Cargando…

Impact evaluation of a maternal and neonatal health training intervention in private Ugandan facilities

Global and country-specific targets for reductions in maternal and neonatal mortality in low-resource settings will not be achieved without improvements in the quality of care for optimal facility-based obstetric and newborn care. This global call includes the private sector, which is increasingly s...

Descripción completa

Detalles Bibliográficos
Autores principales: Baumgartner, Joy Noel, Headley, Jennifer, Kirya, Julius, Guenther, Josh, Kaggwa, James, Kim, Min Kyung, Aldridge, Luke, Weiland, Stefanie, Egger, Joseph
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8359744/
https://www.ncbi.nlm.nih.gov/pubmed/34184060
http://dx.doi.org/10.1093/heapol/czab072
_version_ 1783737601226702848
author Baumgartner, Joy Noel
Headley, Jennifer
Kirya, Julius
Guenther, Josh
Kaggwa, James
Kim, Min Kyung
Aldridge, Luke
Weiland, Stefanie
Egger, Joseph
author_facet Baumgartner, Joy Noel
Headley, Jennifer
Kirya, Julius
Guenther, Josh
Kaggwa, James
Kim, Min Kyung
Aldridge, Luke
Weiland, Stefanie
Egger, Joseph
author_sort Baumgartner, Joy Noel
collection PubMed
description Global and country-specific targets for reductions in maternal and neonatal mortality in low-resource settings will not be achieved without improvements in the quality of care for optimal facility-based obstetric and newborn care. This global call includes the private sector, which is increasingly serving low-resource pregnant women. The primary aim of this study was to estimate the impact of a clinical and management-training programme delivered by a non-governmental organization [LifeNet International] that partners with clinics on adherence to global standards of clinical quality during labour and delivery in rural Uganda. The secondary aim included describing the effect of the LifeNet training on pre-discharge neonatal and maternal mortality. The LifeNet programme delivered maternal and neonatal clinical trainings over a 10-month period in 2017–18. Direct clinical observations of obstetric deliveries were conducted at baseline (n = 263 pre-intervention) and endline (n = 321 post-intervention) for six faith-based, not-for-profit primary healthcare facilities in the greater Masaka area of Uganda. Direct observation comprised the entire delivery process, from initial client assessment to discharge, and included emergency management (e.g. postpartum haemorrhage and neonatal resuscitation). Data were supplemented by daily facility-based assessments of infrastructure during the study periods. Results showed positive and clinically meaningful increases in observed handwashing, observed delayed cord clamping, partograph use documentation and observed 1- and/or 5-minute APGAR assessments (rapid scoring system for assessing clinical status of newborn), in particular, between baseline and endline. High-quality intrapartum facility-based care is critical for reducing maternal and early neonatal mortality, and this evaluation of the LifeNet intervention indicates that their clinical training programme improved the practice of quality maternal and neonatal healthcare at all six primary care clinics in Uganda, at least over a relatively short-term period. However, for several of these quality indicators, the adherence rates, although improved, were still far from 100% and could benefit from further improvement via refresher trainings and/or a closer examination of the barriers to adherence.
format Online
Article
Text
id pubmed-8359744
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-83597442021-08-13 Impact evaluation of a maternal and neonatal health training intervention in private Ugandan facilities Baumgartner, Joy Noel Headley, Jennifer Kirya, Julius Guenther, Josh Kaggwa, James Kim, Min Kyung Aldridge, Luke Weiland, Stefanie Egger, Joseph Health Policy Plan Original Article Global and country-specific targets for reductions in maternal and neonatal mortality in low-resource settings will not be achieved without improvements in the quality of care for optimal facility-based obstetric and newborn care. This global call includes the private sector, which is increasingly serving low-resource pregnant women. The primary aim of this study was to estimate the impact of a clinical and management-training programme delivered by a non-governmental organization [LifeNet International] that partners with clinics on adherence to global standards of clinical quality during labour and delivery in rural Uganda. The secondary aim included describing the effect of the LifeNet training on pre-discharge neonatal and maternal mortality. The LifeNet programme delivered maternal and neonatal clinical trainings over a 10-month period in 2017–18. Direct clinical observations of obstetric deliveries were conducted at baseline (n = 263 pre-intervention) and endline (n = 321 post-intervention) for six faith-based, not-for-profit primary healthcare facilities in the greater Masaka area of Uganda. Direct observation comprised the entire delivery process, from initial client assessment to discharge, and included emergency management (e.g. postpartum haemorrhage and neonatal resuscitation). Data were supplemented by daily facility-based assessments of infrastructure during the study periods. Results showed positive and clinically meaningful increases in observed handwashing, observed delayed cord clamping, partograph use documentation and observed 1- and/or 5-minute APGAR assessments (rapid scoring system for assessing clinical status of newborn), in particular, between baseline and endline. High-quality intrapartum facility-based care is critical for reducing maternal and early neonatal mortality, and this evaluation of the LifeNet intervention indicates that their clinical training programme improved the practice of quality maternal and neonatal healthcare at all six primary care clinics in Uganda, at least over a relatively short-term period. However, for several of these quality indicators, the adherence rates, although improved, were still far from 100% and could benefit from further improvement via refresher trainings and/or a closer examination of the barriers to adherence. Oxford University Press 2021-06-29 /pmc/articles/PMC8359744/ /pubmed/34184060 http://dx.doi.org/10.1093/heapol/czab072 Text en © The Author(s) 2021. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Baumgartner, Joy Noel
Headley, Jennifer
Kirya, Julius
Guenther, Josh
Kaggwa, James
Kim, Min Kyung
Aldridge, Luke
Weiland, Stefanie
Egger, Joseph
Impact evaluation of a maternal and neonatal health training intervention in private Ugandan facilities
title Impact evaluation of a maternal and neonatal health training intervention in private Ugandan facilities
title_full Impact evaluation of a maternal and neonatal health training intervention in private Ugandan facilities
title_fullStr Impact evaluation of a maternal and neonatal health training intervention in private Ugandan facilities
title_full_unstemmed Impact evaluation of a maternal and neonatal health training intervention in private Ugandan facilities
title_short Impact evaluation of a maternal and neonatal health training intervention in private Ugandan facilities
title_sort impact evaluation of a maternal and neonatal health training intervention in private ugandan facilities
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8359744/
https://www.ncbi.nlm.nih.gov/pubmed/34184060
http://dx.doi.org/10.1093/heapol/czab072
work_keys_str_mv AT baumgartnerjoynoel impactevaluationofamaternalandneonatalhealthtraininginterventioninprivateugandanfacilities
AT headleyjennifer impactevaluationofamaternalandneonatalhealthtraininginterventioninprivateugandanfacilities
AT kiryajulius impactevaluationofamaternalandneonatalhealthtraininginterventioninprivateugandanfacilities
AT guentherjosh impactevaluationofamaternalandneonatalhealthtraininginterventioninprivateugandanfacilities
AT kaggwajames impactevaluationofamaternalandneonatalhealthtraininginterventioninprivateugandanfacilities
AT kimminkyung impactevaluationofamaternalandneonatalhealthtraininginterventioninprivateugandanfacilities
AT aldridgeluke impactevaluationofamaternalandneonatalhealthtraininginterventioninprivateugandanfacilities
AT weilandstefanie impactevaluationofamaternalandneonatalhealthtraininginterventioninprivateugandanfacilities
AT eggerjoseph impactevaluationofamaternalandneonatalhealthtraininginterventioninprivateugandanfacilities