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Study protocol: Impact of quality improvement interventions on perinatal outcomes in health facilities-a systematic review
Golden Community, Lalitpur, Nepal.
UNICEF, Hlth Sect, Programme Div, New York, NY USA.
Golden Community, Lalitpur, Nepal;Imperial Coll London, Sch Publ Hlth, Dept Primary Care & Publ Hlth, London, England.
Golden Community, Lalitpur, Nepal.
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2019 (English)In: Systematic Reviews, E-ISSN 2046-4053, Vol. 8, no 1, article id 205Article, review/survey (Refereed) Published
Abstract [en]

Background

About 5.8 million maternal deaths, neonatal deaths and stillbirths occur every year with 99% of them taking place in low- and middle-income countries. Two thirds of them could be prevented through cost-effective interventions during pregnancy, intrapartum and postpartum periods. Despite the availability of standards and guidelines for the care of mother and newborn, challenges remain in translating these standards into practice in health facilities. Although several quality improvement (QI) interventions have been systematically reviewed by the Cochrane Effective Practice and Organization of Care (EPOC) group, evidence lack on QI interventions for improving perinatal outcomes in health facilities. This systematic review will identify QI interventions implemented for maternal and neonatal care in health facilities and their impact on perinatal outcomes.

Methods/design

This review will look at studies of mothers, newborn and both who received inpatient care at health facilities. QI interventions targeted at health system level (macro), at healthcare organization (meso) and at health workers practice (micro) will be reviewed. Mortality of mothers and newborn and relevant health worker practices will be assessed. The MEDLINE, Embase, World Health Organization Global Health Library, Cochrane Library and trial registries electronic databases will be searched for relevant studies from the year 2000 onwards. Data will be extracted from the identified relevant literature using Epi review software. Risk of bias will be assessed in the studies using the Cochrane risk of bias tool for randomized and observational studies. Standard data synthesis and analysis will be used for the review, and the data will be analysed using EPPI Reviewer 4.

Discussion

This review will inform the global agenda for evidence-based health care by (1) providing a basis for operational guidelines for implementing clinical standards of perinatal care, (2) identify research priorities for generating evidence for QI interventions and (3) QI intervention options with lessons learnt for implementation based on the level of needed resources.

Place, publisher, year, edition, pages
2019. Vol. 8, no 1, article id 205
Keywords [en]
Quality improvement, Health system, Health care organization, Health care workers, Perinatal care
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-393760DOI: 10.1186/s13643-019-1110-9ISI: 000481844200001PubMedID: 31416483OAI: oai:DiVA.org:uu-393760DiVA, id: diva2:1355238
Available from: 2019-09-27 Created: 2019-09-27 Last updated: 2019-09-27Bibliographically approved

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