ArticleGlobal health, science and practice2022
Improving the Quality of Health Care in Special Neonatal Care Units of India: A Before and After Intervention Study.
Article in Global health, science and practice, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 18 citations in OpenAlex.
- Facilitating quality improvement activities related to newborn care in low- and middle-income countries: challenges and possible solutions.Maternal health, neonatology and perinatology · 2026Review
- Building a Future without Blindness due to Retinopathy of Prematurity in India: Progress, Challenges, and the Way Forward.Indian pediatrics · 2026Review
- Antibiotic stewardship and point-of-care testing for children in 25 low-income and lower-middle-income countries: a systematic review and meta-analysis.EClinicalMedicine · 2025Article
- Developing and piloting a peer quality improvement coaching protocol for front-line healthcare staff.BMJ open quality · 2025Article
- MusQan Initiative: Challenges and Opportunities.International journal of preventive medicine · 2025Article
- Revolutionizing Neonatal Care: A Comprehensive Review of Intact Cord Resuscitation in Newborns.Cureus · 2024Review
- Oxygen delivery and monitoring in neonatal intensive care units in Mexico in 2011 and in 2023: an observational longitudinal study.BMC nursing · 2024Article
- Use of digital technologies for staff education and training programmes on newborn resuscitation and complication management: a scoping review.BMJ paediatrics open · 2024Article
- Barriers and enablers of quality high-acuity neonatal care in sub-Saharan Africa: protocol for a synthesis of qualitative evidence.BMJ open · 2024Article
- Care of Healthy as well as Sick Newborns in India: A Narrative Review.Indian journal of pediatrics · 2023Review
- Retinopathy of prematurity in India - what can we learn from the polio legacy?The Lancet regional health. Southeast Asia · 2023Review
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe evaluated the efficacy of training health care workers (HCWs) in point-of-care quality improvement (POCQI) and a preterm newborn health care package (PHCP), followed by remote mentoring and supportive supervision in improving health care practices, neonatal survival, and morbidities in special neonatal care units (SNCUs).
methodsThis pre- and postintervention quality improvement study was conducted at 3 SNCUs in Madhya Pradesh, India from February 2017 to February 2019. Clinical care teams comprising doctors and nurses from the study sites were trained in POCQI and the PHCP. The teams identified, prioritized, and analyzed problems and designed quality improvement initiatives at their respective health facilities. Change ideas were tested by the local teams using sequential plan-do-study-act cycles. Facilitators maintained contact with the teams through quarterly review meetings, fortnightly videoconferencing, on-demand phone calls, and group chat service. State SNCU coordinators made follow-up visits to supplement coaching. Study research staff independently collected data on admissions, health care practices, and outcomes of neonates.
findingsA total of 156 HCWs were trained in the POCQI methodology and PHCP. Sixteen quality improvement projects were formulated and implemented. Among 13,821 enrolled neonates (birth weight 2275±635 g; gestation: 35.8±2.8 weeks), improvement was seen in reduction of use of oxygen (36.1% vs. 48.0%; adjusted odds ratio [aOR]=0.60, 95% confidence interval [CI]=0.55, 0.66), antibiotics (29.4% vs. 39.0%; aOR=0.76, 95% CI=0.68, 0.85), and dairy milk (33.8% vs. 49.4%; aOR=0.34, 95% CI=0.31 to 0.38). Enteral feeds were started within 24 hours of admission in a larger number of neonates, resulting in fewer days to reach full feeds. There was no effect on survival at discharge from the hospital (aOR=0.93; 95% CI=0.80, 1.09).
conclusionA collaborative cross-learning quality improvement approach with remote mentoring, coaching, and supportive supervision was successful in improving the quality of care at SNCUs.
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