Caesarean section Pregnancy and Childbirth Single delivery by caesarean section
Conditions
Interventions
Current interventions as of 09/05/2017:
This study combines a multicentre cluster randomized controlled trial with an implementation analysis in an mixed-methods approach. The evidence
2) training of personnel
and 3) decision-support reminders of indications for caesareans via text messages. To analyze the intervention process, a longitudinal qualitative study consisting of deliberative workshops and indivi
and 2) conducting clinical audits of indications for caesareans based on objective criteria (criteria-based clinical audits, CBCA). The trainers will create CBCA teams in their own hospitals and will
Sponsors
CEPED - Centre Population et Développement UMR 196
Eligibility
Sex/Gender
Female
Inclusion criteria
Inclusion criteria: For the hospitals: 1. A minimum of 1000 deliveries per year 2. A minimum of 200 caesarean sections per year 3. The permanent availability of emergency caesarean section 4. The absence of current or recent experience in clinical audits for caesarean 5. Willingness to participate in the study is materialized by a written and signed ward agreement by the hospital director and the head of the maternity unit 6. District or regional hospital For the patients: We will include all women who deliver by caesarean section in selected hospitals during the study period: the first 100 caesarean sections for each center during the pre-intervention period (6 months) and the first 100 caesarean sections for each center in the post-intervention period. . For the health professionals: All health professionals involved in the decision making process for a caesarean section: obstetricians, general practitioners, nurses and midwives.
Exclusion criteria
Exclusion criteria: For the hospitals: 1. University hospitals 2. Private hospitals For the patients: Women admitted in a center participating in the study but whose caesarean section was performed in another center
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The effect of the intervention will be measured by the change in the rate of non-medically justified caesarean sections among all caesarean sections between the periods before and after the intervention. Data on caesarean sections will be collected for 6 months before the intervention period and 6 months after the intervention period. They relate to clinical information for judging the appropriateness of indications for caesarean section according to objective criteria approved by a committee of independent experts. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Knowledge score of health care professionals using specific vignettes 2. Quality scores for the practice of caesareans based on objective criteria (specific tasks) 3. Score of resource availability using the complexity index proposed by WHO 4. Fatality rate of caesarean sections (mother and child) Each of these outcomes will be measured before and after the intervention period. | — |
Countries
Burkina Faso, France
Outcome results
None listed