The coordination WP runs throughout the duration of the project and seeks to support and define the relationships among the partners; the co-operation; and co-ordination processes, in order to ensure smooth progress of the project activities, efficient handling of any problems that may appear and risk management.
In addition, a detailed planning for the project management has been developed, which might readjust according to the needs of the project. Apart from defining the level of responsibility and authority of each person /institution involved and describing the governance structure of the project management, clear and appropriate reporting mechanisms are included. Thus, defined roles, functions, scopes of authority and systems that will help all members of the partnership to ensure effective management and monitoring of the project, will be in place.
Monitoring of the project will take place, based on SMART objectives indicators and specific deadlines. A project handbook to be developed at the first month of the project’s implementation will specify all related processes. Moreover, this handbook will present the whole project across its life- span and the contribution of each partner on the relative project’s stage, based on the implementation timeline. It will also include templates for the necessary technical and financial reporting, to be followed by all partners, ensuring the quality of the processes and the effectiveness of the implementation of the project.
On a 6- month base, a technical report will be prepared by all partners, as well as an interim and a final report by the Project Coordinator. The interim and final report will summarize the completed activities of the project and the ongoing ones, as well as a short action plan of the next period. This reporting method will enable all partners to be aware of what has been achieved so far, to early identify and manage potential risks and to control any upcoming internal or external issues.
Finally, at the early stages of the project a detailed internal communication plan will be drafted and be delivered to all partners. It will describe the project’s mechanisms and tools for internal communication, in order to assure effective and on time communication between the project partners. The relative tools will include emails, online meetings, telephones in a systematic time base, which will be determined at the kick- off meeting.
The everyday communication of the project will take advantage of teleconferences and email, while four main project meetings will take place:
a. Kick-off meeting in Luxembourg: the kick-off meeting will take place in Luxembourg in the beginning of the project. The meeting will signalize the launch of the project and will clarify the roles and tasks of different partners for the remainder of the project. All partners will attend.
b. 1st progress meeting in Athens: The 1st progress meeting will take place in Athens in month 9 of the project. The 1st progress meeting will focus on the finalization of the details of the proposed model and the developed tools while it will set the discussion for the training work package and the pilot implementation work package. oreover, partners will assess the progress of the project up to that point and discuss key issues for the interim project report. Remedial actions will be discussed and agreed in case of any divergence from the original plan. All partners will attend the meeting.
c. 2nd progress meeting in UK: The 2nd progress meeting will take place in UK in month 15 of the project. The 2nd progress meeting will focus on the specifications and the organization of the pilot implementation of the proposed model. Especially the partners from the countries that will implement the pilots (GR, UK, NL) will agree on the general framework of the group and/or individual sessions with the target groups, the reporting and documentation of the pilots, the questionnaires that will be used and the ass


The partnership will create lists containing medical associations, potentially interested organizations and experts on the field, in each participating country. During the project they will be informed on a regular basis about the project’s progress and results (e.g. development of the model and perinatal personal operation plan, piloting implementation, health professionals trained etc). Moreover, partners plan to participate to annual health related conferences in national and European level address informative letters to scientific communities and health professionals of different target groups (midwives, social workers and GPs etc.), organize consultation meetings and presentation of the results in a conference conducted by project’s coordinator and finally scientific papers with the results arising from pilot sessions.
2.1 Dissemination and communication plan. The overall project’s dissemination strategy will be determined in the dissemination plan developed at early stages of the project. The Dissemination and communication plan, delivered on M2, will describe the strategy for dissemination of project’s results, and it will be targeted at the partners of the consortium. The plan will include tasks and timelines for partners; external communication strategy with relevant stakeholders; stakeholder analysis; guidelines and specifications for the dissemination materials (project logo & website; newsletters; press releases; event scoping). In the dissemination plan, the target groups to be informed as part of the dissemination activities of the project will be specified. The focus will be on informing all relevant stakeholders on the developed tools in order to be able to better address migrants’/ refugees’ women health needs. Migrants’ and refugees’ women, will be tailored through specified dissemination channels, in order to be informed for the pilot implementation of the project and the health services that can be offered to them by the project. Important milestones to be specialized in the dissemination plan are:
- E-newsletters. Electronic newsletters will be periodically produced and disseminated to stakeholders through the web site and the project’s mailing list of stakeholders (three newsletter in total). The newsletters are targeted at the direct target groups of the project, but mainly to health professionals, policy makers, and other interested stakeholders who want to be informed about the project, the expected benefits, the learning opportunities offered to them, and how they could utilize it to improve their practices as professionals.
- Final conference, will take place in Brussels at the end of the project. A range of stakeholders will be invited, such as health professionals, policy makers etc. This event will be the formal public launch of project’s finalized materials and products, and will offer presentations of lessons learned from the project experience and the significant issues that have emerged. During the event, the partnership will present project’s results, will distribute project’s deliverables in order to promote the need of specialized healthcare for the target group of migrant and refugee pregnant women.
2.2 Presentations in external events. Besides the project’s conferences and meetings, all partners will present the project at external conferences, workshops, seminars or meetings nationally or internationally (at least 5 events). Each partner will draft minutes from his/her external event participation. These presentations would be delivered throughout the duration of the project and results will be delivered according to the progress reports.
2.3 Reporting on dissemination activities. All partners will be responsible of reporting on the dissemination activities and submit to the WP leader adequate documentation (as dissemination stakeholder lists, recipients’ lists, participants’ lists, photos from events, etc.). A final dissemination report will be developed


The partnership will develop an evaluation and quality assurance plan at the early stages of the project. This plan will specify the procedures and standards for implementation, monitoring and evaluation of the project. Moreover, the partnership will develop a relevant evaluation tool (evaluation questionnaire). The overall evaluation of the project will be performed in two phases: a) in the middle of the project and b) at the end of the project, leading to an interim and final evaluation report, respectively. An external evaluator will be subcontracted, providing an additional and independent evaluation of project’s results and outcomes.
Specifically, this WP includes the following tasks for the internal evaluation of the project:

3.1 Evaluation methodology: CMT (P3) will develop the evaluation plan with projected activities, timeline, expected results and framework of performance indicators and design evaluation methods (questionnaires, interview tools, and other methods to be specified). Important activities of the evaluation WP which will be specialized further are:
- Design of the assessment tools: Based on the developed assessment methodology, the evaluation tools will be designed (both quantitative such as questionnaires and qualitative such as interview guides).
- Interviews and/or focus group with stakeholders: A number of interviews/focus groups will be conducted in each participating country (Greece, UK and NL). The target group of the interviews will be various stakeholders as health professionals, migrant and refugee women and other relevant stakeholders.
- Analysis of the results and reporting of the assessment findings: The collected data (both quantitative and qualitative) will be analysed accordingly. The approach assessment report will include the results from the assessment of the model and the pilot sessions, recommendations for the improvement of implementation of the proposed model, policy recommendations related to the field of perinatal healthcare for migrant and refugee women and other key finding resulting from the whole experience that will be gained throughout the project.

3.2 Interim Evaluation: Partners will evaluate the progress at the interim phase of the project (interim progress meeting, formative evaluation of input processes and outputs until that moment); CMT (P3) will develop an interim evaluation report.

3.3 Final Evaluation: Partners will evaluate the progress at the end of the project (final progress meeting, summative evaluation of outputs and outcomes); CMT (P3) will develop final evaluation report

3.4 Target users evaluation: The target user evaluation (including stakeholders, visitors of the project’s web site, participants in the project’s conference and trainees), will also evaluate the project at the end of the project. CMT (P3) will collate and analyse the responses to generate a report and include it in the final evaluation report.

3.5 External evaluation of main project deliverables: As a general methodology for the evaluation of the developed refugee and migrant maternal care approach, assessment models developed by major health organizations, such as the Tanahasi model developed by WHO, will be used. Such models are used for evaluating the health service delivery performance by considering the dimensions as availability, accessibility, acceptability and quality of the targeted health outcome. The main evaluation questions will be specified and the key issues to be explored. The evaluation methodology will be further developed and specified in order to produce indicators such as:
• Comparative assessment (analysis to different health systems of member countries participating in the project)
• Economic analysis
• Perinatal health assessment on public health indicators: morbidity and mortality rate, breastfeeding rate, perinatal mental health disorders (anxiety, depression, panic attacks)
• Referrals to social services (domestic abuse, welfare benefits etc.)


State of the art activities: The overall aim of the State of the art activities is to gain a holistic knowledge of (a) the current settings & situation in Europe on addressing migrants’/refugees’ women health needs, (b) the best practices in perinatal healthcare for migrant & refugee women and (c) the emerging needs in healthcare provision & in healthcare capacity building for the healthcare professionals. In order for the partnership to identify and assess the recent progress in the field of perinatal healthcare for refugee and migrant women the following tasks will be undertaken:
4.1 EU and national context review on perinatal healthcare for migrant and refugee women. Conduct of field assessment/ mapping of healthcare provision in the different European settings in order to identify (a) The present situation and estimation of the current size of the population, (b) needs of the target groups and the needs of health professionals, (c) existing practices, social services and operational structures of healthcare provision, (d) special issues as legislation or other country specific issues to be taken into consideration. The field assessment will be conducted through:
a) A desk research for the national contexts of Greece, UK and Netherlands and
b) A European qualitative research in the national midwifery schools and/or associations that will focus on the aforementioned issues. The qualitative research through semi-constructive interviews with health professionals will be conducted through the extensive network of midwife organizations of the “European Midwifery Association” (EMA) and will be addressed mainly to European countries with high migrant and refugee population.
The produced deliverable from both the researches will be a Summative Report on EU and national context on perinatal healthcare for migrant and refugee women which will include key findings and recommendations that will be used for the development of the model, the pilot implementation and the design of the training course. The EU and national context review is essential in order to avoid duplicating existing actions /efforts at the EU level in terms of addressing migrants’/ refugees’ women health.

4.2 Development of Perinatal Guidelines for migrant and refugee women. Conduct of literature review of scientific papers and reports from major health organization (such as WHO) and medical journals on perinatal healthcare of migrant and refugee women (special risks, best practices, case studies, implementing tools, social issues etc.). The aim of the literature review is to provide evidence-based research to form the base of sound clinical practice guidelines and recommendations on perinatal healthcare of migrant and refugee women. The produced deliverable will be a set of Guidelines for Perinatal care for migrant and refugee women. The Guidelines will be widely disseminated to health professionals and health organizations throughout Europe, thought the partners’ networks, especially through the extended network of the European Midwives Association and the European Forum for Primary Care, as well as the wide network of organizations of the supporting and collaborating partners of the project

4.3 ORAMMA approach development. The ORAMMA approach on perinatal healthcare for migrant and refugee women will be characterised by four main elements in order to be “an integrated approach”: (1) it will be co-ordinated by a multidisciplinary team of experts, (2) it will be gender-approached, (3) it will be culturally-appropriate and (4) it will be mother-centred. More specifically:
(1) The multidisciplinary team of experts will consist of (a) a midwife, (b) a GP or other medical practitioner, (c) a social worker and (d) an intercultural mediator or cultural doula. The team will act in a collaborative way in order to provide co-ordinated care for the migrant or refugee pregnant woman. Each professional will provide a separate assessment of the mother, but


The process of implementing a community-based health care model, especially for migrant and refugee populations, requires a process of empowering the communities through partnerships, collaborative planning, community actions and overall community capacity building. This work package will organise and implement activities with the overall aim to prepare and empower the communities that the developed approach will be implemented. Including the community itself into the healthcare approach will facilitate the implementation, enhance the participation and increased the health benefits for the target group. The activities to be undertaken are:
5.1 Developing the action plan for the community capacity building. The action plan for community capacity building will include all the theoretical framework and the steps to community capacity building related to health provision in migrant and refugee communities. It will include important theories and strategies as the recruiting of propagating active members of the communities, raising awareness activities for the community and consultation with key stakeholders. Activities that are used by Propagating Keys facilitate the process of community empowerment. In the end, the challenges and opportunities of facilitating empowerment with collaborative partnerships for community health and development is a very important process in health education and in implementing community based models.

5.2 Set the pilot specifications for the organization, implementation, coordination and monitoring of the pilot sessions. According to the Community Capacity Building Action Plan that was developed in the previous WP, a SOP document will be developed that will specialize the action plan for the pilot implementation in Greece, UK and the Netherlands, will include organizational guidelines for the three different settings and will describe in detail the way the pilot sessions will be conducted. Moreover the pilot specifications SOP will include guidelines for reporting and documentation of the pilots. Additionally the partners will select the specific migrant and refugee communities in GR, UK and NL to pilot implement the approach. The current migrant and refugee crisis is ongoing and dynamic. Thus, the partners will choose the most appropriate communities to implement the approach the months beforehand. In order to select the communities a number of criteria will be taken into consideration as the needs of the communities, the size of the target group, the access to the target group and the recruitments possibilities of health professionals to participate in the pilot sessions.

5.3 Recruitment of health professionals and development of the multidisciplinary teams that will conduct the pilot sessions in each country. The multidisciplinary teams of experts will be developed prior to the beginning of the sessions. In each country at least on team consisted of one midwife, one GP or medical practitioner (as obstetrician or gynaecologist), one social worker, one intercultural mediator or cultural doula when applicable and one team coordinator will be selected so to carry out the pilot sessions with the pregnant migrant and refugee women, apply the ORAMMA approach and collect data/ report from the pilot sessions.

5.4 Recruiting of cultural doulas. The multidisciplinary team of health professionals is important to include a cultural doula. According to a number of recent studies, doulas can greatly aid migrant and refugee mothers in gaining access to effective care by acting as advocates, cultural brokers, and emotional and social support . More emphasis on cultural self-awareness in doula training, expanding community doula programs, and more integration of doula services in health-care settings are highly recommended. In this context, before the beginning of the pilots, the team coordinator in each setting will recruit migrant and refugee women for the role of doulas and train them to support and assist the


The pilot implementation of the proposed model will be conducted in three different European settings: in camps/hotspots in Greece, through the NHS in the UK and in municipality-based services in Netherlands. The purpose of the three settings has been made in order pilot test the model in the much different health systems throughout Europe.
The tasks to be undertaken for the pilot implementation are:

6.1 Conduct of pilot sessions. The pilot implementation of the proposed model will be conducted in three different European settings: in camps/hotspots in Greece, through the NHS in the UK and in community-based services in Netherlands and will include the following activities:
1. Detection of pregnant women: The first activity for the beginning of the pilot sessions will be for the health professionals to identify the pregnant migrant and refugee women. This activity (phase 0 of the ORAMMA approach) will be coordinated by the GPs-researchers. The GPs will be responsible for detecting the pregnancies, perform all the necessary medical action to screen the health of the women and make the referral to the midwife-coordinator.
2. Care during pregnancy: The second activity for the pilot sessions will be the pregnancy care of the migrant and refugee women, coordinated by the midwife-researcher of the project (phase 1 of the ORAMMA approach). The midwives will perform all the necessaries visits with the mothers either individually or in groups. Moreover, an important role in this phase will have the cultural doulas, since they will act both as mediators and as supporters for the mother during all the clinical tests and decision for their birth plan.
3. Support after birth: The third activity of the pilot sessions will be the support after the migrant and refugee women will have given birth (phase 2 of the ORAMMA approach). This phase will be coordinated by the social worker-researcher who will provide psychosocial support to the mothers and provide useful information about social benefits and other important issues for the family. In this phase, the midwives will also perform the post-natal check for the mother and the newborns.
In every phase each health professional will perform an evaluation of the mother that will be included in the Personal Operational Plan of each women. Each migrant or refugee woman that will be treated via the proposed model will monitored for at least a six-month period. Approximately a minimum 20-30 migrant or refugee pregnant women per country/health system will participate in the pilot sessions. More specifically a minimum number of visits with the multidisciplinary team is foreseen, unless more visits are needed due to the conditions of the woman:
• 4 midwife visits (3 ante and 1 post-natal): 150 midwife visits per country
• 1 social worker visit: 30 social worker visits per country
• 1 general physician visit: 30 general physician visits per country
The visits with the health professionals will be made either individually or in groups.

6.2 Reporting on the pilot sessions. A final report will be produced after the pilot sessions are finished that will include all the quantitative and qualitative data from the pilot sessions in order to be used for the evaluation of the pilot sessions.
Lead partner and the role of applicants
• P1 (TEI-A), will be responsible for planning; task monitoring; partner coordination; deliverable finalization; remedial action in case of divergence from planning the process.
• P1 (AMS) along with the contribution of P4 (SHU) and P5 (KNOV) will be responsible for developing the SOP document on the pilot specifications and assessment methodology.
• P1 (TEI-A), P4 (SHU) and P5 (KNOV) will be responsible for assigning team coordinators in each country/pilot settings, recruiting the health professionals who will join the multidisciplinary team, coordinate and monitor the pilot process and provide support and ongoing feedback to the multidisciplinary tea
