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Randomized Controlled Trial
. 2018 Dec 1;30(10):769-777.
doi: 10.1093/intqhc/mzy086.

Effectiveness of a WHO Safe Childbirth Checklist Coaching-based intervention on the availability of Essential Birth Supplies in Uttar Pradesh, India

Jenny J Maisonneuve  1 , Katherine E A Semrau  1   2   3 , Pinki Maji  4 , Vinay Pratap Singh  4 , Kate A Miller  1 , Ian Solsky  1 , Neeraj Dixit  4 , Jigyasa Sharma  5 , Janaka Lagoo  1 , Natalie Panariello  1 , Brandon J Neal  1 , Tapan Kalita  4 , Nabihah Kara  1 , Vishwajeet Kumar  6 , Lisa R Hirschhorn  7
Affiliations
Randomized Controlled Trial

Effectiveness of a WHO Safe Childbirth Checklist Coaching-based intervention on the availability of Essential Birth Supplies in Uttar Pradesh, India

Jenny J Maisonneuve et al. Int J Qual Health Care. .

Abstract

Objective: Evaluate the impact of a World Health Organization Safe Childbirth Checklist coaching-based intervention (BetterBirth Program) on availability and procurement of essential childbirth-related supplies.

Design: Matched pair, cluster-randomized controlled trial.

Setting: Uttar Pradesh, India.

Participants: 120 government-sector health facilities (60 interventions, 60 controls). Supply-availability surveys were conducted quarterly in all sites. Coaches collected supply procurement sources from intervention sites.

Interventions: Coaching targeting implementation of Checklist with data feedback and action planning.

Main outcome measures: Mean supply availability by study arm; change in procurement sources for intervention sites.

Results: At baseline, 6 and 12 months, the intervention sites had a mean of 20.9 (95% confidence interval (CI): 20.2-21.5); 22.4 (95% CI: 21.8-22.9) and 22.1 (95% CI:21.4-22.8) items, respectively. Control sites had 20.8 (95% CI: 20.3-21.3); 20.9 (95% CI: 20.3-21.5) and 21.7 (95% CI: 20.8-22.6) items at the same time-points. There was a small but statistically significant higher availability in intervention sites at 6 months (difference-in-difference (DID) = 1.43, P < 0.001), which was not seen by 12 months (DID = 0.37, P = 0.53). Greater difference between intervention and control sites starting in the bottom quartile of supply availability was seen at 6 months (DID = 4.0, P = 0.0002), with no significant difference by 12 months (DID = 1.5, P = 0.154). No change was seen in procurement sources with ~5% procured by patients with some rates as high as 29% (oxytocin).

Conclusions: Implementation of the BetterBirth Program, incorporating supply availability, resulted in modest improvements with catch-up by control facilities by 12 months. Supply-chain coaching may be most beneficial in sites starting with lower supply availability. Efforts are needed to reduce reliance on patient-funding for some critical medications.

Trial registration: ClinicalTrials.gov #NCT02148952; Universal Trial Number: U1111-1131-5647.

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Figures

Figure 1
Figure 1
Mean number of Essential Birth Supplies (N = 28) over time by study arm for sites starting at the bottom quartile of supply availability (<20 of the 28 supplies at baseline).
See this image and copyright information in PMC

References

    1. Koblinsky M, Moyer CA, Calvert C et al. . Quality maternity care for every woman, everywhere: a call to action. Lancet 2016;388:2307–20. - PubMed
    1. Kinney MV, Boldosser-Boesch A, McCallon B. Quality, equity, and dignity for women and babies. Lancet 2016;388:2066–8. - PubMed
    1. Sharma J, Leslie HH, Kundu F et al. . Poor quality for poor women? Inequities in the quality of antenatal and delivery care in Kenya. PLoS One 2017;12:e0171236. - PMC - PubMed
    1. Mohanan M, Bauhoff S, La Forgia G et al. . Effect of Chiranjeevi Yojana on institutional deliveries and neonatal and maternal outcomes in Gujarat, India: a difference-in-differences analysis. Bull World Health Organ 2014;92:187–94. - PMC - PubMed
    1. Randive B, Diwan V, De Costa A. India’s conditional cash transfer programme (the JSY) to promote institutional birth: is there an association between institutional birth proportion and maternal mortality? PLoS One 2013;8:e67452. - PMC - PubMed

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