Medicine and Health Sciences Commons^™

Action Leveraging Evidence To Reduce Perinatal Mortality And Morbidity (Alert): Study Protocol For A Stepped-Wedge Cluster-Randomised Trial In Benin, Malawi, Tanzania And Uganda, Joseph Akuze, Kristi Sidney Annerstedt, Lenka Benova, Effie Chipeta, Jean-Paul Dossou, Mechthild M. Gross, Hussein Kidanto, Bruno Marchal, Helle Mölsted Alvesson, Andrea B. Pembe

Obstetrics and Gynaecology, East Africa

Background: Insufficient reductions in maternal and neonatal deaths and stillbirths in the past decade are a deterrence to achieving the Sustainable Development Goal 3. The majority of deaths occur during the intrapartum and immediate postnatal period. Overcoming the knowledge-do-gap to ensure implementation of known evidence-based interventions during this period has the potential to avert at least 2.5 million deaths in mothers and their offspring annually. This paper describes a study protocol for implementing and evaluating a multi-faceted health care system intervention to strengthen the implementation of evidence-based interventions and responsive care during this crucial period.

Methods: This is a cluster …

National Policies And Care Provision In Pregnancy And Childbirth For Twins In Eastern And Southern Africa: A Mixed-Methods Multi-Country Study, Claudia Hanson, Stephen Munjanja, Agnes Binagwaho, Bellington Vwalika, Andrea B. Pembe, Elsa Jacinto, George K. Chilinda, Kateri B. Donahoe, Sikolia Wanyonyi, Peter Waiswa, Muchabayiwa F. Gidiri, Lenka Benova

Obstetrics and Gynaecology, East Africa

Background: High-risk pregnancies, such as twin pregnancies, deserve particular attention as mortality is very high in this group. With a view to inform policy and national guidelines development for the Sustainable Development Goals, we reviewed national training materials, guidelines, and policies underpinning the provision of care in relation to twin pregnancies and assessed care provided to twins in 8 Eastern and Southern African countries: Kenya, Malawi, Mozambique, Rwanda, Tanzania, Uganda, Zambia, and Zimbabwe.

Methods and findings: We located policies and guidelines by reviewing national repositories and by contacting experts to systematically map country-level maternal and newborn training materials, guidelines, and …

Improving Quality Of Maternal And Newborn Care In Selected Districts In 3 Sub-Saharan Countries: Baseline Quality Assessment, Els Duysburgh, Wei-Hong Zhang, M. Ye, Adrian Williams, S. Massawe, A. Sie, J. Williams, R. Mpembeni, S. Loukanova, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Objectives: To measure pre-intervention quality of routine antenatal and childbirth care in rural districts of Burkina Faso, Ghana and Tanzania and to identify shortcomings.

Methods: In each country, we selected two adjoining rural districts. Within each district, we randomly sampled 6 primary healthcare facilities. Quality of care was assessed through health facility surveys, direct observation of antenatal and childbirth care, exit interviews and review of patient records.

Results: By and large, quality of antenatal and childbirth care in the six districts was satisfactory, but we did identify some critical gaps common to the study sites in all three countries. Counselling …