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Using a quality improvement approach to improve maternal and neonatal care in North Kivu, Democratic Republic of Congo
Providing quality health care services in humanitarian settings is challenging due to population displacement, lack of qualified staff and supervisory oversight, and disruption of supply chains. This study explored whether a participatory quality improvement (QI) intervention could be used in a prot...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5757313/ https://www.ncbi.nlm.nih.gov/pubmed/29231787 http://dx.doi.org/10.1080/09688080.2017.1403276 |
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author | Hynes, Michelle Meehan, Kate Meyers, Janet Maneno, Leon Mashukano Hulland, Erin |
author_facet | Hynes, Michelle Meehan, Kate Meyers, Janet Maneno, Leon Mashukano Hulland, Erin |
author_sort | Hynes, Michelle |
collection | PubMed |
description | Providing quality health care services in humanitarian settings is challenging due to population displacement, lack of qualified staff and supervisory oversight, and disruption of supply chains. This study explored whether a participatory quality improvement (QI) intervention could be used in a protracted conflict setting to improve facility-based maternal and newborn care. A longitudinal quasi-experimental design was used to examine delivery of maternal and newborn care components at 12 health facilities in eastern Democratic Republic of Congo. Study facilities were split into two groups, with both groups receiving an initial “standard” intervention of clinical training. The “enhanced” intervention group then applied a QI methodology, which involved QI teams in each facility, supported by coaches, testing small changes to improve care. This paper presents findings on two of the study outcomes: delivery of active management of the third stage of labour (AMTSL) and essential newborn care (ENC). We measured AMTSL and ENC through exit interviews with post-partum women and matched partographs at baseline and endline over a 9-month period. Using generalised equation estimation models, the enhanced intervention group showed a greater rate of change than the control group for AMTSL (aOR 3.47, 95% CI: 1.17–10.23) and ENC (OR: 49.62, 95% CI: 2.79–888.28), and achieved 100% ENC completion at endline. This is one of the first studies where this QI methodology has been used in a protracted conflict setting. A method where health staff take ownership of improving care is of even greater value in a humanitarian context where external resources and support are scarce. DOI: 10.1080/09688080.2017.1403276 |
format | Online Article Text |
id | pubmed-5757313 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
record_format | MEDLINE/PubMed |
spelling | pubmed-57573132018-12-12 Using a quality improvement approach to improve maternal and neonatal care in North Kivu, Democratic Republic of Congo Hynes, Michelle Meehan, Kate Meyers, Janet Maneno, Leon Mashukano Hulland, Erin Reprod Health Matters Article Providing quality health care services in humanitarian settings is challenging due to population displacement, lack of qualified staff and supervisory oversight, and disruption of supply chains. This study explored whether a participatory quality improvement (QI) intervention could be used in a protracted conflict setting to improve facility-based maternal and newborn care. A longitudinal quasi-experimental design was used to examine delivery of maternal and newborn care components at 12 health facilities in eastern Democratic Republic of Congo. Study facilities were split into two groups, with both groups receiving an initial “standard” intervention of clinical training. The “enhanced” intervention group then applied a QI methodology, which involved QI teams in each facility, supported by coaches, testing small changes to improve care. This paper presents findings on two of the study outcomes: delivery of active management of the third stage of labour (AMTSL) and essential newborn care (ENC). We measured AMTSL and ENC through exit interviews with post-partum women and matched partographs at baseline and endline over a 9-month period. Using generalised equation estimation models, the enhanced intervention group showed a greater rate of change than the control group for AMTSL (aOR 3.47, 95% CI: 1.17–10.23) and ENC (OR: 49.62, 95% CI: 2.79–888.28), and achieved 100% ENC completion at endline. This is one of the first studies where this QI methodology has been used in a protracted conflict setting. A method where health staff take ownership of improving care is of even greater value in a humanitarian context where external resources and support are scarce. DOI: 10.1080/09688080.2017.1403276 2017-12-12 2017-11 /pmc/articles/PMC5757313/ /pubmed/29231787 http://dx.doi.org/10.1080/09688080.2017.1403276 Text en This is an Open Access article that has been identified as being free of known restrictions under copyright law, including all related and neighboring rights (https://creativecommons.org/publicdomain/mark/1.0/). You can copy, modify, distribute and perform the work, even for commercial purposes, all without asking permission. |
spellingShingle | Article Hynes, Michelle Meehan, Kate Meyers, Janet Maneno, Leon Mashukano Hulland, Erin Using a quality improvement approach to improve maternal and neonatal care in North Kivu, Democratic Republic of Congo |
title | Using a quality improvement approach to improve maternal and neonatal care in North Kivu, Democratic Republic of Congo |
title_full | Using a quality improvement approach to improve maternal and neonatal care in North Kivu, Democratic Republic of Congo |
title_fullStr | Using a quality improvement approach to improve maternal and neonatal care in North Kivu, Democratic Republic of Congo |
title_full_unstemmed | Using a quality improvement approach to improve maternal and neonatal care in North Kivu, Democratic Republic of Congo |
title_short | Using a quality improvement approach to improve maternal and neonatal care in North Kivu, Democratic Republic of Congo |
title_sort | using a quality improvement approach to improve maternal and neonatal care in north kivu, democratic republic of congo |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5757313/ https://www.ncbi.nlm.nih.gov/pubmed/29231787 http://dx.doi.org/10.1080/09688080.2017.1403276 |
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