Trial reportBMC pregnancy and childbirth2014
Adherence to evidence based care practices for childbirth before and after a quality improvement intervention in health facilities of Rajasthan, India.
Trial report in BMC pregnancy and childbirth, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 55 citations in OpenAlex.
- Evaluating implementation strategies for essential newborn care interventions in low- and low middle-income countries: a systematic review.Health policy and planning · 2020Pooled it
- Assessing the quality of care in low- and middle-income countries: a rapid review of the landscape of assessment tools.BMJ global health · 2026Review
- Negligence in data recording during institutional birth: exploring health workers' perspectives on the barriers and enablers of data documentation practices.Archives of public health = Archives belges de sante publique · 2025Article
- Collaboration between local authorities and civil society organisations for improving health: a scoping review.BMJ open · 2025Article
- Evidence-based intrapartum care during vaginal births: Direct observations in a tertiary care hospital in Central Sri Lanka.Heliyon · 2024Article
- Decision-maker roles in healthcare quality improvement projects: a scoping review.BMJ open quality · 2024Article
- Evaluation of Dakshata, a scale-up WHO SCC and mentoring-based program, for improving quality of intrapartum care in public sector in Rajasthan, India: repeated mixed-methods surveys.Archives of public health = Archives belges de sante publique · 2023Article
- Article
- Advancing quality and safety of perinatal services in India: opportunities for effective midwifery integration.Health policy and planning · 2022Article
- Safe Delivery application with facilitation increases knowledge and confidence of obstetric and neonatal care among frontline health workers in India.Journal of family medicine and primary care · 2022Article
- Baseline Assessment of Evidence-Based Intrapartum Care Practices in Medical Schools in 3 States in India: A Mixed-Methods Study.Global health, science and practice · 2022Article
- Improving curriculum delivery: Using a results informed quality improvement model for teen behavioral health education.Frontiers in public health · 2022Article
- Evidence-Based Intrapartum Practice and Associated Factors Among Obstetric Care Providers Working in Public Hospitals of South Wollo Zone North-Central Ethiopia: An Institutional-Based Cross-Sectional Study.International journal of women's health · 2022Article
- Measuring facility readiness to provide childbirth care: a comparison of indices using data from a health facility survey in Ethiopia.BMJ global health · 2021Article
- "We are nurses - what can we say?": power asymmetries and Auxiliary Nurse Midwives in an Indian state.Sexual and reproductive health matters · 2021Article
- Disclosing suboptimal indications for emergency caesarean sections due to fetal distress and prolonged labor: a multicenter cross-sectional study at 12 public hospitals in Nepal.Reproductive health · 2020Article
- Statewide implementation of a quality improvement initiative for reproductive, maternal, newborn and child health and nutritionin Bihar, India.Journal of global health · 2020Review
- Situation of labour room documentation at secondary level public health facilities of Cuttack district, Odisha, India - A SWOT analysis.Journal of family medicine and primary care · 2020Article
- Determinants of clean birthing practices in low- and middle-income countries: a scoping review.BMC public health · 2020Article
- Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAfter the launch of Janani Suraksha Yojana, a conditional cash transfer scheme in India, the proportion of women giving birth in institutions has rapidly increased. However, there are important gaps in quality of childbirth services during institutional deliveries. The aim of this intervention was to improve the quality of childbirth services in selected high caseload public health facilities of 10 districts of Rajasthan. This intervention titled "Parijaat" was designed by Action Research & Training for Health, in partnership with the state government and United Nations Population Fund.
methodsThe intervention was carried out in 44 public health facilities in 10 districts of Rajasthan, India. These included district hospitals (9), community health centres (32) and primary health centres (3). The main intervention was orientation training of doctors and program managers and regular visits to facilities involving assessment, feedback, training and action. The adherence to evidence based practices before, during and after this intervention were measured using structured checklists and scoring sheets. Main outcome measures included changes in practices during labour, delivery or immediate postpartum period.
resultsUse of several unnecessary or harmful practices reduced significantly. Most importantly, proportion of facilities using routine augmentation of labour reduced (p = 0), episiotomy for primigravidas (p = 0.0003), fundal pressure (p = 0.0003), and routine suction of newborns (0 = 0.0005). Among the beneficial practices, use of oxytocin after delivery increased (p = 0.0001) and the practice of listening foetal heart sounds during labour (p = 0.0001). Some practices did not show any improvements, such as dorsal position for delivery, use of partograph, and hand-washing.
conclusionsAn intervention based on repeated facility visits combined with actions at the level of decision makers can lead to substantial improvements in quality of childbirth practices at health facilities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.