Details

Autor(en) / Beteiligte

• Montagu, Dominic
• Giessler, Katie
• Nakphong, Michelle Kao
• Roy, Kali Prasad
• Sahu, Ananta Basudev
• Sharma, Kovid
• Green, Cathy
• Sudhinaraset, May
• Vellakkal, Sukumar

Titel

Results of a person-centered maternal health quality improvement intervention in Uttar Pradesh, India

Ist Teil von

• PloS one, 2020-12, Vol.15 (12), p.e0242909-e0242909

Ort / Verlag

United States: Public Library of Science

Erscheinungsjahr

2020

Link zum Volltext

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Poor patient experiences during delivery in Uttar Pradesh, India is a common problem. It delays presentation at facilities after the onset of labor and contributes to poor maternal health outcomes. Patient-centered maternity care (PCMC) is recognized by the World Health Organization as critical to overall quality. Changing PCMC requires changing the process of care, and is therefore especially challenging. We used a matched case-control design to evaluate a quality improvement process directed at PCMC and based on widely established team-based methods used in many OECD countries. The intervention was introduced into three government facilities and teams supported to brainstorm and test improvements over 12 months. Progress was measured through pre-post interviews with new mothers, scored using a validated PCMC scale. Analysis included chi-squared and difference-in-difference tests. On a scale to 100, the PCMC score of the intervention group increased 22.9 points compared to controls. Deliveries attended by midwives, dais, ASHAs or non-skilled providers resulted in significantly higher PCMC scores than those attended to by nurses or doctors. The intervention was associated with one additional visit from a doctor and over two additional visits from nurses per day, compared to the control group. This study has demonstrated the effectiveness of a team-based quality improvement intervention to ameliorate women's childbirth experiences. These improvements were locally designed and led, and offer a model for potential replication.