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Sökning: id:"swepub:oai:DiVA.org:uu-390196" > Scaling Up Safer Bi...

  • Gurung, RejinaGolden Community, Jwagal, Lalitpur, Nepal (författare)

Scaling Up Safer Birth Bundle Through Quality Improvement in Nepal (SUSTAIN) - a stepped wedge cluster randomized controlled trial in public hospitals

  • Artikel/kapitelEngelska2019

Förlag, utgivningsår, omfång ...

  • 2019-06-19
  • BMC,2019
  • electronicrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:uu-390196
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-390196URI
  • https://doi.org/10.1186/s13012-019-0917-zDOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:141212376URI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • Background: Each year, 2.2 million intrapartum-related deaths (intrapartum stillbirths and first day neonatal deaths) occur worldwide with 99% of them taking place in low- and middle-income countries. Despite the accelerated increase in the proportion of deliveries taking place in health facilities in these settings, the stillborn and neonatal mortality rates have not reduced proportionately. Poor quality of care in health facilities is attributed to two-thirds of these deaths. Improving quality of care during the intrapartum period needs investments in evidence-based interventions. We aim to evaluate the quality improvement packageScaling Up Safer Bundle Through Quality Improvement in Nepal (SUSTAIN)on intrapartum care and intrapartum-related mortality in public hospitals of Nepal.Methods: We will conduct a stepped wedge cluster randomized controlled trial in eight public hospitals with each having least 3000 deliveries a year. Each hospital will represent a cluster with an intervention transition period of 2months in each. With a level of significance of 95%, the statistical power of 90% and an intra-cluster correlation of 0.00015, a study period of 19months should detect at least a 15% change in intrapartum-related mortality. Quality improvement training, mentoring, systematic feedback, and a continuous improvement cycle will be instituted based on bottleneck analyses in each hospital. All concerned health workers will be trained on standard basic neonatal resuscitation and essential newborn care. Portable fetal heart monitors (Moyo (R)) and neonatal heart rate monitors (Neobeat (R)) will be introduced in the hospitals to identify fetal distress during labor and to improve neonatal resuscitation. Independent research teams will collect data in each hospital on intervention inputs, processes, and outcomes by reviewing records and carrying out observations and interviews. The dose-response effect will be evaluated through process evaluations.Discussion: With the global momentum to improve quality of intrapartum care, better understanding of QI package within a health facility context is important. The proposed package is based on experiences from a similar previous scale-up trial carried out in Nepal. The proposed evaluation will provide evidence on QI package and technology for implementation and scale up in similar settings.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Jha, Anjani KumarGovt Nepal, Minist Hlth & Populat, Kathmandu, Nepal (författare)
  • Pyakurel, SusheelNepal Hlth Res Council, Kathmandu, Nepal (författare)
  • Gurung, AbhishekGolden Community, Jwagal, Lalitpur, Nepal (författare)
  • Litorp, Helena,1980-Karolinska Institutet,Uppsala universitet,Global hälsa - implementering och hållbarhet(Swepub:uu)helli994 (författare)
  • Wrammert, Johan,1974-Uppsala universitet,Global hälsa - implementering och hållbarhet(Swepub:uu)johwr369 (författare)
  • Jha, Bijay KumarGovt Nepal, Minist Hlth & Populat, Kathmandu, Nepal (författare)
  • Paudel, PrajwalAnweshan, Lalitpur, Nepal (författare)
  • Rahman, Syed MoshfiqurUppsala universitet,Internationell barnhälsa och nutrition(Swepub:uu)syemo332 (författare)
  • Malla, HoneyGolden Community, Jwagal, Lalitpur, Nepal (författare)
  • Sharma, SrijanaGolden Community, Jwagal, Lalitpur, Nepal (författare)
  • Gautam, ManishAnweshan, Lalitpur, Nepal (författare)
  • Linde, Jorgen ErlandStavanger Univ Hosp, Dept Paediat, Stavanger, Norway (författare)
  • Moinuddin, MdICDDR B, Maternal & Child Hlth Div, Dhaka, Bangladesh (författare)
  • Ewald, Uwe,1945-Uppsala universitet,Global hälsa - implementering och hållbarhet(Swepub:uu)uweewald (författare)
  • Målqvist, Mats,1971-Uppsala universitet,Global hälsa - implementering och hållbarhet(Swepub:uu)matma534 (författare)
  • Axelin, AnnaUniv Turku, Turku, Finland (författare)
  • KC, Ashish,1982-Uppsala universitet,Global hälsa - implementering och hållbarhet,Soc Publ Hlth Phys Nepal, Lalitpur, Nepal(Swepub:uu)ashka967 (författare)
  • Golden Community, Jwagal, Lalitpur, NepalGovt Nepal, Minist Hlth & Populat, Kathmandu, Nepal (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:Implementation Science: BMC141748-5908

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