Cargando…

“Safer Births Bundle of Care” Implementation and Perinatal Impact at 30 Hospitals in Tanzania—Halfway Evaluation

Safer Births Bundle of Care (SBBC) consists of innovative clinical and training tools for improved labour care and newborn resuscitation, integrated with new strategies for continuous quality improvement. After implementation, we hypothesised a reduction in 24-h newborn deaths, fresh stillbirths, an...

Descripción completa

Detalles Bibliográficos
Autores principales: Ersdal, Hege, Mdoe, Paschal, Mduma, Estomih, Moshiro, Robert, Guga, Godfrey, Kvaløy, Jan Terje, Bundala, Felix, Marwa, Boniphace, Kamala, Benjamin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9955319/
https://www.ncbi.nlm.nih.gov/pubmed/36832384
http://dx.doi.org/10.3390/children10020255
_version_ 1784894319569666048
author Ersdal, Hege
Mdoe, Paschal
Mduma, Estomih
Moshiro, Robert
Guga, Godfrey
Kvaløy, Jan Terje
Bundala, Felix
Marwa, Boniphace
Kamala, Benjamin
author_facet Ersdal, Hege
Mdoe, Paschal
Mduma, Estomih
Moshiro, Robert
Guga, Godfrey
Kvaløy, Jan Terje
Bundala, Felix
Marwa, Boniphace
Kamala, Benjamin
author_sort Ersdal, Hege
collection PubMed
description Safer Births Bundle of Care (SBBC) consists of innovative clinical and training tools for improved labour care and newborn resuscitation, integrated with new strategies for continuous quality improvement. After implementation, we hypothesised a reduction in 24-h newborn deaths, fresh stillbirths, and maternal deaths by 50%, 20%, and 10%, respectively. This is a 3-year stepped-wedged cluster randomised implementation study, including 30 facilities within five regions in Tanzania. Data collectors at each facility enter labour and newborn care indicators, patient characteristics and outcomes. This halfway evaluation reports data from March 2021 through July 2022. In total, 138,357 deliveries were recorded; 67,690 pre- and 70,667 post-implementations of SBBC. There were steady trends of increased 24-h newborn and maternal survival in four regions after SBBC initiation. In the first region, with 13 months of implementation (n = 15,658 deliveries), an estimated additional 100 newborns and 20 women were saved. Reported fresh stillbirths seemed to fluctuate across time, and increased in three regions after the start of SBBC. Uptake of the bundle varied between regions. This SBBC halfway evaluation indicates steady reductions in 24-h newborn and maternal mortality, in line with our hypotheses, in four of five regions. Enhanced focus on uptake of the bundle and the quality improvement component is necessary to fully reach the SBBC impact potential as we move forward.
format Online
Article
Text
id pubmed-9955319
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-99553192023-02-25 “Safer Births Bundle of Care” Implementation and Perinatal Impact at 30 Hospitals in Tanzania—Halfway Evaluation Ersdal, Hege Mdoe, Paschal Mduma, Estomih Moshiro, Robert Guga, Godfrey Kvaløy, Jan Terje Bundala, Felix Marwa, Boniphace Kamala, Benjamin Children (Basel) Article Safer Births Bundle of Care (SBBC) consists of innovative clinical and training tools for improved labour care and newborn resuscitation, integrated with new strategies for continuous quality improvement. After implementation, we hypothesised a reduction in 24-h newborn deaths, fresh stillbirths, and maternal deaths by 50%, 20%, and 10%, respectively. This is a 3-year stepped-wedged cluster randomised implementation study, including 30 facilities within five regions in Tanzania. Data collectors at each facility enter labour and newborn care indicators, patient characteristics and outcomes. This halfway evaluation reports data from March 2021 through July 2022. In total, 138,357 deliveries were recorded; 67,690 pre- and 70,667 post-implementations of SBBC. There were steady trends of increased 24-h newborn and maternal survival in four regions after SBBC initiation. In the first region, with 13 months of implementation (n = 15,658 deliveries), an estimated additional 100 newborns and 20 women were saved. Reported fresh stillbirths seemed to fluctuate across time, and increased in three regions after the start of SBBC. Uptake of the bundle varied between regions. This SBBC halfway evaluation indicates steady reductions in 24-h newborn and maternal mortality, in line with our hypotheses, in four of five regions. Enhanced focus on uptake of the bundle and the quality improvement component is necessary to fully reach the SBBC impact potential as we move forward. MDPI 2023-01-30 /pmc/articles/PMC9955319/ /pubmed/36832384 http://dx.doi.org/10.3390/children10020255 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ersdal, Hege
Mdoe, Paschal
Mduma, Estomih
Moshiro, Robert
Guga, Godfrey
Kvaløy, Jan Terje
Bundala, Felix
Marwa, Boniphace
Kamala, Benjamin
“Safer Births Bundle of Care” Implementation and Perinatal Impact at 30 Hospitals in Tanzania—Halfway Evaluation
title “Safer Births Bundle of Care” Implementation and Perinatal Impact at 30 Hospitals in Tanzania—Halfway Evaluation
title_full “Safer Births Bundle of Care” Implementation and Perinatal Impact at 30 Hospitals in Tanzania—Halfway Evaluation
title_fullStr “Safer Births Bundle of Care” Implementation and Perinatal Impact at 30 Hospitals in Tanzania—Halfway Evaluation
title_full_unstemmed “Safer Births Bundle of Care” Implementation and Perinatal Impact at 30 Hospitals in Tanzania—Halfway Evaluation
title_short “Safer Births Bundle of Care” Implementation and Perinatal Impact at 30 Hospitals in Tanzania—Halfway Evaluation
title_sort “safer births bundle of care” implementation and perinatal impact at 30 hospitals in tanzania—halfway evaluation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9955319/
https://www.ncbi.nlm.nih.gov/pubmed/36832384
http://dx.doi.org/10.3390/children10020255
work_keys_str_mv AT ersdalhege saferbirthsbundleofcareimplementationandperinatalimpactat30hospitalsintanzaniahalfwayevaluation
AT mdoepaschal saferbirthsbundleofcareimplementationandperinatalimpactat30hospitalsintanzaniahalfwayevaluation
AT mdumaestomih saferbirthsbundleofcareimplementationandperinatalimpactat30hospitalsintanzaniahalfwayevaluation
AT moshirorobert saferbirthsbundleofcareimplementationandperinatalimpactat30hospitalsintanzaniahalfwayevaluation
AT gugagodfrey saferbirthsbundleofcareimplementationandperinatalimpactat30hospitalsintanzaniahalfwayevaluation
AT kvaløyjanterje saferbirthsbundleofcareimplementationandperinatalimpactat30hospitalsintanzaniahalfwayevaluation
AT bundalafelix saferbirthsbundleofcareimplementationandperinatalimpactat30hospitalsintanzaniahalfwayevaluation
AT marwaboniphace saferbirthsbundleofcareimplementationandperinatalimpactat30hospitalsintanzaniahalfwayevaluation
AT kamalabenjamin saferbirthsbundleofcareimplementationandperinatalimpactat30hospitalsintanzaniahalfwayevaluation