Can a quality improvement intervention improve person-centred maternity care in Kenya?

Few evidence-based interventions exist to improve person-centred maternity care in low-resource settings. This study aimed to understand whether a quality improvement (QI) intervention could improve person-centred maternity care (PCMC) experiences for women delivering in public health facilities in...

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Main Authors: May Sudhinaraset, Katie M. Giessler, Michelle Kao Nakphong, Meghan M. Munson, Ginger M. Golub, Nadia G. Diamond-Smith, James Opot, Cathy E. Green
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:Sexual and Reproductive Health Matters
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/26410397.2023.2175448
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author May Sudhinaraset
Katie M. Giessler
Michelle Kao Nakphong
Meghan M. Munson
Ginger M. Golub
Nadia G. Diamond-Smith
James Opot
Cathy E. Green
author_facet May Sudhinaraset
Katie M. Giessler
Michelle Kao Nakphong
Meghan M. Munson
Ginger M. Golub
Nadia G. Diamond-Smith
James Opot
Cathy E. Green
author_sort May Sudhinaraset
collection DOAJ
description Few evidence-based interventions exist to improve person-centred maternity care in low-resource settings. This study aimed to understand whether a quality improvement (QI) intervention could improve person-centred maternity care (PCMC) experiences for women delivering in public health facilities in Kenya. A pre–post design was used to examine changes in PCMC scores across three intervention and matched control facilities at baseline (n = 491) and endline (n = 677). A QI intervention, using the Model for Improvement, was implemented in three public health facilities in Nairobi and Kiambu Counties in Kenya. Difference-in-difference analyses using models that included main effects of both treatment group and survey round was conducted to understand the impact of the intervention on PCMC scores. Findings suggest that intervention facilities’ average total PCMC score decreased by 5.3 points post-intervention compared to baseline (95% CI: −8.8, −1.9) and relative to control facilities, holding socio-demographic and facility variables constant. Additionally, the intervention was significantly associated with a 1.8-point decrease in clinical quality index pre–post-intervention (95% CI: −2.9, −0.7), decreased odds of provider visits, and less likelihood to plan to use postpartum family planning. While improving the quality of women’s experiences during childbirth is a critical component to ensure comprehensive, high-quality maternity care experiences and outcomes, further research is required to understand which intervention methods may be most appropriate to improve PCMC in resource-constrained settings.
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spelling doaj-art-dfa5f9966ac54d7e9da5b062113667ac2025-08-20T03:27:17ZengTaylor & Francis GroupSexual and Reproductive Health Matters2641-03972023-12-0131110.1080/26410397.2023.2175448Can a quality improvement intervention improve person-centred maternity care in Kenya?May Sudhinaraset0Katie M. Giessler1Michelle Kao Nakphong2Meghan M. Munson3Ginger M. Golub4Nadia G. Diamond-Smith5James Opot6Cathy E. Green7Associate Professor, Community Health Sciences, Los Angeles (UCLA), University of California, Los Angeles, CA, USA.Senior Research Analyst, Institute for Global Health Sciences, San Francisco (UCSF), University of California, San Francisco, CA, USADoctoral Student, Community Health Sciences, Los Angeles (UCLA), University of California, Los Angeles, CA, USAProgram Manager, Jacaranda Health, Nairobi, KenyaSenior Research and Business Development Manager, Innovations for Poverty Action, Nairobi, KenyaAssistant Professor, Epidemiology and Biostatistics, University of California, San Francisco, CA, USASenior Research Associate, Innovations for Poverty Action, Nairobi, KenyaSenior Improvement Advisor, Jacaranda Health, Nairobi, KenyaFew evidence-based interventions exist to improve person-centred maternity care in low-resource settings. This study aimed to understand whether a quality improvement (QI) intervention could improve person-centred maternity care (PCMC) experiences for women delivering in public health facilities in Kenya. A pre–post design was used to examine changes in PCMC scores across three intervention and matched control facilities at baseline (n = 491) and endline (n = 677). A QI intervention, using the Model for Improvement, was implemented in three public health facilities in Nairobi and Kiambu Counties in Kenya. Difference-in-difference analyses using models that included main effects of both treatment group and survey round was conducted to understand the impact of the intervention on PCMC scores. Findings suggest that intervention facilities’ average total PCMC score decreased by 5.3 points post-intervention compared to baseline (95% CI: −8.8, −1.9) and relative to control facilities, holding socio-demographic and facility variables constant. Additionally, the intervention was significantly associated with a 1.8-point decrease in clinical quality index pre–post-intervention (95% CI: −2.9, −0.7), decreased odds of provider visits, and less likelihood to plan to use postpartum family planning. While improving the quality of women’s experiences during childbirth is a critical component to ensure comprehensive, high-quality maternity care experiences and outcomes, further research is required to understand which intervention methods may be most appropriate to improve PCMC in resource-constrained settings.https://www.tandfonline.com/doi/10.1080/26410397.2023.2175448Maternal healthwomen’s experiences of careperson-centred maternity carematernity carequality of carerespectful maternity care
spellingShingle May Sudhinaraset
Katie M. Giessler
Michelle Kao Nakphong
Meghan M. Munson
Ginger M. Golub
Nadia G. Diamond-Smith
James Opot
Cathy E. Green
Can a quality improvement intervention improve person-centred maternity care in Kenya?
Sexual and Reproductive Health Matters
Maternal health
women’s experiences of care
person-centred maternity care
maternity care
quality of care
respectful maternity care
title Can a quality improvement intervention improve person-centred maternity care in Kenya?
title_full Can a quality improvement intervention improve person-centred maternity care in Kenya?
title_fullStr Can a quality improvement intervention improve person-centred maternity care in Kenya?
title_full_unstemmed Can a quality improvement intervention improve person-centred maternity care in Kenya?
title_short Can a quality improvement intervention improve person-centred maternity care in Kenya?
title_sort can a quality improvement intervention improve person centred maternity care in kenya
topic Maternal health
women’s experiences of care
person-centred maternity care
maternity care
quality of care
respectful maternity care
url https://www.tandfonline.com/doi/10.1080/26410397.2023.2175448
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