Impact evaluation of KOICA MNCH project in Jimma Ethiopia using a difference in differences analysis

BACKGROUND: The maternal mortality ratio in Ethiopia is 412, which is higher than its neighboring countries. To address this issue and improve the health of women of childbearing age, the Maternal Neonatal and Child Health (MNCH) project was implemented in Jimma zone, Oromia, Ethiopia with support from the Korea International Cooperation Agency (KOICA). The objective of this study is to measure the impact of the project on maternal health in Jimma, Ethiopia. METHODS: The study employed DID analysis to measure the impact of the project on five key variables, including ANC 4, institutional delivery, satisfaction with MCH-related services, pregnancy-related knowledge, and delivery-related knowledge. A total of 789 participants were randomly selected for the baseline survey from both the intervention and control groups in 2017. The same groups were surveyed again one year later using the same study design for the endline survey. RESULTS: The study found that the trends in ANC4 and the level of satisfaction with the MCH service provided were similar in both the intervention and control groups. However, significant impacts were observed in terms of institutional delivery, pregnancy-related knowledge, and delivery-related knowledge. The odds ratio for institutional delivery was 2.83 (p < 0.01) for women in the intervention group compared to the control group. Similarly, the odds ratio for pregnancy-related knowledge was 0.67 (p < 0.01), and the odds ratio for delivery-related knowledge was 1.70 (p < 0.01) for women in the intervention group compared to the control group. CONCLUSIONS: The study concludes that the KOICA MNCH project partially achieved its objective, as the intervention had a positive impact on institutional delivery and maternal knowledge levels. However, the insignificant impact on ANC4 and the level of satisfaction with MCH services suggest the need for further intervention to fully address maternal health issues in Ethiopia. KEY MESSAGES: • This study is significant because it has provided empirical evidence that maternal health projects implemented in the Jimma Zone of Ethiopia can positively impact various aspects of maternal health. • The results of this study can serve as a valuable reference for policymakers and healthcare professionals involved in designing and implementing maternal health interventions.