Evidence map›Paper›PMID 38135302›Full record

ArticleBMJ open quality2023

Quality improvement collaboratives as part of a quality improvement intervention package for preterm births at sub-national level in East Africa: a multi-method analysis.

Rogers Mandu, Lara Miller, Gertrude Namazzi, Nana Twum-Danso, Kevin Jacton Abidha Achola, Isabella Cooney, Elizabeth Butrick, Nicole Santos, Leakey Masavah, Alphonce Nyakech and 3 more

Registry-linked trialOpen access · goldAbstract read
PubMed Publisher
In one paragraph

Article in BMJ open quality, 2023. 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 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.7field-weighted citation impact, top 13% 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

4 citing papers in PubMed, 3 citations in OpenAlex.

  1. Improving quality and safety at scale.Pediatric research · 2026
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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

13 authors at 4 institutions in 4 countries.

Rogers ManduSchool of Public Health, Makerere University, Kampala, Kampala, Uganda.
Lara MillerInstitute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA.
Gertrude NamazziSchool of Public Health, Makerere University, Kampala, Kampala, Uganda.
Nana Twum-DansoIndependent Consultant, New York, New York, USA.
Kevin Jacton Abidha AcholaKenya Medical Research Institute, Nairobi, Kenya.
Isabella CooneyInstitute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA.
Elizabeth ButrickInstitute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA Elizabeth.butrick@ucsf.edu.ORCID 0000-0002-0026-7464
Nicole SantosInstitute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA.
Leakey MasavahKenya Medical Research Institute, Nairobi, Kenya.
Alphonce NyakechKenya Medical Research Institute, Nairobi, Kenya.
Leah KirumbiKenya Medical Research Institute, Nairobi, Kenya.
Peter WaiswaSchool of Public Health, Makerere University, Kampala, Kampala, Uganda.
Dilys WalkerInstitute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA.
University of California, San Francisco · USKenya Medical Research Institute · KEMakerere University · UGKarolinska Institutet · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundQuality improvement collaboratives (QIC) are an approach to accelerate the spread and impact of evidence-based interventions across health facilities, which are found to be particularly successful when combined with other interventions such as clinical skills training. We implemented a QIC as part of a quality improvement intervention package designed to improve newborn survival in Kenya and Uganda. We use a multi-method approach to describe how a QIC was used as part of an overall improvement effort and describe specific changes measured and participant perceptions of the QIC.

methodsWe examined QIC-aggregated run charts on three shared indicators related to uptake of evidence-based practices over time and conducted key informant interviews to understand participants' perceptions of quality improvement practice. Run charts were evaluated for change from baseline medians. Interviews were analysed using framework analysis.

resultsRun charts for all indicators reflected an increase in evidence-based practices across both countries. In Uganda, pre-QIC median gestational age (GA) recording of 44% improved to 86%, while Kangaroo Mother Care (KMC) initiation went from 51% to 96% and appropriate antenatal corticosteroid (ACS) use increased from 17% to 74%. In Kenya, these indicators went from 82% to 96%, 4% to 74% and 4% to 57%, respectively. Qualitative results indicate that participants appreciated the experience of working with data, and the friendly competition of the QIC was motivating. The participants reported integration of the QIC with other interventions of the package as a benefit.

conclusionsIn a QIC that demonstrated increased evidence-based practices, QIC participants point to data use, friendly competition and package integration as the drivers of success, despite challenges common to these settings such as health worker and resource shortages. TRIAL REGISTRATION NUMBER: NCT03112018.

Indexed as

Kangaroo-Mother Care MethodPremature BirthAfrica, EasternClinical CompetenceFemaleHumansInfant, NewbornPregnancyQuality ImprovementHealth services researchImplementation scienceMaternal Health ServicesPaediatricsPDSA

Identifiers

PMID38135302
OpenAlexW4390110064

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.