Health Facility Networking for Maternal Health

President and Fellows of Harvard College

Status: Completed

Conditions: Provider Skill; Provider Confidence; Referral Systems; Maternal Health

Treatments: Other: Emergency Drills; Other: Hospital-health center networking system; Other: Team-Based Supportive supervision; Other: Post Basic Emergency Obstetric Training Mentorship; Other: Facility Checklists; Other: Midwives exchange program; Other: Training of health workers in Basic Obstetric Emergency Care; Other: Strengthening the referral network

Study type: Interventional

Funder types: Other

Identifiers

NCT01802957

MHTF IR Ethiopia

Details and patient eligibility

About

This study will introduce a multi-faceted intervention package which will be implemented in the newly developed network of St. Paul's Hospital Millennium Medical College (St. Paul) and the surrounding seven satellite health centers. The goal is to assess if this group of interventions improve the skills and confidence of providers to handle obstetric emergencies, if they streamline the referral process and if they result in improved maternal/newborn health outcomes.

Enrollment: 10,787 patients

Sex: All

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

Sample population for each data collection instrument:

Baseline/Endline:

Key Informant Interviews:

• St. Paul hospital: Maternal Child Health (MCH) Head, Midwife/nurse from Labor and Delivery (L&D), Midwife/nurse from Emergency
• Health Centers: Medical Director, Head of MCH (midwife) Midwife from L&D, Referral focal person

Health Facility Assessment:

• Manager/most senior health worker asked (one from each facility)

Provider Survey:

• All providers in the MCH at both the hospital and health center level

Chart review:

• All deliveries in all centers will be screened during the intervention phase. Data on every birth will be collected from the log books of each facility. The data collector will then find the medical record of that patient to assess the Standard of Care (SOC) during Ante-natal care (ANC)- if available from the chart, L&D and screen for an obstetric complication. If there was a complication, the near miss data will be collected.

Telephone registration log book:

• all phone calls between HC and Hospital

Facility Checklists:

• Forms completed by Supportive Supervision Teams at quarterly visits

Standardized BEmONC training evaluation

• Will be given to every provider undergoing the training, as part of the training curriculum.

Monthly mentoring evaluations - for the six months post-training mentorship, for all providers who have undergone BEmONC training.

Supportive Supervision Gap Identification Checklists

• Collected quarterly from each of the 9 facilities

Trial design

10,787 participants in 1 patient group

St. Paul and Networked Health Centers

Other group

Description:

An uncontrolled before and after design with baseline and follow-up cross sectional measurements will be used at the overall site level (St. Paul Hospital and the 8 associated HCs). There will be no control unit.

Treatment:

Other: Emergency Drills

Other: Facility Checklists

Other: Post Basic Emergency Obstetric Training Mentorship

Other: Team-Based Supportive supervision

Other: Midwives exchange program

Other: Strengthening the referral network

Other: Training of health workers in Basic Obstetric Emergency Care

Other: Hospital-health center networking system