Trial reportBulletin of the World Health Organization2017
Improving the quality of hospital care for children by supportive supervision: a cluster randomized trial, Kyrgyzstan.
Trial report in Bulletin of the World Health Organization, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Assessing the quality of care for children attending health facilities: a systematic review of assessment tools.BMJ global health · 2021Pooled it
- Quality of medical services provided to mothers, newborns and children at the hospital level in the Kyrgyz Republic.Journal of global health · 2026Article
- Paediatric care in hospitals in Kyrgyzstan and Tajikistan: impact of a quality improvement initiative.Journal of global health · 2025Article
- Advancing the quality of maternal, newborn, and child healthcare: insights from pilot hospitals in the Kyrgyz Republic.Journal of global health · 2025Article
- A systematic, standard-based, participatory assessment of a Continuous Quality Improvement project in Kyrgyzstan and Tajikistan: results for maternal care.Journal of global health · 2025Article
- A systematic, standards-based, participatory assessment of a continuous quality improvement project in Kyrgyzstan and Tajikistan: results for neonatal care.Journal of global health · 2025Article
- Long-term outcomes of a paediatric quality improvement project in Central Asia: changes take time, time for a change.Journal of global health · 2025Article
- Unnecessary hospitalisations and polypharmacy practices in Tajikistan: a health system evaluation for strengthening primary healthcare.Archives of disease in childhood · 2023Article
- Innovative approach to monitor performance of integrated disease surveillance and response after the Ebola outbreak in Sierra Leone: lessons from the field.BMC health services research · 2022Article
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- Mixed-methods evaluation of a continuing education approach to improving district hospital care for children in Lao PDR.Tropical medicine & international health : TM & IH · 2022Article
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- Assessing quality of newborn care at district facilities in Malawi.BMC health services research · 2020Article
- Towards improved health service quality in Tanzania: contribution of a supportive supervision approach to increased quality of primary healthcare.BMC health services research · 2019Observational
- Observational
- Supportive supervision to improve the quality and outcome of outpatient care among malnourished children: a cluster randomised trial in Arua district, Uganda.BMJ global health · 2019Article
- Nutritional services for children in Beira, Mozambique: a study reporting on participatory use of data to generate quality improvement recommendations.BMJ open quality · 2019Article
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- Article
Corrections and comments
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine whether periodic supportive supervision after a training course improved the quality of paediatric hospital care in Kyrgyzstan, where inappropriate care was common but in-hospital postnatal mortality was low.
methodsIn a cluster, randomized, parallel-group trial, 10 public hospitals were allocated to a 4-day World Health Organization (WHO) course on hospital care for children followed by periodic supportive supervision by paediatricians for 1 year, while 10 hospitals had no intervention. We assessed prospectively 10 key indicators of inappropriate paediatric case management, as indicated by WHO guidelines. The primary indicator was the combination of the three indicators: unnecessary hospitalization, increased iatrogenic risk and unnecessary painful procedures. An independent team evaluated the overall quality of care.
findingsWe prospectively reviewed the medical records of 4626 hospitalized children aged 2 to 60 months. In the intervention hospitals, the mean proportion of the primary indicator decreased from 46.9% (95% confidence interval, CI: 24.2 to 68.9) at baseline to 6.8% (95% CI: 1.1 to 12.1) at 1 year, but was unchanged in the control group (45.5%, 95% CI: 25.2 to 67.9, to 64.7%, 95% CI: 43.3 to 86.1). At 1 year, the risk ratio for the primary indicator in the intervention versus the control group was 0.09 (95% CI: 0.06 to 0.13). The proportions of the other nine indicators also decreased in the intervention group (
conclusionPeriodic supportive supervision for 1 year after a training course improved both adherence to WHO guidelines on hospital care for children and the overall quality of paediatric care.
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