ReviewGlobal health action2020
Translating international guidelines for use in routine maternal and neonatal healthcare quality measurement.
Review in Global health action, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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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.
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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.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Factors that influence the implementation of (inter)nationally endorsed health and social care standards: a systematic review and meta-summary.BMJ quality & safety · 2023Pooled it
- WHO recommendations for pregnancy and postpartum care should include hypertensive disorders of pregnancy.Bulletin of the World Health Organization · 2026Article
- Improving WHO's understanding of WHO guideline uptake and use in Member States: a scoping review.Health research policy and systems · 2022Article
- Towards a harmonised framework for developing quality of care indicators for global health: a scoping review of existing conceptual and methodological practices.BMJ health & care informatics · 2022Article
- Assessment of Prenatal Care Quality and Related Factors after the Implementation of the Family Physician Program in Northwest Iran.Iranian journal of nursing and midwifery researchArticle
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImproving facility-based quality for maternal and neonatal care is the key to reducing morbidity and mortality rates in low- and middle-income countries. Recent guidance from WHO and others has produced a large number of indicators to choose from to track quality.
objectiveTo explore how to translate complex global maternal and neonatal health standards into actionable application at the facility level.
methodsWe applied a two-step process as an example of how the 352 indicators in WHO's 2016 Standards for Improving Quality of Maternal and Newborn Care in Health Facilities might be reduced to only those with the strongest evidence base, associated with outcomes, and actionable by facility managers. We applied Hill criteria and assessed whether indicators were within the control of facility managers. We next conducted a rapid review of supporting literature and applied GRADE analysis, retaining those with scores of 'moderate' or 'high'. To understand the utility and barriers to measuring this limited set of indicators in practice, we undertook a case study of hypothetical measurement application in two districts in Bangladesh, interviewing 25 clinicians, managers, and other stakeholders.
resultsFrom the initial 352 indicators, 56 were retained. The 56 indicators were used as a base for interviews. Respondents emphasized the practical challenges to the use of complex guides and the need for parsimonious and actionable sets of quality indicators.
conclusionsThis work offers one way to move towards a reduced quality indicator set, beginning from current WHO guidance. Despite study limitations, this work provides evidence of the need for reduced and evidence-based sets of quality indicators if guides are to be used to improve quality in practice. We hope that future research will build on and refine our efforts. Measuring quality effectively so that evidence guides and improves practice is the first step to assuring safe maternal and neonatal care.
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