INTRODUCTION: Reversing Ethiopia’s high maternal mortality ratio requires high access to interven... more INTRODUCTION: Reversing Ethiopia’s high maternal mortality ratio requires high access to interventions that address common causes of maternal deaths. We sought to determine levels of use of interventions and status of determinants of use that is needed by maternal health programmers. METHODS: We randomly selected 19 hospitals from a total list of hospitals in Ethiopia from which a total of 192 labors and 126 antenatal care counseling sessions were observed for use of interventions recommended by the World Health Organization regarding prevention of prolonged labor, postpartum hemorrhage, preeclampsia, & puerperal sepsis. Data on selected determinants of use were collected using key informant interviews & facility visits. Frequencies & means were computed using Excel software. Study was approved by Ethiopian Public Health Association & Johns Hopkins Bloomberg School of Public Health Ethical Review Boards. RESULTS: Only 41% of pregnant mothers were screened for preeclampsia; partograp...
Comparing estimates of child mortality reduction modelled in LiST with pregnancy history survey d... more Comparing estimates of child mortality reduction modelled in LiST with pregnancy history survey data for a community-based NGO project in
Evaluation of the effectiveness of care groups in expanding population coverage of Key child surv... more Evaluation of the effectiveness of care groups in expanding population coverage of Key child survival interventions and reducing under-5 mortality: a comparative analysis using the lives saved tool (LiST)
Additional file 2: Supplementary Material 2. Final level 2 and 3 data. Changes over time in the %... more Additional file 2: Supplementary Material 2. Final level 2 and 3 data. Changes over time in the % of successfully resuscitated newborns. Changes over time in newborn health outcomes.
Additional file 1: Supplementary Material 1. Final mentorship data level 1. Mentorship scores of ... more Additional file 1: Supplementary Material 1. Final mentorship data level 1. Mentorship scores of mentees over the course of mentorship visits, throughout project implementation.
Maternal and Newborn Quality of Care Survey L & D Observation Checklist. The standardized data co... more Maternal and Newborn Quality of Care Survey L & D Observation Checklist. The standardized data collection tool which was modified for use in each country for data collection for labor and delivery services. (PDF 285 kb)
Maternal and Newborn Quality of Care Survey ANC Observation Checklist. The standardized data coll... more Maternal and Newborn Quality of Care Survey ANC Observation Checklist. The standardized data collection tool which was modified for use in each country for data collection for ANC services. (PDF 163 kb)
This is meant to be a practical manual for project managers and local partners for putting into p... more This is meant to be a practical manual for project managers and local partners for putting into practice pro-sustainability principles in planning implementing monitoring and evaluating community-oriented health programs/projects. It is organized around the Sustainability Framework and has "real world" thinking based on its use over the last several years. In developing this manual the authors fleshed out and documented some best practices for using the Sustainability Framework like practical tools such as a project managers sustainability checklist guidance on developing a vision guidance for including sustainability thinking into a DIP workshop a tool for measuring local key NGO and MOH organizational capacity.
This case demonstrates how a Quality Improvement (QI) initiative systematically improved the deli... more This case demonstrates how a Quality Improvement (QI) initiative systematically improved the delivery of maternal and newborn health services at a large number of health-care facilities in Mozambique, with limited external assistance (e.g., external supervision or technical assistance after the initial 6 months), despite facing the challenges common to many low-income settings. In particular, this case examines the organization of a QI effort, including the formation of QI teams, enhancement of data collection to document QI activities, and national scale-up of a QI intervention. The QI intervention applied relied on provider training provider training on evidence-based standards, assessment of compliance with the performance standards, strengthening of the health management information system to enable tracking of selected quality-of-care indicators, and formation of facility-level QI teams to lead the implementation of the standards through performance assessments and action plans...
Background This study explored effects of couples’ communication and male participation in birth ... more Background This study explored effects of couples’ communication and male participation in birth preparedness and complication readiness (BPCR) on delivery in a health facility (“institutional delivery”). A cross-sectional, baseline household survey was conducted in November 2016 prior to an integrated maternal and child health project in Nampula and Sofala Provinces in Mozambique. Methods The study used the Knowledge, Practices and Coverage survey tool, a condensed version of the Demographic and Health Survey and other tools. The sample included 1422 women. Multivariable logit regression models tested the association of institutional delivery with couples’ communication and four elements of BPCR both with and without male partners: 1) saving money, 2) arranging transport, 3) choosing a birth companion, and 4) choosing a delivery site; controlling for partners’ attendance in antenatal care and social and demographic determinants (education, wealth, urban/rural location, and province...
Background: Helping Babies Breathe (HBB) is a competency-based educational method for an evidence... more Background: Helping Babies Breathe (HBB) is a competency-based educational method for an evidence-based protocol to manage birth asphyxia in low resource settings. HBB has been shown to improve health worker skills and neonatal outcomes, but studies have documented problems with skills retention and little evidence of effectiveness at large scale in routine practice. This study examined the effect of complementing provider training with clinical mentorship and quality improvement as outlined in the second edition HBB materials.This “system-oriented” approach was implemented in all public health facilities (n=172) in ten districts in Rwanda from 2015 to 2018. Methods: A before-after mixed methods study assessed changes in provider skills and neonatal outcomes related to birth asphyxia. Mentee knowledge and skills were assessed with HBB objective structured clinical exam (OSCE) B pre and post training and during mentorship visits up to one year afterward. The study team extracted heal...
INTRODUCTION: Reversing Ethiopia’s high maternal mortality ratio requires high access to interven... more INTRODUCTION: Reversing Ethiopia’s high maternal mortality ratio requires high access to interventions that address common causes of maternal deaths. We sought to determine levels of use of interventions and status of determinants of use that is needed by maternal health programmers. METHODS: We randomly selected 19 hospitals from a total list of hospitals in Ethiopia from which a total of 192 labors and 126 antenatal care counseling sessions were observed for use of interventions recommended by the World Health Organization regarding prevention of prolonged labor, postpartum hemorrhage, preeclampsia, & puerperal sepsis. Data on selected determinants of use were collected using key informant interviews & facility visits. Frequencies & means were computed using Excel software. Study was approved by Ethiopian Public Health Association & Johns Hopkins Bloomberg School of Public Health Ethical Review Boards. RESULTS: Only 41% of pregnant mothers were screened for preeclampsia; partograp...
Comparing estimates of child mortality reduction modelled in LiST with pregnancy history survey d... more Comparing estimates of child mortality reduction modelled in LiST with pregnancy history survey data for a community-based NGO project in
Evaluation of the effectiveness of care groups in expanding population coverage of Key child surv... more Evaluation of the effectiveness of care groups in expanding population coverage of Key child survival interventions and reducing under-5 mortality: a comparative analysis using the lives saved tool (LiST)
Additional file 2: Supplementary Material 2. Final level 2 and 3 data. Changes over time in the %... more Additional file 2: Supplementary Material 2. Final level 2 and 3 data. Changes over time in the % of successfully resuscitated newborns. Changes over time in newborn health outcomes.
Additional file 1: Supplementary Material 1. Final mentorship data level 1. Mentorship scores of ... more Additional file 1: Supplementary Material 1. Final mentorship data level 1. Mentorship scores of mentees over the course of mentorship visits, throughout project implementation.
Maternal and Newborn Quality of Care Survey L & D Observation Checklist. The standardized data co... more Maternal and Newborn Quality of Care Survey L & D Observation Checklist. The standardized data collection tool which was modified for use in each country for data collection for labor and delivery services. (PDF 285 kb)
Maternal and Newborn Quality of Care Survey ANC Observation Checklist. The standardized data coll... more Maternal and Newborn Quality of Care Survey ANC Observation Checklist. The standardized data collection tool which was modified for use in each country for data collection for ANC services. (PDF 163 kb)
This is meant to be a practical manual for project managers and local partners for putting into p... more This is meant to be a practical manual for project managers and local partners for putting into practice pro-sustainability principles in planning implementing monitoring and evaluating community-oriented health programs/projects. It is organized around the Sustainability Framework and has "real world" thinking based on its use over the last several years. In developing this manual the authors fleshed out and documented some best practices for using the Sustainability Framework like practical tools such as a project managers sustainability checklist guidance on developing a vision guidance for including sustainability thinking into a DIP workshop a tool for measuring local key NGO and MOH organizational capacity.
This case demonstrates how a Quality Improvement (QI) initiative systematically improved the deli... more This case demonstrates how a Quality Improvement (QI) initiative systematically improved the delivery of maternal and newborn health services at a large number of health-care facilities in Mozambique, with limited external assistance (e.g., external supervision or technical assistance after the initial 6 months), despite facing the challenges common to many low-income settings. In particular, this case examines the organization of a QI effort, including the formation of QI teams, enhancement of data collection to document QI activities, and national scale-up of a QI intervention. The QI intervention applied relied on provider training provider training on evidence-based standards, assessment of compliance with the performance standards, strengthening of the health management information system to enable tracking of selected quality-of-care indicators, and formation of facility-level QI teams to lead the implementation of the standards through performance assessments and action plans...
Background This study explored effects of couples’ communication and male participation in birth ... more Background This study explored effects of couples’ communication and male participation in birth preparedness and complication readiness (BPCR) on delivery in a health facility (“institutional delivery”). A cross-sectional, baseline household survey was conducted in November 2016 prior to an integrated maternal and child health project in Nampula and Sofala Provinces in Mozambique. Methods The study used the Knowledge, Practices and Coverage survey tool, a condensed version of the Demographic and Health Survey and other tools. The sample included 1422 women. Multivariable logit regression models tested the association of institutional delivery with couples’ communication and four elements of BPCR both with and without male partners: 1) saving money, 2) arranging transport, 3) choosing a birth companion, and 4) choosing a delivery site; controlling for partners’ attendance in antenatal care and social and demographic determinants (education, wealth, urban/rural location, and province...
Background: Helping Babies Breathe (HBB) is a competency-based educational method for an evidence... more Background: Helping Babies Breathe (HBB) is a competency-based educational method for an evidence-based protocol to manage birth asphyxia in low resource settings. HBB has been shown to improve health worker skills and neonatal outcomes, but studies have documented problems with skills retention and little evidence of effectiveness at large scale in routine practice. This study examined the effect of complementing provider training with clinical mentorship and quality improvement as outlined in the second edition HBB materials.This “system-oriented” approach was implemented in all public health facilities (n=172) in ten districts in Rwanda from 2015 to 2018. Methods: A before-after mixed methods study assessed changes in provider skills and neonatal outcomes related to birth asphyxia. Mentee knowledge and skills were assessed with HBB objective structured clinical exam (OSCE) B pre and post training and during mentorship visits up to one year afterward. The study team extracted heal...
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