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Does Quality Certification Work? An Assessment of Manyata, a Childbirth Quality Program in India's Private Sector.
- Source :
-
Global health, science and practice [Glob Health Sci Pract] 2022 Dec 21; Vol. 10 (6). Date of Electronic Publication: 2022 Dec 21 (Print Publication: 2022). - Publication Year :
- 2022
-
Abstract
- Background: In India, more than 60% of hospital beds are in private facilities, yet several studies have observed suboptimal quality of care in private facilities. We aimed to understand the role of Manyata, a quality improvement initiative in private facilities focused on mentorship and clinical standards, to improve the knowledge and skills of health care providers, their adherence to key childbirth-related clinical practices, and health outcomes for women and newborns.<br />Methods: We conducted a secondary analysis of Manyata program data collected from 466 private facilities across 3 states (Jharkhand, Maharashtra, and Uttar Pradesh) in India from October 2016 to February 2019. We calculated means and 95% confidence intervals for knowledge and skills assessment, adherence to facility standards was analyzed by calculating the proportion of facilities passing a given quality standard at baseline and endline, and changes in pregnancy outcomes were assessed with autoregression modeling.<br />Results: From assessments conducted before and after training among providers in Manyata, we observed a significant increase in average knowledge score (6.3 vs. 13.2 of 20) and skill score (8.0 vs. 34.3 of 40). Overall, a significant increase occurred in adherence to clinical standards between baseline and endline assessments (29% vs. 93%). The standards with the greatest improvements were identification and management of eclampsia/preeclampsia, postpartum hemorrhage, and neonatal resuscitation. There were no significant changes over time in absolute rate of reported complications; however, referral rates from private facilities for preeclampsia and newborn sepsis identification and management declined.<br />Conclusion: Our analysis indicates private facilities' adherence to quality standards and nurses' childbirth knowledge and practical skills increased during Manyata. Additional efforts are needed to ensure high-quality care during cesarean deliveries at private facilities. Future studies with rigorous design are required to evaluate the impact of this quality improvement initiative in improving pregnancy outcomes.<br /> (© Marx Delaney et al.)
Details
- Language :
- English
- ISSN :
- 2169-575X
- Volume :
- 10
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Global health, science and practice
- Publication Type :
- Academic Journal
- Accession number :
- 36562433
- Full Text :
- https://doi.org/10.9745/GHSP-D-22-00093