Maternal Health Clinical Trial
Official title:
Validation of a Midwifery Model in Palestine - Usage and Quality
To validate a model of Continuity of Midwifery Care implemented in the region of Nabuls and
Jericho in Palestine in 2013, register data from the Palestinian Ministry of Health will be
analyzed for the following indicators related to usage and quality.
Changes in these variables before and after the implementation will be compared between the
16 clinics where the model was implemented and all comparable clinics in the region.
In 2013 a program for continuity of midwifery care (midwives at the local hospital provided
ante- and post natal care i clinics located in rural villages) in the region Nablus and
Jericho on the West Bank, Palestine. By the end of 2013, the model was implemented in 16 of
a total of 53 clinics in the region. In order to compare the impact of the continuity of
midwifery care on changes in usage of pre- and postnatal services and quality of care,
registry data will be obtained from all clinics two years before the implementation
(2011-2012) and for two years after the implementation (2014-2015). The following indicators
will be compared between the 16 clinics where the program was implemented and comparable
clinics where the program has not yet been implemented:
1. Mean number of antenatal visits per woman (Usage primary outcome)
2. Proportion of total pregnant women that visited the clinic (Usage secondary outcome))
3. Percentage of pregnant referred to higher level of care (Quality primary outcome)
4. Percentage of women referred for high blood sugar levels (Quality secondary outcome)
5. Percentage of women receiving postnatal home visits (Quality primary outcome)
6. Proportion of women seen by doctor after birth (Quality secondary outcome)
7. Proportion of newborns seen by doctor after birth (Quality secondary outcome)
8. Total number of consultations for mother and child after birth (Usage secondary
outcome)
All data will be obtained from the monthly statistical reports sent from the clinics to the
Palestinian Ministry of health.
Data sources, statistical procedures, power and sample size:
The governmental registry includes data from two years before and two years after the
implementation. The registry consists of unidentifiable recordings reported monthly from all
clinics to the central statistical database in the Ministry of Health. A copy of the heath
authority registry was obtained for statistical analysis.
Descriptive and inferential statistics will be used to analyse collected quantitative data.
Data will be registered and analysed using the computer statistical package SPSS version 21
and STATA. Prior to analysis all variables will be checked for data file errors.
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