Evaluation of a quality improvement intervention for obstetric and neonatal care in selected public health facilities across six states of India
In India, in recent years, there has been a great increase in the number of women delivering in health facilities; however, the quality of obstetric and neonatal care within these facilities is often quite poor, which contributes to continuing high rates of maternal and neonatal mortality.
The USAID ASSIST Project supported health workers in 125 public health facilities across six states – delivering approximately 180,000 babies per year – to use quality improvement (QI) approaches to provide better care to women and babies before, during, and immediately after delivery.
This study analyzed the impact of this intervention on nine elements of routine delivery and newborn care and found that quality improvement had a positive, statistically significant impact on 8 out of the nine elements of care.Perinatal mortality declined from 26.7 to 22.9 deaths/1000 live births (p < 0.01) over this same period; however, it is difficult to show statistically that this was directly caused by the intervention.
This paper discusses the intervention and its evaluation in detail and presents the implications of its finding for policymakers and health professionals.