Maternal and neonatal mortality and morbidity remain unacceptably high in many low and middle income
countries. SEA-ORCHID was a five year international collaborative project in South East Asia which aimed to determine
whether health care and health outcomes for mothers and babies could be improved by developing capacity for research
generation, synthesis and use.
Methods: Nine hospitals in Indonesia, Malaysia, the Philippines and Thailand participated in SEA-ORCHID. These hospitals
were supported by researchers from three Australian centres. Health care practices and outcomes were assessed for 1000
women at each hospital both before and after the intervention. The capacity development intervention was tailored to the
needs and context of each hospital and delivered over an 18 month period. Main outcomes included adherence to forms of
care likely to be beneficial and avoidance of forms of care likely to be ineffective or harmful.
Results: We observed substantial variation in clinical practice change between sites. The capacity development intervention
had a positive impact on some care practices across all countries, including increased family support during labour and
decreased perineal shaving before birth, but in some areas there was no significant change in practice and a few beneficial
practices were followed less often.
Conclusion: The results of SEA-ORCHID demonstrate that investing in developing capacity for research use, synthesis and
generation can lead to improvements in maternal and neonatal health practice and highlight the difficulty of implementing
evidence-based practice change.