The quality of clinical maternal and neonatal healthcare – a strategy for identifying ‘routine care signal functions’
Includes bibliographical references (page 16-19).
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Plos One
2016
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| Accesso online: | http://hdl.handle.net/10361/5236 |
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10361-52362019-09-30T02:58:39Z The quality of clinical maternal and neonatal healthcare – a strategy for identifying ‘routine care signal functions’ Brenner, Stephan Allegri, Manuela De Gabrysch, Sabine Chinkhumba, Jobiba Sarker, Malabika Muula, Adamson S. James P Grant School of Public Health, BRAC University Includes bibliographical references (page 16-19). Background A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH) programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs), a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC), the ‘EmOC signal functions’, a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example. Methods We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi. Results Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants’ adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks. Conclusion The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period.We hope our suggested indicators for essential routine care processes will contribute to streamlining MNH program evaluations in LMICs. Stephan Brenner Manuela De Allegri Sabine Gabrysch Jobiba Chinkhumba Malabika Sarker Adamson S. Muula 2016-05-05T16:13:13Z 2016-05-05T16:13:13Z 2015 2015-04-15 Article Brenner S, De Allegri M, Gabrysch S, Chinkhumba J, Sarker M, Muula AS (2015) The Quality of Clinical Maternal and Neonatal Healthcare – A Strategy for Identifying ‘Routine Care Signal Functions’. PLoS ONE 10(4): e0123968. doi:10.1371/ journal.pone.0123968 1932-6203 http://hdl.handle.net/10361/5236 en BRAC University Journals are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission. 19 pages application/pdf Plos One |
| institution |
Brac University |
| collection |
Institutional Repository |
| language |
English |
| description |
Includes bibliographical references (page 16-19). |
| author2 |
James P Grant School of Public Health, BRAC University |
| author_facet |
James P Grant School of Public Health, BRAC University Brenner, Stephan Allegri, Manuela De Gabrysch, Sabine Chinkhumba, Jobiba Sarker, Malabika Muula, Adamson S. |
| format |
Article |
| author |
Brenner, Stephan Allegri, Manuela De Gabrysch, Sabine Chinkhumba, Jobiba Sarker, Malabika Muula, Adamson S. |
| spellingShingle |
Brenner, Stephan Allegri, Manuela De Gabrysch, Sabine Chinkhumba, Jobiba Sarker, Malabika Muula, Adamson S. The quality of clinical maternal and neonatal healthcare – a strategy for identifying ‘routine care signal functions’ |
| author_sort |
Brenner, Stephan |
| title |
The quality of clinical maternal and neonatal healthcare – a strategy for identifying ‘routine care signal functions’ |
| title_short |
The quality of clinical maternal and neonatal healthcare – a strategy for identifying ‘routine care signal functions’ |
| title_full |
The quality of clinical maternal and neonatal healthcare – a strategy for identifying ‘routine care signal functions’ |
| title_fullStr |
The quality of clinical maternal and neonatal healthcare – a strategy for identifying ‘routine care signal functions’ |
| title_full_unstemmed |
The quality of clinical maternal and neonatal healthcare – a strategy for identifying ‘routine care signal functions’ |
| title_sort |
quality of clinical maternal and neonatal healthcare – a strategy for identifying ‘routine care signal functions’ |
| publisher |
Plos One |
| publishDate |
2016 |
| url |
http://hdl.handle.net/10361/5236 |
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