Evaluation of the Effectiveness of a Quality Improvement Intervention
- Conditions
- Maternal and Child Health
- Registration Number
- NCT04278612
- Lead Sponsor
- University of KwaZulu
- Brief Summary
This rigorous evaluation demonstrated that implementation of a time-limited quality improvement strategy effectively improved coverage of some components of an integrated maternal and child health service in a complex health environment, but we were unable to achieve the changes needed to provide a comprehensive package of care for mothers and children.
- Detailed Description
Background: Despite policies and guidelines recommending integration of health services in South Africa, provision of maternal and child health services remains fragmented. This study evaluated a rapid, scaleable, quality improvement intervention to improve integration of maternal and child health and HIV services at a primary health level, in KwaZulu-Natal, South Africa.
Methods: A three-month intervention comprised of six quality improvement mentoring visits, learning sessions with clinic staff to share learnings, and a self-administered checklist aimed to assist health workers monitor and implement an integrated package of health services for mothers and children. The study evaluated 27 clinics in four sub-districts using a stepped-wedge design. Each sub-district received the intervention sequentially in a randomly selected order. Five waves of data collection were conducted in all participating clinics between December 2016-February 2017. A multi-level, mixed effects logistic regression was used to account for random cluster fixed time and group effects using Stata V13.1.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Female
- Target Recruitment
- 1438
Women who attended the clinic for maternal and child health care services at 27 participating clinics from January 2016-February 2017.
Women who did not attend the clinic for maternal and child health care services at 27 participating clinics from January 2016-February 2017.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Primary Outcome Measures
Name Time Method Quality of Maternal and Child Care 3 months Proportion of mother-baby pairs who received comprehensive care
- Secondary Outcome Measures
Name Time Method Quality of Child Care 3 months Proportion of babies who receive growth monitoring services
Quality of Maternal Care 3 months Proportion of mothers who receive feeding advice