Do facility-based audits help West African hospitals to provide better care for patients with obstetric emergencies?

Effectiveness of facility-based audits to improve the responsiveness of West African district hospitals to obstetric emergencies: a three-country cluster randomised controlled trial

Status

Active, not recruiting

Phases

Unknown

Study type

Interventional

Source

ISRCTN

Registry ID

ISRCTN67206260

Enrollment

Registered

2008-10-21

Start date

2008-11-01

Completion date

Unknown

Last updated

2021-01-11

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Major life-threatening obstetric complications: haemorrhage, uterine rupture, eclampsia, septicaemia Pregnancy and Childbirth Obstetric death of unspecified cause

Interventions

Prior to the trial, a 3 - 5 day refresher course on clinical management of major obstetric complications, use of partogramme and essential clinical documentation has been given to staff of all 36 part

Eligibility

Sex/Gender

Female

Inclusion criteria

Inclusion criteria: 1. District hospitals, supplemented by regional hospitals where number of eligible district hospitals was insufficient 2. Minimum number of births/year: 500 in Benin, 600 in Burkina Faso, 1000 in Niger 3. Minimum 50 caesarean sections/year

Exclusion criteria

Exclusion criteria: 1. Audits of obstetric near-miss morbidity already underway 2. Insecurity (Niger, desert region) 3. Unclear status as in health system (certain confessional hospitals in Benin) 4. Inability of key staff to communicate in French (Hospital in Burkina Faso run by Chinese Cooperation)

Design outcomes

Primary

Measure	Time frame
1. Quality of care score, based on compliance with adapted WHO treatment guidelines 2. Delay between decision for and start of emergency caesarean section 3. Perinatal mortality in mature newborns without malformations and, in the case of stillbirths, without signs of maceration. Maturity defined as gestational age greater than or equal to 35 weeks or gestational age greater than or equal to 8 months or birth weight greater than or equal to 200 g or length greater than or equal to 45 cm Comparison based on period month -6 to -1 before audit training versus period month +7 to +24 after audit training, with period month +1 to +6 considered as run-in period.	—

Measure

Time frame

1. Quality of care score, based on compliance with adapted WHO treatment guidelines 2. Delay between decision for and start of emergency caesarean section 3. Perinatal mortality in mature newborns without malformations and, in the case of stillbirths, without signs of maceration. Maturity defined as gestational age greater than or equal to 35 weeks or gestational age greater than or equal to 8 months or birth weight greater than or equal to 200 g or length greater than or equal to 45 cm Comparison based on period month -6 to -1 before audit training versus period month +7 to +24 after audit training, with period month +1 to +6 considered as run-in period.

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Secondary

Measure	Time frame
Secondary analyses will be used to generate hypotheses only, not to judge the success of the audit interventions.	—

Countries

Benin, Burkina Faso, Niger

Outcome results

None listed

Source: ISRCTN (via WHO ICTRP) · Data processed: Feb 4, 2026