Maternal Health Clinical Trial
Official title:
Health Facility Networking for Maternal Health
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.
Status | Completed |
Enrollment | 10787 |
Est. completion date | December 2014 |
Est. primary completion date | October 2014 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | Both |
Age group | N/A and older |
Eligibility |
Inclusion Criteria: 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 |
Intervention Model: Single Group Assignment, Masking: Open Label
Country | Name | City | State |
---|---|---|---|
Ethiopia | Addis Ketema Health Center | Addis Ketema Subcity, Woreda 4 | |
Ethiopia | Woreda 7 Health Center | Addis Ketema Subcity, Woreda 9, Addis Ababa, | |
Ethiopia | Semen Health Center | Arada Sub City, Addis Ababa | |
Ethiopia | Selam Health Center | Gulele Sub City, Woreda 9, Addis Ababa | |
Ethiopia | St. Paul Hospital Millennium Medical College | Gulele Subcity, Addis Ababa | |
Ethiopia | Shegole Health Center | Gulele Subcity, Woreda 10, Addis Ababa | |
Ethiopia | Woreda 7 Health Center | Gulele Subcity, Woreda 7 | |
Ethiopia | Kolfe Health center | Kolfe sub City, Woreda 2, Addis Ababa |
Lead Sponsor | Collaborator |
---|---|
Harvard School of Public Health | Addis Continental Institute of Public Health, Bill and Melinda Gates Foundation, Institute for Clinical Effectiveness and Health Policy, Maternal Health Task Force, Saint Paul Hospital Millennium Medical College |
Ethiopia,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Improved provider skill levels | Provider skill will be measured through baseline and endline evaluations, mentoring reports, and the standardized evaluations used in the Basic Emergency Obstetric Care trainings. | One Year | No |
Primary | Improved provider self-efficacy | Improved provider confidence will be assessed at baseline and at endline with a standardized data collection instrument. | One Year | No |
Primary | Increased use of effective interventions for obstetric emergencies | 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. | One Year | No |
Primary | Improved standards of care for pregnant women | 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. | One Year | No |
Primary | Improved Referral Systems | 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. |
One Year | No |
Secondary | Sustainable, continuous quality improvement cycles through supportive supervision | Quarterly, a supportive supervision team will visit each of the health facilities involved in this study, and, using a checklist and a participatory approach, will identify areas to improve the quality of care provided. Each action item will will have a person assigned to it, and a plan to resolve the issue. Follow up supportive supervision visits will begin with an assessment of the previous visit's action plan, and then work to identify new areas for quality improvement. This process is iterative. | One year | No |
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