Evaluation of the Effectiveness of a Quality Improvement Intervention

Maternal and Child Health Clinical Trial

Official title:

Evaluation of the Effectiveness of a Quality Improvement Intervention to Support Integration of Maternal, and Child and HIV Care in Primary Health Care Facilities in South Africa

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04278612
• Other study ID #: UNIP123
• Status: Completed
• Phase: N/A
• Start date: January 18, 2016
• Est. completion date: January 16, 2019

Study information

• Verified date: February 2020
• Source: University of KwaZulu
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This rigorous evaluation demonstrated that implementation of a time-limited quality improvement strategy effectively improved coverage of some components of an integrated maternal and child health service in a complex health environment, but we were unable to achieve the changes needed to provide a comprehensive package of care for mothers and children.

Description:

Background: Despite policies and guidelines recommending integration of health services in South Africa, provision of maternal and child health services remains fragmented. This study evaluated a rapid, scaleable, quality improvement intervention to improve integration of maternal and child health and HIV services at a primary health level, in KwaZulu-Natal, South Africa.

Methods: A three-month intervention comprised of six quality improvement mentoring visits, learning sessions with clinic staff to share learnings, and a self-administered checklist aimed to assist health workers monitor and implement an integrated package of health services for mothers and children. The study evaluated 27 clinics in four sub-districts using a stepped-wedge design. Each sub-district received the intervention sequentially in a randomly selected order. Five waves of data collection were conducted in all participating clinics between December 2016-February 2017. A multi-level, mixed effects logistic regression was used to account for random cluster fixed time and group effects using Stata V13.1.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 1438
• Est. completion date: January 16, 2019
• Est. primary completion date: February 5, 2017
• Accepts healthy volunteers: No
• Gender: Female
• Age group: N/A and older

Eligibility

Inclusion Criteria:

Women who attended the clinic for maternal and child health care services at 27 participating clinics from January 2016-February 2017.

Exclusion Criteria:

Women who did not attend the clinic for maternal and child health care services at 27 participating clinics from January 2016-February 2017.

Related Conditions & MeSH terms

• Maternal and Child Health

Intervention

Other:
• Quality improvement intervention to strengthen health service provision
Quality improvement intervention comprising of regular improvement meetings based at clinics.

Locations

Country	Name	City	State
n/a

Sponsors (3)

Lead Sponsor	Collaborator
University of KwaZulu	Institute for Healthcare Improvement, UNICEF

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Quality of Maternal and Child Care	Proportion of mother-baby pairs who received comprehensive care	3 months
Secondary	Quality of Child Care	Proportion of babies who receive growth monitoring services	3 months
Secondary	Quality of Maternal Care	Proportion of mothers who receive feeding advice	3 months