About SEA-ORCHID
Project Overview
Project Design
Project Partners
Project Staff
Project Advisory Group

Summary
Each year there are over half a million maternal deaths world-wide and 98% of these occur in the developing world. This represents a tragic and striking health risk differential between the developed and developing world. For women in Asia the lifetime risk of a maternal death is one in 65 compared with one in 1,800 for women in developed countries (Reference)

By establishing a network of researchers and teachers of evidence-based health care across four South East Asian countries, supported from Australia , this collaborative project aims to improve the clinical practice of treating pregnancy and childbirth related disorders and so enhance the health outcomes of mothers and infants in SE Asia.

Aims and objectives
The SEA-ORCHID project aims to address the following broad scientific question: Can the health of mothers and babies in Thailand , Indonesia , the Philippines and Malaysia be improved by increasing capacity for research synthesis, implementation of effective interventions, and identification of gaps in knowledge needing further research?

The objectives of the SEA-ORCHID project are to answer the following questions as components of the broad question:

• What is the current teaching and practice related to pregnancy and childbirth in SE Asia?
• What are the local barriers to the use of research evidence in SE Asia and how can they be overcome?
• Will a targeted intervention to build capacity for the generation, evaluation and implementation of relevant evidence lead to improved research output, research implementation and health outcomes?

Rationale
Providing access to reliable health information for workers in developing countries is potentially the single most cost effective and achievable strategy for sustainable improvement in health care. Information provision alone however is not enough; we need to ensure that clinical practice changes in response to that information. Based on research evidence we know that changing behaviour of health workers is a complex process requiring access to information, the skills to appraise and interpret that information and a sense of having contributed to the process.

The Cochrane Collaboration has had success in the developed world in involving clinicians in the process of generating and using evidence. The intervention used in this project will draw on the experience of the Cochrane Collaboration in terms of infrastructure provision, training, support and methodological development, and involve local researchers to ensure it is regionally appropriate and result in increased capacity within SE Asia.

Design and methods
The project is an interrupted time series, which will both extend and benefit from existing networks. The project comprises five phases (pre-study, pre-intervention, intervention, outcome assessment and reporting/ dissemination) over five years. It will be conducted across seven centres; four in SE Asian and three in Australia . At each SE Asian centre a study node will be established. These will be based within existing departments and form both the study co-ordination centre and the focus for evidence-based practice activities within the region.

Project phases

1. Pre-study phase (2004)
2. Pre-intervention phase (2005)
3. Intervention phase (2006-mid 2007)
4. Outcome assessment phase (mid 2007-mid 2008)
5. Reporting phase (mid 2008-end 2008)

Participating Centres

Funding
SEA-ORCHID is jointly funded by an International Collaborative Research Grant from the National Health and Medical Research Council of Australia (No. 307703) and Wellcome Trust, United Kingdom (071672/Z/03/Z).

References
Global Health Council
Making Childbirth Safer Through Promoting Evidence-Based Care

SEA-ORCHID Study Group
SEA-ORCHID Project Protocol (as published in BMC Medical Research Methodology)

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