Format

Send to

Choose Destination
See comment in PubMed Commons below
Int J Qual Health Care. 2013 Oct;25(5):477-87. doi: 10.1093/intqhc/mzt054. Epub 2013 Aug 7.

Impact evaluation of a quality improvement intervention on maternal and child health outcomes in Northern Ghana: early assessment of a national scale-up project.

Author information

1
CB# 7445, UNC-Chapel Hill, Chapel Hill, NC 27516, USA. kavita_singh@unc.edu.

Abstract

OBJECTIVE:

To evaluate the influence of the early phase of Project Fives Alive!, a national child survival improvement project, on key maternal and child health outcomes.

DESIGN:

The evaluation used multivariable interrupted time series analyses to determine whether change categories tested were associated with improvements in the outcomes of interest.

PARTICIPANTS:

The evaluation used program and outcome data from interventions focused on health-care staff in 27 facilities.

SETTING:

Northern Ghana.

INTERVENTION:

The project uses a quality improvement (QI) approach whereby process failures are identified by health staff and process changes are tested in the health facilities and corresponding communities to address those failures.

MAIN OUTCOME MEASURES:

The maternal health outcomes were early antenatal care attendance and skilled delivery, and the child health outcomes were underweight infants attending child wellness clinics, facility-level neonatal mortality and facility-level infant mortality.

RESULTS:

Postnatal care changes for the first 1-2 days of life (β= 0.10, P = 0.07) and the first 6-7 days of life (β = 0.10, P = 0.07) were associated with a higher rate of visits by underweight infants to child wellness clinics. There was an association between the early pregnancy identification change category with increased skilled delivery (β = 1.36 P = 0.07). In addition, a greater number of change categories tested was associated with increased skilled delivery (β = 0.05, P = 0.01).

CONCLUSION:

The QI approach of testing and implementing simple and low cost locally inspired changes has the potential to lead to improved health outcomes at scale both in Ghana and other low- and middle-income countries.

KEYWORDS:

Ghana; impact evaluation; maternal and child health; mortality; quality improvement; time series analysis

PMID:
23925506
PMCID:
PMC3888142
DOI:
10.1093/intqhc/mzt054
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Silverchair Information Systems Icon for PubMed Central
    Loading ...
    Support Center