New Global Health Action supplement sharing MANIFEST findings

A new collection of research articles in the journal Global Health Action shares findings from the Maternal and Neonatal Implementation for Equitable Systems (MANIFEST) study in Uganda, led by the Makerere University School of Public Health in Kampala. The team, who are partners in Future Health Systems, used a participatory action research approach to engage different actors to improve maternal and neonatal health outcomes in the districts of Pallisa, Kibuku and Kamuli, in eastern Uganda.

Taking a systems lens to consider how numerous levels and partners dynamically interact to advance or stall maternal and newborn health, the MANIFEST team built on previous interventions that led to significant, if isolated, gains in community newborn health practices and facility deliveries.

MANIFEST’s blend of interventions comprised support for community outreach in the form of community health worker (CHW) home visits, coupled with community awareness (dialogues, radio) and community capacity strengthening (community savings and transport initiatives) to ensure that, with community support, mothers and families felt empowered to seek timely care. To ensure that this increased demand was met with quality services, MANIFEST also facilitated enabling environments for healthcare workers to respond through supportive supervision, clinical mentoring and participatory action research steered by local district health teams.

This collection of articles highlights the evidence and learning generated from the MANIFEST study, and identifies a number of implications for future efforts to strengthen maternal and newborn health, as well as considerations for further research.

Articles in the supplement:

• Maternal and newborn health implementation research: programme outcomes, pathways of change and partnerships for equitable health systems in Uganda
• Maternal and neonatal implementation for equitable systems. A study design paper
• Effect of a participatory multisectoral maternal and newborn intervention on maternal health service utilization and newborn care practices: a quasi-experimental study in three rural Ugandan districts
• Effect of a participatory multisectoral maternal and newborn intervention on birth preparedness and knowledge of maternal and newborn danger signs among women in Eastern Uganda: a quasi-experiment study
• A cascade model of mentorship for frontline health workers in rural health facilities in Eastern Uganda: processes, achievements and lessons
• Effect of support supervision on maternal and newborn health services and practices in Rural Eastern Uganda
• Balancing the cost of leaving with the cost of living: drivers of long-term retention of health workers: an explorative study in three rural districts in Eastern Uganda
• Working with community health workers to improve maternal and newborn health outcomes: implementation and scale-up lessons from eastern Uganda
• Characteristics of community savings groups in rural Eastern Uganda: opportunities for improving access to maternal health services
• ‘Nurture the sprouting bud; do not uproot it’. Using saving groups to save for maternal and newborn health: lessons from rural Eastern Uganda
• Experiences of using a participatory action research approach to strengthen district local capacity in Eastern Uganda

You can also read a blog post about the work of MANIFEST written by UNICEF Chief of Health, Stefan Peterson.