s): Behavioral
Intervention description(s): Implementation of quality, high-impact interventions at institutional and community levels to increase access to and utilization of RMNCH services
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Prevention