Perinatal care Pregnancy and Childbirth
Conditions
Interventions
Non-clinical interventions targeted simultaneously at clinicians, women and health organizations to reduce unnecessary C-sections in Argentina, Burkina Faso, Thailand and Vietnam. The QUALI-DEC strate
Sponsors
Institut de Recherche pour le Développement
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Healthcare professionals: 1. Involved in obstetric care in the various participating hospitals. Health professionals have been defined as as obstetricians and nurses/midwives working on the maternity ward in the study facilities, and administrators as those working as managers on the maternity ward or health facility (e.g. medical/clinical director, head of obstetrics, matron-in-charge). Patients: 1. All women who are admitted to deliver in any participating facility during the study period. Delivery is defined as the birth of infant weighing =500 g or =22 weeks (=1000 g in Burkina Faso and Thailand), alive or dead, with or without malformations, by any route.
Exclusion criteria
Exclusion criteria: 1. Women admitted to participating hospitals for abortions or miscarriages 2. Women who delivered at home or in another centre with postnatal transfer
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Monthly C-section rate in participating hospitals among lower-risk women with no previous C-section with singleton pregnancy, with the foetus in cephalic presentation, and that has reached at least 37 weeks’ gestation (Groups 1-4 of the Robson classification) in the 6 months before and the 48 months after the start of the intervention | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Feasibility of the intervention assessed using document review and individual in-depth interviews with health professionals, women and potential companions during the baseline period and at the end of the intervention period 2. Fidelity of the intervention assessed using document review and individual in-depth interviews with health professionals, women and potential companions during the baseline period and at the end of the intervention period 3. Acceptability of the intervention assessed using document review and individual in-depth interviews with health professionals, women and potential companions during the baseline period and at the end of the intervention period 4. Scalability of the intervention assessed using document review and individual in-depth interviews with health professionals, women and potential companions during the baseline period and at the end of the intervention period The following outcome measures are for the cross-sectional study and will be assessed at months 6 and 30 of the study: 5. Maternal morbidity assessed using a questionnaire to post-partum mothers or from medical records 6. Perinatal morbidity assessed using a questionnaire to post-partum mothers or from medical records 7. Mother's satisfaction with the birth assessed using a questionnaire filled during the interview with post-partum women before they leave the maternity ward 8. Payment for medical care assessed using a questionnaire filled during the interview with post-partum women before they leave the maternity ward 9. Indirect costs of care for childbirth (e.g. cost of transportation to hospital) assessed using a questionnaire filled during the interview with post-partum women before they leave the maternity ward 10. Loss of earnings assessed using a questionnaire filled during the interview with post-partum women before they leave the maternity ward 11. Description of prenatal care (including use of the DAT) assessed using a questionnaire filled during the inter | — |
Countries
Argentina, Burkina Faso, Thailand, Viet Nam
Contacts
Public ContactAlexandre Dumont
Outcome results
None listed