Health Facility Networking for Maternal Health
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 10,787
- 试验地点
- 8
- 主要终点
- Improved provider skill levels
研究概览
简要总结
This study will introduce a multi-faceted intervention package which will be implemented in the newly developed network of St. Paul's Hospital Millennium Medical College (St. Paul) and the surrounding seven satellite health centers. The goal is to assess if this group of interventions improve the skills and confidence of providers to handle obstetric emergencies, if they streamline the referral process and if they result in improved maternal/newborn health outcomes.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Sample population for each data collection instrument:
- •Baseline/Endline:
- •Key Informant Interviews:
- •St. Paul hospital: Maternal Child Health (MCH) Head, Midwife/nurse from Labor and Delivery (L&D), Midwife/nurse from Emergency
- •Health Centers: Medical Director, Head of MCH (midwife) Midwife from L&D, Referral focal person
- •Health Facility Assessment:
- •Manager/most senior health worker asked (one from each facility)
- •Provider Survey:
- •All providers in the MCH at both the hospital and health center level
- •Chart review:
- •All deliveries in all centers will be screened during the intervention phase. Data on every birth will be collected from the log books of each facility. The data collector will then find the medical record of that patient to assess the Standard of Care (SOC) during Ante-natal care (ANC)- if available from the chart, L&D and screen for an obstetric complication. If there was a complication, the near miss data will be collected.
- •Telephone registration log book:
- •all phone calls between HC and Hospital
- •Facility Checklists:
- •Forms completed by Supportive Supervision Teams at quarterly visits
- •Standardized BEmONC training evaluation
- •Will be given to every provider undergoing the training, as part of the training curriculum.
- •Monthly mentoring evaluations - for the six months post-training mentorship, for all providers who have undergone BEmONC training.
- •Supportive Supervision Gap Identification Checklists
- •Collected quarterly from each of the 9 facilities
排除标准
- 未提供
结局指标
主要结局
Improved provider skill levels
时间窗: One Year
Provider skill will be measured through baseline and endline evaluations, mentoring reports, and the standardized evaluations used in the Basic Emergency Obstetric Care trainings.
Increased use of effective interventions for obstetric emergencies
时间窗: One Year
Continuous data extraction from patient charts will be used to assess the appropriate treatment for obstetric emergencies over the study period. Additionally changes in time-to-treatment for post-partum hemorrhage and pre-eclampsia/eclampsia cases will also be assessed from patient charts.
Improved provider self-efficacy
时间窗: One Year
Improved provider confidence will be assessed at baseline and at endline with a standardized data collection instrument.
Improved standards of care for pregnant women
时间窗: One Year
Continuous extraction from patient records throughout the study period will be used to assess the trends in the Standards of Care (SOC) for Ante-natal (ANC), and care during Labor and Delivery.
Improved Referral Systems
时间窗: One Year
* Decreases the proportion of referrals made without proper prior communication to the receiving health facility * Formalized feedback mechanisms between Saint Paul and the Health Centers * Decreased number of inappropriate referrals from Health Centers to St. Paul * Appropriate back-referrals from St. Paul to Health Centers Data on Health Center/Hospital communication and referrals will be collected through phone logs, and referral sheets.
次要结局
- Sustainable, continuous quality improvement cycles through supportive supervision(One year)
研究者
Ana Langer
Professor of the Practice of Public Health Coordinator of the Dean's Special Initiative in Women and Health
Harvard School of Public Health (HSPH)