Ethiopia: Saving Newborn Lives Project / Community-Based Interventions for Newborns in Ethiopia (COMBINE) Project

Dates: 2007-2013

Country: Ethiopia

Client(s): Save the Children

Services: Assessment, Monitoring, Evaluation, and Research

Technical Expertise: Newborn and Child Health , Universal Health Coverage, Research, Monitoring, and Evaluation


Nearly 120,000 newborns die of preventable causes annually in Ethiopia. The high neonatal mortality rate is attributable to various factors: A majority of the population is at least 10 kilometers away from a health center and coverage of maternal and child health services in the country is extremely low. Nearly half (44%) of neonatal deaths in the country are due to infections, most of which are easily treatable. Unfortunately, treatment is not readily accessible to communities and few caretakers seek care at health centers when their child is ill.

Under the Saving the Newborn Lives Project, Save the Children USA and John Snow, Inc., in collaboration with the Federal Ministry of Health (FMoH), Ethiopian Paediatrics Society, WHO, and UNICEF are conducting a randomized control trial for community-based treatment of neonatal infections and pneumonia. The Community Based Interventions for Newborns in Ethiopia (COMBINE) uses Health Extension Workers (HEWs) with support from Community Health Promoters (CHPs) to expand essential newborn care practices, recognition of danger signs, and prompt care seeking in households.

Collaboration between community volunteers (CHP) and health extension workers (HEW) forms the cornerstone of COMBINE's approach to reach mothers and newborns. This study will assess the effectiveness, feasibility, acceptability, and cost of integrating community-based management of neonatal infections and pneumonia by HEWs into the current Ministry of Health's training and implementation of integrated management of childhood illness (IMNCI) as well as building the capacity of HEWs and CHPs to improve newborn care practices, home management of illness, and care seeking practices for sick neonates.