Ethiopia Performance Monitoring for Action (EPMA)
Ethiopia Performance Monitoring for Action (EPMA) is a survey project designed to generate data on a variety of Reproductive, Maternal, Newborn, Child Health (RMNCH) indicators that inform decision making by national and regional governments. The project implements cross-sectional and cohort surveys to collect information not currently measured by other large-scale surveys, focusing on the RMNCH continuum of care and the barriers and facilitators to such care.
Project Leadership & Governance
The Addis Ababa University School of Public Health (AAU), led by Principal Investigator Dr. Solomon Shiferaw and Co-Principal Investigator Dr. Assefa Seme, implements EPMA in close collaboration with the Federal Ministry of Health (MOH) and the Ethiopian Statistical Service (ESS).
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Strategic Framework
Two Primary Outcomes
Ethiopia Performance Monitoring for Action (EPMA) is organized around two overarching primary outcomes designed to institutionalize data generation and advance regional research excellence.
Country-Owned RMNCH Survey Research Platform Established Within the Country's Data Architecture
The RMNCH survey research platform includes:
1)Implementing a cross-sectional nationally and regionally representative survey—one focusing on health facilities (service delivery points [SDPs]) and the other on households including women of reproductive age (WRA) and 9–14 girls, providing estimates on key RMNCH, adolescent health, and selected nutrition indicators.
2)A cohort study (panel survey) representing five regions focusing on maternal and newborn health (MNH) and postpartum family planning (PPFP).
Household & WRA Survey
Interviews the household head and women aged 9 to 49. (Only HPV vaccination-related questions are measured from the 9 to 14-year age group). Measures household characteristics, water & sanitation, respondent background characteristics, fertility, marriage, awareness and use of family planning methods, childhood vaccination, complementary feeding, and neonatal, infant, and child mortality.
Women's autonomy, violence against women, and household head perspectives on social accountability.
Health Facility (SDP) Survey
Conducted in Service Delivery Points (SDPs) to measure RMNCH and adolescent health service availability, service readiness, Health Information System (HIS) implementation, and selected health systems building block indicators.
SDP sample is linked with household/women data and conducted at the exact same time, providing invaluable insights into how the service environment shapes service access and utilization.
Cohort Study (Panel Survey)
Longitudinal panel study representing five regions in Ethiopia, focusing on maternal and newborn health (MNH) and postpartum family planning (PPFP).
Maternal, newborn, and infant health care indicators, child feeding habits, postpartum FP, violence during pregnancy, and women's autonomy to access maternal care.
Establish a Center of Excellence in RMNCH Survey Research in East Africa
The EPMA/AAU aspires to establish itself as a Center of Excellence (CoE) in survey research in East Africa. AAU collaborates with its local and international partner organizations to achieve this outcome. Investing in individual as well as organizational capacity of the CoE through training of postdoctoral fellows and tailored training workshops/continuing education programs will ensure the center thrives by attracting qualified professionals and diverse funding, fostering stakeholder engagement, and cultivating a dynamic research community.
Capacity & Fellowships
Individual and organizational capacity building through training of postdoctoral fellows, tailored training workshops, and continuing education programs for researchers.
FCDO Performance Financing
The credibility of PMA Ethiopia's platform attracted investment from partners. FCDO invested in PMA-Ethiopia and used it for performance-based financing of its Family Planning by Choice (FbC) Project with MOH and other stakeholders.
UNFPA Commodity Surveys
Since 2014, UNFPA has been actively conducting surveys on the availability of reproductive health supplies using the PMA platform in Ethiopia.
Core Measurement Scope
Key Survey Indicators & Objectives
The EPMA surveys aim to provide nationally and regionally representative estimates of key RMNCH indicators from household and service delivery points, including but not limited to:
Continuum of Care (Two-Yearly)
Contraceptive use, Antenatal Care (ANC), delivery, Postnatal Care (PNC), Immunization, Postpartum Family Planning (PPFP), and other related indicators on a two-yearly basis.
Family Planning Intent
Intent to use a family planning method among women of reproductive age.
Essential Newborn Practices
Status and adoption of essential newborn practices during and immediately after delivery.
Stockouts & Service Readiness
Stockout of contraceptives and essential medicines and service readiness of health facilities to provide quality RMNCH services.
Geographic & Spatial Disparities
Monitor geographic and spatial disparity in coverage of key RMNCH indicators across national and regional levels.
Adolescent HPV Vaccination
Coverage of the HPV vaccination among 9–14-year-old adolescent girls.
Health Service Utilization Factors
Identify factors associated with the use of health services, including individual, partner, and community influences.
Reproductive Empowerment & Norms
Develop and/or validate measures of reproductive empowerment, fertility intention, and community norms that influence access to and use of health services.
DHIS2 Data Validation
Validate selected service statistics that health facilities capture with the national DHIS2 platform.
Platform Capabilities
Features of EPMA
EPMA leverages specialized methodology and technology infrastructure to deliver accurate and reliable public health metrics across Ethiopia.
Innovative Mobile Technology
GPS, time stamps, and QR/Bar code tracking for verifiable, high-precision field data collection.
Annual (or Semi-Annual) Indicators
Rapid-frequency health indicator measurement supporting timely monitoring, evaluation, and national planning.
Consistency with DHS Measures
Provides consistency with standard DHS measures while introducing new indicators of quality, choice, access, and empowerment.
Expandable Health Platform
Establishes a platform that is expandable to data collection needs within the health and related sectors (e.g., Reproductive Health Commodity Survey supported by UNFPA).
Strengthens Local Capacity
Grounded in an established network of partner universities/research institutions and a nationwide network of resident enumerators.
National Ownership & Evidence
Milestones & Governance
Commissioning by the Strategic Affairs Directorate
EPMA has achieved significant milestones, including serving as an evidence source in the areas of RMNCH/FP for the Ministry of Health (MOH) to develop policies, programs, and guidelines. This was reinforced by the official commissioning of the EPMA platform by the Strategic Affairs Directorate to address MOH’s data needs in Reproductive, Maternal, and Newborn Health (RMNCH) and Family Planning (FP).
Chaired by the State Minister of Health
The initiative established a Project Advisory Board (PAB), chaired by the State Minister of Health and comprising RMNCH/FP stakeholders, which guided the inclusion of contextually relevant research questions and ensured accurate interpretation of findings.