Action Leveraging Evidence to Reduce perinatal morTality and morbidity in sub-Saharan Africa

Project Information

ALERT

Grant agreement ID: 847824

DOI

10.3030/847824

Project closed

EC signature date 5 December 2019

Start date 1 January 2020

End date 31 December 2024

Funded under

• SOCIETAL CHALLENGES - Health, demographic change and well-being

Total cost

€ 3 999 976,25

EU contribution

€ 3 999 976,25

Coordinated by

KAROLINSKA INSTITUTET
Sweden

CORDIS provides links to public deliverables and publications of HORIZON projects.

Links to deliverables and publications from FP7 projects, as well as links to some specific result types such as dataset and software, are dynamically retrieved from OpenAIRE .

Deliverables

Documents, reports (8)

Trial protocol submitted

We will provide a full protocol of our intervention and evaluation design. The protocol will follow the standards of reporting as provided in the CONSORT statement for stepped-wedge cluster-randomised trials including the i) intervention details; ii) settings iii) outcomes and the assessment methods of outcomes as well as iv) a discussion on expected results. We aim to submit to BMC Implementation Science.

Methododological approach for quantitative assessment of responsiveness and mitreatment

This report will provide the methodological design of piloting, testing and implementing the quantitative assessment of responsiveness and mistreatment. We report will account of translating, response-testing, validation using other qualitative methods to investigate into responsiveness and mistreatment as well as the methods to administer the questionnaire (exit interviews versus electronic responses from home six week after birth using mobile phones).

Final report on health systems context and implementation bottlenecks

This report will provide a full account of the health systems and local health services bottlenecks and problems

Summary report of the experiences with implementing the ALERT co-design in 16 hopsitals

We will summarise the experience of implementing our co-design approach in the 4 hospitals in each of the four countries. This report should detail the methodology, the ethical challenges, the lessons learned as well how we used the co-design approach for the training and QI. Case reports will be included in this summary report.

Final synthesis report of the realist process evaluation

We will provide a full report on the learnings from the process evaluation. The report will include i) the development of the implementation theory including adaptations, the ii) final change theory; iii) the methods of assessment and iv) the results. The report will include case stories to illustrate and highlight specific lessons learned.

Final economic evaluation report

We will provide a report of the economic costs of the intervention. This report will include the i) methods used including the methods for the equity assessment ii) the assessment details and the final results. the report will follow the the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.

Synthesis report for national dissemination

This report will summarise and synthesis all experience and results accumulated during the course of implementation. The report will include different chapters illustrating the key lessons learned from WP 2,3,4,6,7 & 8 and comparative results (between country analysis). the report will also provide the final results from the stepped-wedge trial. The report will be targeted for national stakeholders particularly. Case stories will complement the report.

Full dissemination package including policy briefs

Following up from the full scientific report and the dissemination materials for the national stakeholder level, we will prepare a folder with different information material including policy briefs, blogs, newsletter, presentations and publications. The results in the different formats will be made available in printed versions as well as web-based versions.

Other (2)

Report of prototype for a perinatal e-registies

We will prepare a full protocol as well as the data quality assurance tools and the data entry platform. The report will include i) the variables to be assessed; b) the data collection details including the daily, weekly and monthly summary sheets and quality assurance measures c) and the data processing and data use details. The annex will include a detailed health providers protocol detailing instructions in relation to each variable.

Developed training modules

We will develop adapted training modules specifically to expressed needs of the care providers and observed challenges in the maternities. The deliverable will include the curriculum, the developed education materials including ppt, exercises, group work instructions etc. A facilitator guide will also be included.

Publications

Peer reviewed articles (23)

Assessment of midwifery care providers intrapartum care competencies, in four sub-Saharan countries: a mixed-method study protocol

Author(s): Ann-Beth Moller, Joanne Welsh, Mechthild M. Gross, Max Petzold, Elizabeth Ayebare, Effie Chipeta, Hashim Hounkpatin, Bianca Kandeya, Beatrice Mwilike, Antoinette Sognonvi, Claudia Hanson
Published in: Reproductive Health, Issue 18/1, 2021, ISSN 1742-4755
Publisher: BioMed Central
DOI: 10.1186/s12978-021-01109-8

Mixed vulnerabilities: the biological risk of high parity is aggravated by emergency referral in Benin, Malawi, Tanzania and Uganda

Author(s): Manuela Straneo, Lenka Beňová, Thomas van den Akker, Muzdalifat S. Abeid, Elizabeth Ayebare, Jean-Paul Dossou, Greta Handing, Bianca Kandeya, Andrea B. Pembe, Claudia Hanson
Published in: International Journal for Equity in Health, Issue 24, 2025, ISSN 1475-9276
Publisher: BioMed Central
DOI: 10.1186/s12939-025-02379-5

<i>Data for whom?</i>Experiences and perceptions of a perinatal eRegistry in two hospitals in Mtwara region, Tanzania

Author(s): Jil Molenaar, Amani Kikula, Yusufu Kionga, Hassan Tearish Berenge, Lenka Benova, Josefien van Olmen, Claudia Hanson, Muzdalifat Abeid, Andrea Barnabas Pembe
Published in: BMJ Global Health, Issue 9, 2024, Page(s) e016765, ISSN 2059-7908
Publisher: BMJ Global Health
DOI: 10.1136/bmjgh-2024-016765

Getting the numbers right: Power, creativity and ‘good’ routine maternal and neonatal health data in Southern Tanzania

Author(s): Jil Molenaar, Amani Kikula, Josefien van Olmen, Andrea Pembe, Lenka Beňová
Published in: Social Science &amp; Medicine, Issue 366, 2025, Page(s) 117668, ISSN 0277-9536
Publisher: Pergamon Press Ltd.
DOI: 10.1016/j.socscimed.2024.117668

Birth asphyxia and its association with grand multiparity and referral among hospital births: A prospective cross‐sectional study in Benin, Malawi, Tanzania and Uganda

Author(s): Greta Handing, Manuela Straneo, Christian Agossou, Phillip Wanduru, Bianca Kandeya, Muzdalifat S. Abeid, Kristi S. Annerstedt, Claudia Hanson
Published in: Acta Obstetricia et Gynecologica Scandinavica, Issue 103, 2024, Page(s) 590-601, ISSN 0001-6349
Publisher: Wiley-Blackwell
DOI: 10.1111/aogs.14754

A time-stratified, case–crossover study of heat exposure and perinatal mortality from 16 hospitals in sub-Saharan Africa

Author(s): Claudia Hanson, Jeroen de Bont, Kristi Sidney Annerstedt, Maria del Rosario Alsina, Federica Nobile, Nathalie Roos, Peter Waiswa, Andrea Pembe, Jean-Paul Dossou, Effie Chipeta, Lenka Benova, Hussein Kidanto, Cherie Part, Massimo Stafoggia, Veronique Filippi, Petter Ljungman
Published in: Nature Medicine, Issue 30, 2024, Page(s) 3106-3113, ISSN 1078-8956
Publisher: Nature Publishing Group
DOI: 10.1038/s41591-024-03245-7

“Letting themselves go during care” – exploring patient autonomy during co-designed intrapartum care in a Beninese maternity ward

Author(s): Nicole S. Rodriguez Neufeld, Christelle Boyi Hounsou, Armelle Akouavi Vigan, Regine Unkels, Gisèle Houngbo, Alice Stockart, Claudia Hanson, Jean-Paul Dossou, Helle Mölsted Alvesson
Published in: BMC Pregnancy and Childbirth, Issue 24, 2024, ISSN 1471-2393
Publisher: BioMed Central
DOI: 10.1186/s12884-024-06777-5

Understanding maternity care providers’ use of data: A qualitative study in Southern Tanzania

Author(s): Regine Unkels, Fadhlun Alwy Al-beity, Zamoyoni Julius, Elibariki Mkumbo, Andrea B Pembe, Claudia Hanson, Helle Mölsted-Alvesson
Published in: BMJ Global Health, 2022, ISSN 2059-7908
Publisher: BMJ Global Health
DOI: 10.1101/2022.10.11.22280938

Methodological reflections on health system-oriented assessment of maternity care in 16 hospitals in sub-Saharan Africa: an embedded case study

Author(s): Anteneh Asefa, Jean-Paul Dossou, Claudia Hanson, Christelle Boyi Hounsou, Gertrude Namazzi, Samuel Meja, Dickson Ally Mkoka, Gottfried Agballa, Josephine Babirye, Aline Semaan, Kristi Sidney Annerstedt, Thérèse Delvaux, Bruno Marchal, Sara Van Belle, Virginia Castellano Pleguezuelo, Lenka Beňová
Published in: Health policy and planning, Issue 37 / 10, 2022, ISSN 0268-1080
Publisher: Oxford University Press
DOI: 10.1093/heapol/czac078

Understanding maternity care providers’ use of data in Southern Tanzania

Author(s): Regine Unkels, Fadhlun Alwy Al-Beity, Zamoyoni Julius, Elibariki Mkumbo, Andrea B Pembe, Claudia Hanson, Helle Molsted-Alvesson
Published in: BMJ global health, Issue 8 / 1, 2023, ISSN 2059-7908
Publisher: BMJ Publishing Group
DOI: 10.1136/bmjgh-2022-010937

Protocol for a scoping review to identify and map in-service education and training materials for midwifery care in sub-Saharan Africa from 2000 to 2020

Author(s): Joanne Welsh, Mechthild M Gross, Claudia Hanson, Hashim Hounkpatin, Ann-Beth Moller
Published in: BMJ Open, Issue 11/3, 2021, Page(s) e047118, ISSN 2044-6055
Publisher: BMJ Publishing Group
DOI: 10.1136/bmjopen-2020-047118

Midwifery care providers' childbirth and immediate newborn care competencies: A cross-sectional study in Benin, Malawi, Tanzania and Uganda.

Author(s): Moller, A. B., Welsh, J., Agossou, C., Ayebare, E., Chipeta, E., Dossou, J. P., Gross, M. M., Houngbo, G., Hounkpatin, H., Kandeya, B., Mwilike, B., Petzold, M., & Hanson, C.
Published in: PLOS global public health, Issue 3(6), 2023, ISSN 2767-3375
Publisher: PLOS
DOI: 10.1371/journal.pgph.0001399

Strengthening capacity in hospitals to reduce perinatal morbidity and mortality through a codesigned intervention package: protocol for a realist evaluation as part of a stepped-wedge trial of the Action Leveraging Evidence to Reduce perinatal morTality and morbidity (ALERT) in sub-Saharan Africa project

Author(s): Ibukun-Oluwa Omolade Abejirinde, Virginia Castellano Pleguezuelo, Lenka Benova, Jean-Paul Dossou, Claudia Hanson, Christelle Boyi Metogni, Samuel Meja, D A Mkoka, Gertrude Namazzi, Kristi Sidney Annerstedt, Bruno Marchal, The ALERT Study Team
Published in: BMJ Open, Issue 12 / 4, 2022, ISSN 2044-6055
Publisher: BMJ Publishing Group
DOI: 10.1136/bmjopen-2021-057414

Women’s and maternity care providers’ perceptions of pain management during childbirth in hospitals in Southern Tanzania

Author(s): Katrine Thorgaard-Rasmussen, Helle Mölsted Alvesson, Andrea B. Pembe, Lilian T. Mselle, Regine Unkels, Emmy Metta, Fadhlun M. Alwy Al-beity
Published in: BMC Pregnancy and Childbirth, Issue 24, 2024, ISSN 1471-2393
Publisher: BioMed Central
DOI: 10.1186/s12884-024-06606-9

Exploring women’s experiences of care during hospital childbirth in rural Tanzania: a qualitative study

Author(s): Emmy Metta, Regine Unkels, Lilian Teddy Mselle, Claudia Hanson, Helle Molsted Alvesson, Fadhlun M. Alwy Al-beity
Published in: BMC Pregnancy and Childbirth, Issue 24, 2024, ISSN 1471-2393
Publisher: BioMed Central
DOI: 10.1186/s12884-024-06396-0

Are midwives ready to provide quality evidence-based care after pre-service training? Curricula assessment in four countries—Benin, Malawi, Tanzania, and Uganda

Author(s): Ann-Beth Moller, Joanne Welsh, Elizabeth Ayebare, Effie Chipeta, Mechthild M. Gross, Gisele Houngbo, Hashim Hounkpatin, Bianca Kandeya, Beatrice Mwilike, Gorrette Nalwadda, Max Petzold, Antoinette Sognonvi, Claudia Hanson
Published in: PLOS Global Public Health, Issue 2 / 9, 2022, ISSN 2767-3375
Publisher: PLOS
DOI: 10.1371/journal.pgph.0000605

Do in-service training materials for midwifery care providers in sub-Saharan Africa meet international competency standards? A scoping review 2000–2020

Author(s): Joanne Welsh, Hashim Hounkpatin, Mechthild M. Gross, Claudia Hanson & Ann-Beth Moller
Published in: BMC Medical Education, Issue 22 / 1, 2022, ISSN 1472-6920
Publisher: BioMed Central
DOI: 10.1186/s12909-022-03772-2

Parental participation in newborn care in the view of health care providers in Uganda: a qualitative study

Author(s): Phillip Wanduru, Claudia Hanson, Doris Kwesiga, Angelina Kakooza-Mwesige, Helle Mölsted Alvesson, Peter Waiswa
Published in: Reproductive Health, Issue 21, 2024, ISSN 1742-4755
Publisher: BioMed Central
DOI: 10.1186/s12978-024-01896-w

Mothers' perceptions and experiences of caring for sick newborns in Newborn Care Units in public hospitals in Eastern Uganda: a qualitative study.

Author(s): Wanduru, P., Hanson, C., Waiswa, P., Kakooza-Mwesige, A., & Alvesson, H. M.
Published in: Reproductive health, Issue 20(1), 106, 2023, ISSN 1742-4755
Publisher: BioMed Central
DOI: 10.1186/s12978-023-01649-1

Eliciting the Initial Programme Theory in a Realist Evaluation of Facility-Based Maternal Death Reviews in Benin: Methodological Process, Challenges and Lessons Learned

Author(s): Christelle Boyi Hounsou, Jean-Paul Dossou, Thérèse Delvaux, Lenka Beňová, Edgard-Marius Ouendo, Marjolein Zweekhorst, Bruno Marchal
Published in: International Journal of Qualitative Methods, Issue 24, 2025, ISSN 1609-4069
Publisher: International Institute for Qualitative Methodology, University of Alberta
DOI: 10.1177/16094069241309277

Quality of reporting and trends of emergency obstetric and neonatal care indicators: an analysis from Tanzania district health information system data between 2016 and 2020

Author(s): Josephine Shabani, Honorati Masanja, Sophia Kagoye, Jacqueline Minja, Shraddha Bajaria, Yeromin Mlacha, Sia Msuya, Mahundi Masoud, Daudi Simba, Andrea B. Pembe, Ahmad Mohamed Makuwani, Habib Ismail, Maro Chacha, Claud Kumalija, Ties Boerma, Claudia Hanson
Published in: BMC Pregnancy and Childbirth, Issue 23, 2023, ISSN 1471-2393
Publisher: BioMed Central
DOI: 10.1186/s12884-023-06028-z

Action leveraging evidence to reduce perinatal mortality and morbidity (ALERT): study protocol for a stepped-wedge cluster-randomised trial in Benin, Malawi, Tanzania and Uganda

Author(s): Joseph Akuze, Kristi Sidney Annerstedt, Lenka Benova, Effie Chipeta, Jean-Paul Dossou, Mechthild M. Gross, Hussein Kidanto, Bruno Marchal, Helle Mölsted Alvesson, Andrea B. Pembe, Wim van Damme, Peter Waiswa, Claudia Hanson & ALERT Study Team
Published in: BMC Health Services Research, Issue 21 / 1, 2021, ISSN 1472-6963
Publisher: BioMed Central
DOI: 10.1186/s12913-021-07155-z

Provision and utilization of maternal health services during the COVID-19 pandemic in 16 hospitals in sub-Saharan Africa.

Author(s): Semaan, A., Annerstedt, K. S., Beňová, L., Dossou, J. P., Boyi Hounsou, C., Agballa, G., Namazzi, G., Kandeya, B., Meja, S., Ally Mkoka, D., Asefa, A., El-halabi, S., & Hanson, C.
Published in: Frontiers in Global Women's Health, Issue 4, 2023, ISSN 2673-5059
Publisher: Frontiers Media S.A
DOI: 10.3389/fgwh.2023.1192473