Effectiveness of facility-based audits to improve the responsiveness of West African district hospitals to obstetric emergencies : a three-country cluster randomised controlled trial

  • De Brouwere, Vincent, (Promotor)

Project Details

Description

Effectiveness of facility-based audits to improve the responsiveness of West African district hospitals to obstetric emergencies : a three-country cluster randomised controlled trial

Elaborate the trial intervention protocol for background and innovative strategy (control and innovation arm)
Elaborate the training curricula for background intervention that will be reinforced in control and innovation hospitals: guidelines on obstetric emergencies (with harmonisation according to local context), partograph, monitoring and documentation
Train the trainers on background intervention
Write the manual for district hospital staff on how to conduct clinical auditsElaborate the training curricula for the innovative strategy: the clinical audit (ACBC and RCCP)
Train the trainers on clinical audits
In 2007-2008, all tasks were delivered and the ITM team trained the trainers in Burkina and Benin on background intervention (8 July - 15 July 2007), then on clinical audits (25 July - 8 August 2008).

Objectives
To contribute to the evidence base concerning effective, acceptable and sustainable quality assurance strategies for hospital care in developing countries, using maternal and perinatal health care as a modelTo decrease maternal and perinatal mortality and severe morbidity in developing countries by improving district hospitals responsiveness to obstetric emergencies through introducing facility-based audits into routine hospital practice, provided they are effectiveTo strengthen the capacity of research institutions in developing countries to devise and conduct research providing robust evidence on strategies addressing key public health issues

Activities and expected results

Cluster-randomised controlled trial carried out in West African district hospitals to assess the effectiveness of two types of facility-based audits, criterion-based clinical audits (CBCA) and patient-centred case reviews (PCCR)
Primary outcome variable is a responsiveness score, designed to measure technical and organisational management of obstetric emergencies
Additional outcome measures include the delay between decision and start of emergency caesarean section, and hospital based perinatal mortality
Understanding, by means of a concurrent anthropological study, of how audits work or why they fail improved; and barriers and facilitators for their successful integration into routine practice identified
Cost-effectiveness of both interventions assessed through an economic evaluation.
AcronymAUDOBEM-AFRO
StatusFinished
Effective start/end date21/12/0631/12/11

Funding

  • European Commission: €249,009.20