Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Process evaluation of a knowledge translation intervention using facilitation of local stakeholder groups to impove neonatal survival in Quang Ninh province, Vietnam
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Internationell barnhälsa och nutrition/Mårtensson)
Nursing office, Department of Medical Services Administration, Ministry of Health Vietnam.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). Hanoi School of Public Health, Hanoi, Vietnam. (Internationell barnhälsa och nutrition/Mårtensson)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Internationell barnhälsa och nutrition/Mårtensson)
Show others and affiliations
2016 (English)In: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 17, no 1, 23Article in journal (Refereed) Published
Abstract [en]

Background

Annually, 2.8 million neonatal deaths occur worldwide, despite the fact that three-quarters of them could be prevented if available evidence-based interventions were used. Facilitation of community groups has been recognized as a promising method to translate knowledge into practice. In northern Vietnam, the Neonatal Health – Knowledge Into Practice trial evaluated facilitation of community groups (2008–2011) and succeeded in reducing the neonatal mortality rate (adjusted odds ratio, 0.51; 95 % confidence interval 0.30–0.89). The aim of this paper is to report on the process (implementation and mechanism of impact) of this intervention.

Methods

Process data were excerpted from diary information from meetings with facilitators and intervention groups, and from supervisor records of monthly meetings with facilitators. Data were analyzed using descriptive statistics. An evaluation including attributes and skills of facilitators (e.g., group management, communication, and commitment) was performed at the end of the intervention using a six-item instrument. Odds ratios were analyzed, adjusted for cluster randomization using general linear mixed models.

Results

To ensure eight active facilitators over 3 years, 11 Women’s Union representatives were recruited and trained. Of the 44 intervention groups, composed of health staff and commune stakeholders, 43 completed their activities until the end of the study. In total, 95 % (n = 1508) of the intended monthly meetings with an intervention group and a facilitator were conducted. The overall attendance of intervention group members was 86 %. The groups identified 32 unique problems and implemented 39 unique actions. The identified problems targeted health issues concerning both women and neonates. Actions implemented were mainly communication activities. Communes supported by a group with a facilitator who was rated high on attributes and skills (n = 27) had lower odds of neonatal mortality (odds ratio, 0.37; 95 % confidence interval, 0.19–0.73) than control communes (n = 46).

Conclusions

This evaluation identified several factors that might have influenced the outcomes of the trial: continuity of intervention groups’ work, adequate attributes and skills of facilitators, and targeting problems along a continuum of care. Such factors are important to consider in scaling-up efforts.

Place, publisher, year, edition, pages
2016. Vol. 17, no 1, 23
Keyword [en]
community health workers, facilitation, knowledge translation, neonatal health, neonatal mortality, process evaluation, Vietnam
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
International Health
Identifiers
URN: urn:nbn:se:uu:diva-173395DOI: 10.1186/s13063-015-1141-zISI: 000368034800002OAI: oai:DiVA.org:uu-173395DiVA: diva2:525463
Funder
Sida - Swedish International Development Cooperation AgencySwedish Research Council
Available from: 2012-05-08 Created: 2012-04-23 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Knowledge Translation in Vietnam: Evaluating facilitation as a tool for improved neonatal health and survival
Open this publication in new window or tab >>Knowledge Translation in Vietnam: Evaluating facilitation as a tool for improved neonatal health and survival
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Neonatal mortality remains a problem worldwide, despite the existence of low-cost and evidence-based interventions. Unfortunately, the translation of these interventions into practice is deficient.

The aim of this thesis was to study aspects of knowledge translation (KT) before and during the Neonatal Knowledge Into Practice (NeoKIP) trial in Quang Ninh, Vietnam. Over a period of three years, this trial evaluated the use of facilitators from the Women’s Union who supported maternal and newborn health groups (MNHG) comprised of eight local stakeholders, as an intervention for improved neonatal survival.

In the first two studies (before intervention) we assessed primary health care staff’s knowledge and material preparedness regarding evidence-based neonatal care and explored how primary health care staff translated knowledge into practice. The last two studies (during intervention) were process evaluations aimed at describing the implementation, process and mechanism of the NeoKIP intervention.

Primary health care workers achieved 60% of the maximum score in the knowledge survey. Two separate geographical areas were identified with differences in staff levels of knowledge and concurrent disparities in neonatal survival, antenatal care and post-natal home visits. Staff perceived formal training to be the best way to acquire knowledge but asked for more interaction between colleagues within the healthcare system. Traditional medicine, lack of resources, low workload and poorly paid staff constituted barriers for the development of staff knowledge and skills.

Eleven facilitators were trained to cover eight facilitator positions. Of the 44 MNHGs, 43 completed their activities to the end of the study. In total, 95% of the monthly meetings with a MNHG and a facilitator were conducted with attendance at 86%. MNHGs identified 32 unique problems, mainly families’ knowledge/behavior, and implemented 39 unique actions, mostly regarding communication. MNHGs experienced that the group was strategically composed to influence change in the communes and facilitators were identified as being important to sustaining activities over time. The facilitators’ lack of health knowledge was regarded as a deficit in assisting the MNHGs, but their performance and skills increased over time.

This low-cost model, building on local stakeholder involvement, has the capacity to be scaled up within existing healthcare structures.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. 59 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 785
Keyword
Knowledge translation, Facilitation, Neonatal mortality, Primary health care, Vietnam
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
International Health
Identifiers
urn:nbn:se:uu:diva-173874 (URN)978-91-554-8396-8 (ISBN)
Public defence
2012-08-24, Sal IX, Universitetshuset, Biskopsgatan 3, Uppsala, 09:15 (English)
Opponent
Supervisors
Available from: 2012-05-31 Created: 2012-05-08 Last updated: 2012-08-01

Open Access in DiVA

fulltext(502 kB)189 downloads
File information
File name FULLTEXT01.pdfFile size 502 kBChecksum SHA-512
ac0f8e42bb2f970235611c37040ab52a6a48424c0ecb474234aa1e7056a21b22a162f62247afd27c0f541abf8ae6c4c39c51bf4a1aaaf375c5dc35d10e7f2cb5
Type fulltextMimetype application/pdf

Other links

Publisher's full text

Search in DiVA

By author/editor
Eriksson, LeifDuc, Duong MEkholm Selling, KatarinaNga, Nguyen ThuPersson, Lars-Åke
By organisation
Department of Women's and Children's HealthInternational Maternal and Child Health (IMCH)
In the same journal
Trials
Public Health, Global Health, Social Medicine and Epidemiology

Search outside of DiVA

GoogleGoogle Scholar
Total: 189 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 786 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf