Evidence map›Paper›PMID 33276773›Full record

Trial reportBMC health services research2020

A comparison of intensive vs. light-touch quality improvement interventions for maternal health in Uttar Pradesh, India.

Dominic Montagu, Katie Giessler, Michelle Kao Nakphong, Cathy Green, Kali Prosad Roy, Ananta Basudev Sahu, Kovid Sharma, May Sudhinarset

2 registry-linked trialsOpen access · goldAbstract readClinical TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.3field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT04208841 nacompletednot on this map

Strengthening Person-centered Accessibility, Respect, and Quality of Maternal Health Services in India, Phase 2

TypeinterventionalSponsorUniversity of California, San FranciscoRan2018 to 2019Enrolled1,971ConditionsReproductive HealthArmsPerson-Centered Care Quality Improvement Collaborative Sustain, Person-Centered Care Quality Improvement Collaborative Spread
NCT04208867 nacompletednot on this map

Strengthening People-centered Accessibility, Respect, and Quality for Reproductive Health Services in Uttar Pradesh, India, Phase 1

TypeinterventionalSponsorUniversity of California, San FranciscoRan2016 to 2018Enrolled2,989ConditionsMaternal Health, Delivery, Reproductive HealthArmsQI Collaborative
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 3 countries.

Dominic MontaguUniversity of California San Francisco, 550 16th St., San Francisco, CA, USA. dominic.montagu@ucsf.edu.ORCID http://orcid.org/0000-0002-2477-5543
Katie GiesslerUniversity of California San Francisco, 550 16th St., San Francisco, CA, USA.
Michelle Kao NakphongUniversity of California Los Angeles, 650 Charles E. Young Drive South, Los Angeles, CA, 90095-1772, USA.
Cathy GreenIndepedent Improvement Consultant, 24 One Chapmans Peak Drive, Western Cape, Hout Bay, South Africa.
Kali Prosad RoyPopulation Services International, C-445 Chittranjan Park, New Delhi, 110019, India.
Ananta Basudev SahuPopulation Services International. Nidhi Kamal Tower, 202, 2nd Floor, Plot - 37 & 38B, Barwara House, Ajmer Road, Jaipur, Rajasthan, India.
Kovid SharmaPopulation Services International, Lucknow, Uttar Pradesh, India.
May SudhinarsetUniversity of California Los Angeles, 650 Charles E. Young Drive South, Los Angeles, CA, 90095-1772, USA.
Population Services International · INUniversity of California, Los Angeles · USUniversity of California, San Francisco · US

Funding

Scientific and Technical CoreP2CHD041022 · NICHD · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Martha Jane Bailey · 2016 to 2026
$6.9M
Gates Foundation INV-009179NICHD NIH HHS P2C HD041022
6 · The paper itself

Abstract

backgroundPoor patient experiences during delivery leads to delayed presentation at facilities and contributes to poor maternal health outcomes. Person-centered maternity care (PCMC) is a key component of quality. Improving PCMC requires changing the process of care which can be complex and necessitate significant external input, making replication and scale difficult. This study compares the effectiveness two Quality Improvement (QI) intervention phases, one Intensive, one Light-Touch.

methodsWe use a matched case-control design to compare two phases of a QI Intervention targeting PCMC, with three facilities in each. The Intensive phase was introduced into three government facilities where teams were supported to identify, design, and test potential improvements over 12 months. The Light-Touch phase was subsequently introduced in three other government facilities and changes were tracked over six months. We compared the two groups using multivariate linear regression and difference-in-difference models to assess changes in PCMC outcome

resultsBoth Intensive and Light-Touch arms demonstrated large improvements in PCMC. On a scale from 0 to 100, Intensive facilities increased in PCMC scores from 85.02 to 97.13, while Light-Touch facilities increased from 63.42 to 87.47. For both there was a 'halo' effect, with a similar improvement recorded for the specific improvement activities focused on, as w ell as aspects of PCMC not directly addressed.

conclusionsThis study demonstrates that a short, inexpensive, light-touch and directive intervention can change staff practices and significantly improve the experiences of women during childbirth. It also shows that improvements in a few areas of provider-patient interaction have a 'halo' effect, changing many other aspects of patient-provider interaction at the same time.

trial registrationQI Phase 1 - NCT04208867 . Retrospectively registered. December 19th, 2019. QI Phase 2 - NCT04208841 . Retrospectively registered. December 23, 2019.

Indexed as

Maternal HealthMaternal Health ServicesFemaleHumansIndiaPregnancyQuality ImprovementTouchMaternal healthPerson-centered careQuality improvement

Identifiers

PMID33276773
PMCPMC7716449
OpenAlexW3108666921

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.