CPHP, the Center for Public Health Practice, at the Faculty of Health Sciences (FHS) – AUB, is currently conducting an evaluation to explore the added benefits of the MAP (Medical Aid for Palestinians) Home Visitation program to existing services provided by UNRWA maternal and childcare services. The objectives of the evaluation are 1) to evaluate the effectiveness of the MAP HV program in relation to selected MCH indicators of interest, 2) to measure the additional benefits, if any, accruing to high-risk mothers and families assisted by both MAP and UNRWA, in comparison to those assisted by UNRWA only and 3) to propose a road map for improving activities and services provided by MAP to provide better support to existing UNRWA services.
In the evaluation plan, we are using a mixed method approach with both quantitative and qualitative tools for data collection and analysis, to compare a variety of outcomes in women receiving UNRWA+MAP services versus women receiving UNRWA services only within the same area. The quantitative component consists of a comparison of 12 maternal and child health outcome indicators between mothers and children benefiting from both UNRWA & MAP services and those benefiting from UNRWA services only. The qualitative component consists of gathering data from three sources through in-depth interviews and focus group discussions. These will be administered with beneficiaries of services offered by UNRWA only (from 3 different sites), beneficiaries benefiting from both MAP & UNRWA (from 4 different sites) as well as from MAP midwives/community nurses providing the intervention in the three camps where MAP Home Visitation program is implemented i.e. Ein EL Helwi, Bedawwi and Naher El Bared. The results from the quantitative analysis and the qualitative analysis will be triangulated, or cross matched, or compared, or used to explain the findings. This process will serve to maximize validity and robustness of evaluation results and enable us to draw solid recommendations to inform current and future interventions. The findings and recommendations of this evaluation are expected to become available in March 2018.
Brief Background: Worldwide, 99% of preventable maternal mortality occur in developing countries. While between 1990 and 2015, maternal and neonatal mortality worldwide dropped by around 44% and 31 % respectively, the Maternal Mortality Rate (MMR) in Low Middle Income Countries (LMICs) is still high (239 per 100,000 live births) versus (12 per 100,000 live births) in High Income Countries (HICs) in 2015. Likewise, the neonatal mortality rates were 21 per 1,000 live birth for LMICs and 3 per 1,000 live birth for HICs in 2015. In Lebanon, the MMR for Palestinian refugees is 42.1 per 100,000 live births versus 24 per 100,000 live birth and 15.8 per 100,000 live births for Palestinian refugees in Jordan and West Bank respectively. UNRWA and MAP, which are non-governmental organizations, have assisted the Palestinian refugees in providing a wide range of humanitarian aid including care services related to maternal and child health. MAP has recently introduced a Maternal and Child Health home visitation program that began to take effect 10 years ago. The MAP Home Visitation (HV) program is implemented in 5 Palestinian refugee camp sites in both North and South Lebanon including 2 in Saida (in Ein El Helwi), 1 in Naher el Bared and 1 in Bedawi.