Effectiveness of a WHO Safe Childbirth Checklist Coaching-based intervention on the availability of Essential Birth Supplies in Uttar Pradesh, India.
Int J Qual Health Care
; 30(10): 769-777, 2018 Dec 01.
Article
em En
| MEDLINE
| ID: mdl-29718354
ABSTRACT
OBJECTIVE:
Evaluate the impact of a World Health Organization Safe Childbirth Checklist coaching-based intervention (BetterBirth Program) on availability and procurement of essential childbirth-related supplies.DESIGN:
Matched pair, cluster-randomized controlled trial.SETTING:
Uttar Pradesh, India.PARTICIPANTS:
120 government-sector health facilities (60 interventions, 60 controls). Supply-availability surveys were conducted quarterly in all sites. Coaches collected supply procurement sources from intervention sites.INTERVENTIONS:
Coaching targeting implementation of Checklist with data feedback and action planning. MAIN OUTCOMEMEASURES:
Mean supply availability by study arm; change in procurement sources for intervention sites.RESULTS:
At baseline, 6 and 12 months, the intervention sites had a mean of 20.9 (95% confidence interval (CI) 20.2-21.5); 22.4 (95% CI 21.8-22.9) and 22.1 (95% CI21.4-22.8) items, respectively. Control sites had 20.8 (95% CI 20.3-21.3); 20.9 (95% CI 20.3-21.5) and 21.7 (95% CI 20.8-22.6) items at the same time-points. There was a small but statistically significant higher availability in intervention sites at 6 months (difference-in-difference (DID) = 1.43, P < 0.001), which was not seen by 12 months (DID = 0.37, P = 0.53). Greater difference between intervention and control sites starting in the bottom quartile of supply availability was seen at 6 months (DID = 4.0, P = 0.0002), with no significant difference by 12 months (DID = 1.5, P = 0.154). No change was seen in procurement sources with ~5% procured by patients with some rates as high as 29% (oxytocin).CONCLUSIONS:
Implementation of the BetterBirth Program, incorporating supply availability, resulted in modest improvements with catch-up by control facilities by 12 months. Supply-chain coaching may be most beneficial in sites starting with lower supply availability. Efforts are needed to reduce reliance on patient-funding for some critical medications. TRIAL REGISTRATION ClinicalTrials.gov #NCT02148952; Universal Trial Number U1111-1131-5647.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Parto Obstétrico
/
Equipamentos e Provisões
/
Lista de Checagem
/
Melhoria de Qualidade
Tipo de estudo:
Clinical_trials
Limite:
Female
/
Humans
/
Newborn
/
Pregnancy
País/Região como assunto:
Asia
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article