NCT04278612

Evaluation of the Effectiveness of a Quality Improvement Intervention

Evaluation of the Effectiveness of a Quality Improvement Intervention to Support Integration of Maternal, and Child and HIV Care in Primary Health Care Facilities in South Africa

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 1,438 (actual)
• Sponsor: University of KwaZulu · Academic / Other
• Sex: Female
• Age: —
• Healthy volunteers: Not accepted

Summary

This rigorous evaluation demonstrated that implementation of a time-limited quality improvement strategy effectively improved coverage of some components of an integrated maternal and child health service in a complex health environment, but we were unable to achieve the changes needed to provide a comprehensive package of care for mothers and children.

Detailed description

Background: Despite policies and guidelines recommending integration of health services in South Africa, provision of maternal and child health services remains fragmented. This study evaluated a rapid, scaleable, quality improvement intervention to improve integration of maternal and child health and HIV services at a primary health level, in KwaZulu-Natal, South Africa. Methods: A three-month intervention comprised of six quality improvement mentoring visits, learning sessions with clinic staff to share learnings, and a self-administered checklist aimed to assist health workers monitor and implement an integrated package of health services for mothers and children. The study evaluated 27 clinics in four sub-districts using a stepped-wedge design. Each sub-district received the intervention sequentially in a randomly selected order. Five waves of data collection were conducted in all participating clinics between December 2016-February 2017. A multi-level, mixed effects logistic regression was used to account for random cluster fixed time and group effects using Stata V13.1.

Conditions

• Maternal and Child Health

Interventions

Type	Name	Description
OTHER	Quality improvement intervention to strengthen health service provision	Quality improvement intervention comprising of regular improvement meetings based at clinics.

Timeline

• Start date: 2016-01-18
• Primary completion: 2017-02-05
• Completion: 2019-01-16
• First posted: 2020-02-20
• Last updated: 2020-02-20