Perceived effectiveness and recommendations from a childbirth quality assurance and improvement programme in India’s private sector: a qualitative evaluation using the RE-AIM framework
Introduction Previous studies have revealed inconsistent quality of care in India’s private sector, where nearly one in three facility births take place. Manyata is a quality assurance and improvement programme launched in 2016 by the Federation of Obstetrics and Gynaecological Societies of India (F...
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Public Health |
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| author | Katherine Semrau Meghna Desai Lauren Spigel Somesh Kumar Megan Marx Delaney Lauren Bobanski Suranjeen Pallipamula Natalie Henrich Tapas Sadasivan Nair Hema Divakar Rajat Chabba Shweta Jindal Gulnoza Usmanova Sukanya Dutta Aarushi Gupta Sucheta Kinjawadekar Priti Kumar Priyanka Kumari Prerna Mukharya Hrishikesh Pai Ameya Purandare Pompy Sridhar |
| author_facet | Katherine Semrau Meghna Desai Lauren Spigel Somesh Kumar Megan Marx Delaney Lauren Bobanski Suranjeen Pallipamula Natalie Henrich Tapas Sadasivan Nair Hema Divakar Rajat Chabba Shweta Jindal Gulnoza Usmanova Sukanya Dutta Aarushi Gupta Sucheta Kinjawadekar Priti Kumar Priyanka Kumari Prerna Mukharya Hrishikesh Pai Ameya Purandare Pompy Sridhar |
| author_sort | Katherine Semrau |
| collection | DOAJ |
| description | Introduction Previous studies have revealed inconsistent quality of care in India’s private sector, where nearly one in three facility births take place. Manyata is a quality assurance and improvement programme launched in 2016 by the Federation of Obstetrics and Gynaecological Societies of India (FOGSI) that provides training, mentorship and accreditation to private maternity facilities. We aimed to understand participants’ motivations for joining or not joining, the perceived value of Manyata and recommendations for sustainment and scale.Methods We aimed to sample 238 Manyata participants for semi-structured, in-depth interviews between February and July 2021. Participants included facility owners, nurses, FOGSI quality assessors, programme implementers and Manyata leaders. Data were coded and analysed using a deductive and inductive process. Codes were mapped to the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework, which we expanded to include scale.Results We interviewed 185 programme participants. Maternity facility owners joined Manyata due to its affiliation with FOGSI, encouragement from peers and the desire to standardise care and train their staff. Barriers to joining included cost, unclear value and little motivation to improve practice. Participants most valued Manyata for improving staff competency, quality of care, standardised care processes and staff satisfaction. Participants felt that continuous training, mentorship and quality assurance would be necessary to maintain Manyata over time, and Manyata could and should be scaled across India and to other countries.Conclusion Strategies for engaging with the private sector should include building strategic partnerships and messaging a value proposition that emphasises training, standardised care processes and improved quality of care. A blended virtual and in-person model may be leveraged for ongoing training and quality assurance and to scale across contexts. Our evaluation of Manyata distills tangible lessons that policymakers, professional societies and public health practitioners can use to bridge the quality gap in their own private-sector maternity systems. |
| format | Article |
| id | doaj-art-f1908892a1dc48a8bdc22b23e85a16aa |
| institution | Kabale University |
| issn | 2753-4294 |
| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-f1908892a1dc48a8bdc22b23e85a16aa2025-01-22T03:40:10ZengBMJ Publishing GroupBMJ Public Health2753-42942025-01-013110.1136/bmjph-2024-001054Perceived effectiveness and recommendations from a childbirth quality assurance and improvement programme in India’s private sector: a qualitative evaluation using the RE-AIM frameworkKatherine Semrau0Meghna Desai1Lauren Spigel2Somesh Kumar3Megan Marx Delaney4Lauren Bobanski5Suranjeen Pallipamula6Natalie Henrich7Tapas Sadasivan Nair8Hema Divakar9Rajat Chabba10Shweta Jindal11Gulnoza Usmanova12Sukanya Dutta13Aarushi Gupta14Sucheta Kinjawadekar15Priti Kumar16Priyanka Kumari17Prerna Mukharya18Hrishikesh Pai19Ameya Purandare20Pompy Sridhar2110 Division of Global Health Equity and Department of Medicine, Brigham and Womens Hospital, Boston, Massachusetts, USADivision of Global Health Protection, U.S. Centers for Disease Control and Prevention (CDC), Country Office, New Delhi, IndiaAriadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women`s Hospital, Boston, Massachusetts, USA5 Dept. of Pediatrics, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, IndiaAriadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Womens Hospital, Boston, Massachusetts, USAAriadne Labs, Harvard T.H. Chan School of Public Health/Brigham and Women’s Hospital, Boston, Massachusetts, USA2 Jhpiego - an affiliate of Johns Hopkins University, Ranchi, JharkhandHarvard T.H. Chan School of Public Health/Brigham and Women’s Hospital, Boston, Massachusetts, USAHealth Workforce Department, WHO, Geneve, Switzerland17 Asian Research and Training Institute for Skill Transfer (ARTIST), Bengaluru, Indiasenior technical adviserJhpiego India, New Delhi, IndiaJhpiego India, New Delhi, IndiaOutline India, Gurugram, IndiaOutline India, Gurugram, IndiaThe Federation of Obstetric and Gynaecological Societies of India, Mumbai, IndiaThe Federation of Obstetric and Gynaecological Societies of India, Mumbai, IndiaJhpiego India, New Delhi, IndiaOutline India, Gurugram, IndiaThe Federation of Obstetric and Gynaecological Societies of India, Mumbai, IndiaThe Federation of Obstetric and Gynaecological Societies of India, Mumbai, IndiaMSD for Mothers, Mumbai, IndiaIntroduction Previous studies have revealed inconsistent quality of care in India’s private sector, where nearly one in three facility births take place. Manyata is a quality assurance and improvement programme launched in 2016 by the Federation of Obstetrics and Gynaecological Societies of India (FOGSI) that provides training, mentorship and accreditation to private maternity facilities. We aimed to understand participants’ motivations for joining or not joining, the perceived value of Manyata and recommendations for sustainment and scale.Methods We aimed to sample 238 Manyata participants for semi-structured, in-depth interviews between February and July 2021. Participants included facility owners, nurses, FOGSI quality assessors, programme implementers and Manyata leaders. Data were coded and analysed using a deductive and inductive process. Codes were mapped to the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework, which we expanded to include scale.Results We interviewed 185 programme participants. Maternity facility owners joined Manyata due to its affiliation with FOGSI, encouragement from peers and the desire to standardise care and train their staff. Barriers to joining included cost, unclear value and little motivation to improve practice. Participants most valued Manyata for improving staff competency, quality of care, standardised care processes and staff satisfaction. Participants felt that continuous training, mentorship and quality assurance would be necessary to maintain Manyata over time, and Manyata could and should be scaled across India and to other countries.Conclusion Strategies for engaging with the private sector should include building strategic partnerships and messaging a value proposition that emphasises training, standardised care processes and improved quality of care. A blended virtual and in-person model may be leveraged for ongoing training and quality assurance and to scale across contexts. Our evaluation of Manyata distills tangible lessons that policymakers, professional societies and public health practitioners can use to bridge the quality gap in their own private-sector maternity systems.https://bmjpublichealth.bmj.com/content/3/1/e001054.full |
| spellingShingle | Katherine Semrau Meghna Desai Lauren Spigel Somesh Kumar Megan Marx Delaney Lauren Bobanski Suranjeen Pallipamula Natalie Henrich Tapas Sadasivan Nair Hema Divakar Rajat Chabba Shweta Jindal Gulnoza Usmanova Sukanya Dutta Aarushi Gupta Sucheta Kinjawadekar Priti Kumar Priyanka Kumari Prerna Mukharya Hrishikesh Pai Ameya Purandare Pompy Sridhar Perceived effectiveness and recommendations from a childbirth quality assurance and improvement programme in India’s private sector: a qualitative evaluation using the RE-AIM framework BMJ Public Health |
| title | Perceived effectiveness and recommendations from a childbirth quality assurance and improvement programme in India’s private sector: a qualitative evaluation using the RE-AIM framework |
| title_full | Perceived effectiveness and recommendations from a childbirth quality assurance and improvement programme in India’s private sector: a qualitative evaluation using the RE-AIM framework |
| title_fullStr | Perceived effectiveness and recommendations from a childbirth quality assurance and improvement programme in India’s private sector: a qualitative evaluation using the RE-AIM framework |
| title_full_unstemmed | Perceived effectiveness and recommendations from a childbirth quality assurance and improvement programme in India’s private sector: a qualitative evaluation using the RE-AIM framework |
| title_short | Perceived effectiveness and recommendations from a childbirth quality assurance and improvement programme in India’s private sector: a qualitative evaluation using the RE-AIM framework |
| title_sort | perceived effectiveness and recommendations from a childbirth quality assurance and improvement programme in india s private sector a qualitative evaluation using the re aim framework |
| url | https://bmjpublichealth.bmj.com/content/3/1/e001054.full |
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