The effect of Expanding Maternal and Neonatal Survival interventions on improving the coverage of labor monitoring and complication prevention practices in hospitals in Indonesia: A difference-in-difference analysis
| Autor: | Maya Tholandi, Sudirman Sudirman, Mandri Apriatni, Dwirani Amelia, Situ Nurul Qomariyah, Alisa Pedrana, Saifuddin Ahmed, Pancho Kaslam, Agus Rahmanto, Reena Sethi, Mark R. Emerson |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Resuscitation medicine.medical_specialty Maternal-Child Health Services Non-Randomized Controlled Trials as Topic Psychological intervention 03 medical and health sciences 0302 clinical medicine Pregnancy Infant Mortality Childbirth Infection control Medicine Humans 030212 general & internal medicine 030219 obstetrics & reproductive medicine Labor Obstetric business.industry Infant Newborn Obstetrics and Gynecology Infant General Medicine Delivery Obstetric Quality Improvement Confidence interval Labor monitoring Difference in differences Hospitals Maternal Mortality Indonesia Emergency medicine Female Complication business Program Evaluation |
| Zdroj: | International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 144 |
| ISSN: | 1879-3479 |
| Popis: | Objective To assess whether the Expanding Maternal and Neonatal Survival (EMAS) program was associated with improved care provided during hospital-based childbirth. Methods A quasi-experimental study with two rounds of data collection examined whether EMAS interventions improved facility-based labor and childbirth care. Direct clinical observations were conducted for 1208 deliveries across 13 hospitals in 12 districts. Primary outcome measures included implementation of standard practices to reduce the risk of complications during labor and childbirth for both women and newborns. Results Adjusted difference-in-difference analysis compared the mean difference in quality scores between EMAS intervention hospitals and comparison sites and consistently found significantly better performance in EMAS sites: 14 points higher for labor monitoring (β-coefficient 14.1; 95% confidence interval [CI], 7.1-21.0); 38 points higher for newborn resuscitation readiness (β-coefficient 38.1; 95% CI, 31.1-45.2); and 33 points higher for infection prevention practices (β-coefficient 32.6; 95% CI, 28.5-36.8). Conclusion EMAS approaches emphasizing facility readiness and adherence to performance standards significantly improved labor monitoring and complication prevention practices during childbirth. |
| Databáze: | OpenAIRE |
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