Stillbirth Clinical Trial
Official title:
Effects of a Health Workforce Capacity Building and Quality Improvement Intervention on Intrapartum Stillbirth, Early Newborn Mortality and Post-pregnancy Family Planning in Kinshasa: a Cluster Randomized Evaluation
The aim of the study is to evaluate a health workforce capacity building and quality improvement intervention focused on integrated day-of-birth and post-pregnancy care at 16 hospitals in Kinshasa, Democratic Republic of Congo. The intervention package consists of a low-dose, high-frequency (LDHF) training of health workers, support for quality improvement teams, and provision of critical equipment, supplies and drugs within a quality improvement (QI) framework.
The health workforce capacity building and quality improvement intervention will be
implemented in two phases: eight facilities will receive the intervention in phase 1 and the
remaining eight facilities will receive the intervention in phase 2.
Objective 1: For objective 2 on facility-based health outcomes, the study design is a
cluster-randomized evaluation in phase 1. The intervention's effects will be assessed by
comparing an intervention group and a control group of facilities. These will be selected
from 16 Kinshasa health facilities. Intervention and control facilities' monthly reported
health outcomes will be compared in a 12-month baseline period and 12-month period during and
after the intervention implementation (Phase 1) in a difference-in-difference analysis. In
Phase 2, all facilities will have their monthly service statistics and health outcomes
reviewed for trends in improvement.
Overall, in Phase 1, eight intervention sites will be matched to eight sites serving as
controls. In Phase 2, the eight Phase 1 control sites will then receive the same package as
the intervention sites in Phase 1. Sites will be stratified by case load, low and high (over
90 births per month), and funding (public or private funding). Within each stratum, prior to
start of the intervention, there will be random selection to intervention and control groups
to allow for baseline comparability between groups.
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