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Int J Gynaecol Obstet. 2011 Jul;114(1):4-9. doi: 10.1016/j.ijgo.2011.02.007.

Methodology and tools for quality improvement in maternal and newborn health care.

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Maternal and Newborn Health Unit, Liverpool School of Tropical Medicine, Liverpool, UK.



To gain an overview of approaches, methodologies, and tools used in quality improvement of maternal and newborn health in low-income countries.


Electronic search of MEDLINE and organizational databases for literature describing approaches, methodologies, and tools used to improve the quality of maternal and newborn health care in low-income countries. Relevant papers and reports were reviewed and summarized.


Developing a culture of quality is an important requisite for successful quality improvement. Methodologies to improve quality include the development of standards and guidelines and the performance of mortality, near-miss, and criterion-based audits. Tools for data collection and process description were identified, and examples of work to improve quality of care are provided.


The documented experience with the identified approaches, methodologies, and tools indicates that none is sufficient by itself to achieve a desirable improvement in quality of care. The choice of methodologies and tools depends on the healthcare system and its available resources. There is a lack of studies that describe the process of quality improvement and a need for research to provide evidence of the effectiveness of the identified methods and tools.

[Indexed for MEDLINE]

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