Rose L Molina1,2,3, Jimena Villar4, Andrea Reyes5, James Elliott6, Mark Begley7, Mike Johnson7, Lindsay Palazuelos7, Mariana Montaño5, Hugo Flores3,5,8, Katherine E A Semrau3,8,9, Daniel Palazuelos3,7,8. 1. Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA. 2. Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA. 3. Harvard Medical School, Boston, MA, USA. 4. Department of Sexual and Reproductive Rights, Geneva Foundation for Medical Education and Research, Geneva, Switzerland. 5. Compañeros En Salud, Ángel Albino Corzo, Chiapas, Mexico. 6. School of Public Health, Boston University, Boston, MA, USA. 7. Partners In Health, Boston, MA, USA. 8. Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA. 9. Ariadne Labs, Boston, MA, USA.
Abstract
OBJECTIVE: To evaluate changes in quality of care after implementing an adapted safe childbirth checklist (SCC) in Chiapas, Mexico. METHODS: A convergent mixed-methods study was conducted among 447 women in labor who attended a rural community hospital between September 1, 2016, and June 30, 2017. Logistic regression analysis was used to evaluate adherence to evidence-based practices over time, adjusting for provider. Participants were surveyed about their perceptions of care after hospital discharge. A purposefully sampled subgroup also completed in-depth interviews. Thematic analysis was performed to evaluate perceptions of care. RESULTS: 384 (85.9%) women were attended by staff that used the adapted SCC during delivery. Of these, 221 and 28 completed the hospital discharge survey and in-depth interview, respectively. Adherence with offering a birth companion (odds ratio [OR] 3.06, 95% CI 1.40-6.68), free choice of birth position (2.75, 1.21-6.26), and immediate skin-to-skin contact (4.53, 1.97-10.39) improved 6-8 months after implementation. Participants' perceived quality of care improved over time. Provider communication generated positive perceptions. Reprimanding women for arriving in early labor or complaining of pain generated negative perceptions. CONCLUSION: Use of the adapted SCC improved quality of care through increased adherence with essential and respectful delivery practices.
OBJECTIVE: To evaluate changes in quality of care after implementing an adapted safe childbirth checklist (SCC) in Chiapas, Mexico. METHODS: A convergent mixed-methods study was conducted among 447 women in labor who attended a rural community hospital between September 1, 2016, and June 30, 2017. Logistic regression analysis was used to evaluate adherence to evidence-based practices over time, adjusting for provider. Participants were surveyed about their perceptions of care after hospital discharge. A purposefully sampled subgroup also completed in-depth interviews. Thematic analysis was performed to evaluate perceptions of care. RESULTS: 384 (85.9%) women were attended by staff that used the adapted SCC during delivery. Of these, 221 and 28 completed the hospital discharge survey and in-depth interview, respectively. Adherence with offering a birth companion (odds ratio [OR] 3.06, 95% CI 1.40-6.68), free choice of birth position (2.75, 1.21-6.26), and immediate skin-to-skin contact (4.53, 1.97-10.39) improved 6-8 months after implementation. Participants' perceived quality of care improved over time. Provider communication generated positive perceptions. Reprimanding women for arriving in early labor or complaining of pain generated negative perceptions. CONCLUSION: Use of the adapted SCC improved quality of care through increased adherence with essential and respectful delivery practices.
Authors: Dale A Barnhart; Katherine E A Semrau; Corwin M Zigler; Rose L Molina; Megan Marx Delaney; Lisa R Hirschhorn; Donna Spiegelman Journal: Implement Sci Commun Date: 2020-02-25
Authors: Oscar E C van Maarseveen; Wietske H W Ham; Nils L M van de Ven; Tim F F Saris; Luke P H Leenen Journal: Eur J Trauma Emerg Surg Date: 2019-08-07 Impact factor: 3.693