PMID- 38365280
OWN - NLM
STAT- Publisher
LR  - 20240303
IS  - 2169-575X (Electronic)
IS  - 2169-575X (Linking)
VI  - 12
IP  - 1
DP  - 2024 Feb 16
TI  - Effectiveness of Capacity-Building and Quality Improvement Interventions to 
      Improve Day-of-Birth Care in Kinshasa, Democratic Republic of the Congo.
LID - 10.9745/GHSP-D-23-00236 [doi]
LID - e2300236
AB  - In sub-Saharan African settings like the Democratic Republic of the Congo, 
      high-quality care during childbirth and the immediate postpartum period is 
      lacking in public facilities, necessitating multipronged interventions to improve 
      care. We used a pre-post design to examine the effectiveness of a low-dose, 
      high-frequency capacity-building and quality improvement (QI) intervention to 
      improve care for women and newborns around the day of birth in 16 health 
      facilities in Kinshasa, Democratic Republic of the Congo. Effectiveness was 
      assessed based on changes in provider skills, key health indicators, and 
      beneficiary satisfaction. To assess changes in the competency of the 188 
      providers participating in the intervention, we conducted objective structured 
      clinical examinations on care for mothers and newborns on the day of birth, 
      immediate postpartum family planning (PPFP) counseling and method provision, and 
      postabortion care before and after implementation of training and at 6 and 12 
      months after training. Interrupted time series (ITS) analysis techniques were 
      used to analyze routine health service data for changes in select maternal, 
      newborn, and postpartum outcomes before and after the intervention. To assess 
      changes in clients' perceptions of care, 2 rounds of telephone surveys were 
      administered. Before the intervention, less than 2% of participating providers 
      demonstrated competency in skills. Immediately after training, more than 80% 
      demonstrated competency, and 70% retained competency after 12 months. ITS 
      analyses show the risk of early neonatal death declined significantly by 9% (95% 
      confidence interval [CI]=4%, 13%, P<.001), and likelihood of immediate PPFP 
      uptake increased significantly by 72% (95% CI=53%, 92%, P<.001). Client 
      satisfaction improved by 58% over the life of the project. These findings build 
      on previous studies documenting the effectiveness of clinical capacity-building 
      and QI approaches. If implemented at scale, this approach has the potential to 
      substantively contribute to improving maternal and perinatal health in similar 
      settings.
CI  - (c) Kikaya et al.
FAU - Kikaya, Virgile
AU  - Kikaya V
AD  - Jhpiego, Kinshasa, Democratic Republic of the Congo. virgile.kikaya@jhpiego.org.
FAU - Katembwe, Fernand
AU  - Katembwe F
AD  - Jhpiego, Kinshasa, Democratic Republic of the Congo.
FAU - Yabili, Jacky
AU  - Yabili J
AD  - Jhpiego, Kinshasa, Democratic Republic of the Congo.
FAU - Mbwanya, Marcel
AU  - Mbwanya M
AD  - Jhpiego, Kinshasa, Democratic Republic of the Congo.
FAU - Dhuse, Elana
AU  - Dhuse E
AD  - Jhpiego, Baltimore, MD, USA.
FAU - Gomez, Patricia
AU  - Gomez P
AD  - Jhpiego, Baltimore, MD, USA.
FAU - Waxman, Rachel
AU  - Waxman R
AD  - Jhpiego, Baltimore, MD, USA.
FAU - Mohan, Diwakar
AU  - Mohan D
AD  - Department of International Health, Johns Hopkins Bloomberg School of Public 
      Health, Baltimore, MD, USA.
FAU - Tappis, Hannah
AU  - Tappis H
AD  - Jhpiego, Baltimore, MD, USA.
AD  - Department of International Health, Johns Hopkins Bloomberg School of Public 
      Health, Baltimore, MD, USA.
LA  - eng
PT  - Journal Article
DEP - 20240216
PL  - United States
TA  - Glob Health Sci Pract
JT  - Global health, science and practice
JID - 101624414
SB  - IM
PMC - PMC10906559
EDAT- 2024/02/17 10:43
MHDA- 2024/02/17 10:43
PMCR- 2024/02/28
CRDT- 2024/02/16 20:43
PHST- 2023/09/06 00:00 [received]
PHST- 2024/01/23 00:00 [accepted]
PHST- 2024/02/17 10:43 [medline]
PHST- 2024/02/17 10:43 [pubmed]
PHST- 2024/02/16 20:43 [entrez]
PHST- 2024/02/28 00:00 [pmc-release]
AID - GHSP-D-23-00236 [pii]
AID - 10.9745/GHSP-D-23-00236 [doi]
PST - aheadofprint
SO  - Glob Health Sci Pract. 2024 Feb 16;12(1):e2300236. doi: 10.9745/GHSP-D-23-00236.