Evidence map›Paper›PMID 36580073›Full record

Trial reportJournal of global health2022

Effect of a quality improvement intervention for management of preterm births on outcomes of all births in Kenya and Uganda: A secondary analysis from a facility-based cluster randomized trial.

Rakesh Ghosh, Phelgona Otieno, Elizabeth Butrick, Nicole Santos, Peter Waiswa, Dilys Walker, Preterm Birth Initiative Kenya and Uganda Implementation Research Collaborative

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03112018 (Strengthening Intrapartum and Immediate Newborn Care to Reduce Morbidity and Mortality of Preterm Infants in Health Facilities in Migori County, Kenya and Busoga Region, Uganda), which is 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
0.8field-weighted citation impact, top 23% 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.

NCT03112018 nacompletednot on this map

Strengthening Intrapartum and Immediate Newborn Care to Reduce Morbidity and Mortality of Preterm Infants in Health Facilities in Migori County, Kenya and Busoga Region, Uganda: an Implementation Science RCT

TypeinterventionalSponsorUniversity of California, San FranciscoRan2016 to 2019Enrolled102,988ConditionsPregnancy Complications, Preterm Labor, PreTerm Birth, StillbirthArmsdata strengthening, modified Safe childbirth checklist - control, modified Safe childbirth checklist - enhanced, PRONTO training, QI cycles
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  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

7 authors at 4 institutions in 4 countries.

Rakesh Ghosh *University of California, San Francisco, Institute for Global Health Sciences, USA.
Phelgona Otieno *Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya.
Elizabeth ButrickUniversity of California, San Francisco, Institute for Global Health Sciences, USA.
Nicole SantosUniversity of California, San Francisco, Institute for Global Health Sciences, USA.
Peter WaiswaMakerere University, School of Public Health, Uganda.
Dilys WalkerUniversity of California, San Francisco, Institute for Global Health Sciences, USA.
Preterm Birth Initiative Kenya and Uganda Implementation Research Collaborative
University of California, San Francisco · USGlobal Brain Health Institute · USKarolinska Institutet · SEKenya Medical Research Institute · KE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: A large proportion of early neonatal deaths occur at the time or on the first day of birth. The Preterm Birth Initiative East Africa (PTBi EA) set out to decrease mortality among preterm births through improving quality of facility-based intrapartum care. The PTBi EA cluster randomized trial's primary analysis showed the package reduced intrapartum stillbirth and neonatal death among preterm infants. This secondary analysis examines the impact of the PTBi intervention package on stillbirth and predischarge newborn deaths combined, among all births in 20 participating facilities in Kenya and Uganda. Methods: Eligible facilities were pair-matched and randomly assigned (1:1) into either the intervention or the control group. All facilities received support for data strengthening and a modified World Health Organization (WHO) Safe Childbirth Checklist; facilities in the intervention group additionally received provider mentoring using PRONTO simulation and team training as well as quality improvement collaboratives. We abstracted data from maternity registers. Results: Of the total 29 442 births that were included, Kenya had 8468 and 6465 births and Uganda had 8719 and 5790 births, in the control and intervention arms, respectively. There were 935 stillbirths and predischarge newborn deaths in the control arm and 439 in the intervention arm. The adjusted odds ratio (aOR) for the effect of the intervention on the combined outcome, among all births, was 0.96 (95% confidence interval (CI) = 0.69-1.32), which was different by country: Kenya - 1.12 (95% CI = 0.72-1.73); Uganda - 0.65 (95% CI = 0.44-0.98); P Conclusions: The intervention package improved survival among all births in Uganda but not in Kenya. These results suggest the importance of context and facility differences that were observed between the two countries. Registration: This trial is registered with ClinicalTrials.gov, NCT03112018.

Indexed as

Perinatal DeathPremature BirthFemaleHumansInfantInfant, NewbornInfant, PrematureKenyaPregnancyQuality ImprovementStillbirthUganda

Identifiers

PMID36580073
PMCPMC9799078
OpenAlexW4313325651

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.