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Assessment of facility readiness for implementing the WHO/UNICEF standards for improving quality of maternal and newborn care in health facilities – experiences from UNICEF’s implementation in three…

Overview of attention for article published in BMC Health Services Research, July 2018
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Title
Assessment of facility readiness for implementing the WHO/UNICEF standards for improving quality of maternal and newborn care in health facilities – experiences from UNICEF’s implementation in three countries of South Asia and sub-Saharan Africa
Published in
BMC Health Services Research, July 2018
DOI 10.1186/s12913-018-3334-0
Pubmed ID
Authors

Alexander Manu, Shams Arifeen, John Williams, Edward Mwasanya, Nabila Zaka, Beth Anne Plowman, Debra Jackson, Priscilla Wobil, Kim Dickson

Abstract

There is a global drive to promote facility deliveries but unless coupled with concurrent improvement in care quality, it might not translate into mortality reduction for mothers and babies. The World Health Organization published the new "Standards for improving quality of care for mothers and newborns in health facilities" but these have not been tested in low- and middle-income settings. UNICEF and its partners are taking the advantage provided by the Mother and Baby Friendly Hospital Initiative in Bangladesh, Ghana and Tanzania to test these standards to inform country adaptation. This manuscript presents a framework used for assessment of facility quality of care to inform the effect of quality improvement interventions. This assessment employed a quasi-experimental design with pre-post assessments in "implementation" and "comparison" facilities-the latter will have no quality improvement interventions implemented. UNICEF and assessment partners developed an assessment framework, developed uniform data collection tools and manuals for harmonised training and implementation across countries. The framework involves six modules assessing: facility structures, equipment, drugs and supplies; policies and guidelines supporting care-giving, staff recruitment and training; care-providers competencies; previous medical records; provider-client interactions (direct observation); and client perspectives on care quality; using semi-structured questionnaires and data collectors with requisite training. In Bangladesh, the assessment was conducted in 3 districts. In one "intervention" district, the district hospital and five upazilla health complexes were assessed. similar number of facilities were assessed each two adjoining comparison districts. In Ghana it was in three hospitals and five health centres and in Tanzania, two hospitals and four health centres. In the latter countries, same number of facilities were selected in the same number of districts to serve for comparison. Outcomes were structured to examine whether facilities currently provide services commensurate with their designation (basic or comprehensive emergency obstetric and newborn care). These outcomes were stratified so that they inform intervention implementation in the short-, medium- and long-term. This strategy and framework provides a very useful model for supporting country implementation of the new WHO standards. It will serve as a template around which countries can build quality of care assessment strategies and metrics to inform their health systems on the effect of QI interventions on care processes and outcomes.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 275 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 275 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 43 16%
Researcher 27 10%
Student > Bachelor 25 9%
Student > Ph. D. Student 24 9%
Student > Doctoral Student 15 5%
Other 41 15%
Unknown 100 36%
Readers by discipline Count As %
Medicine and Dentistry 71 26%
Nursing and Health Professions 37 13%
Social Sciences 27 10%
Agricultural and Biological Sciences 5 2%
Psychology 5 2%
Other 24 9%
Unknown 106 39%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 July 2018.
All research outputs
#13,104,474
of 23,094,276 outputs
Outputs from BMC Health Services Research
#4,390
of 7,739 outputs
Outputs of similar age
#158,440
of 326,642 outputs
Outputs of similar age from BMC Health Services Research
#161
of 223 outputs
Altmetric has tracked 23,094,276 research outputs across all sources so far. This one is in the 42nd percentile – i.e., 42% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,739 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.8. This one is in the 42nd percentile – i.e., 42% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 326,642 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 50% of its contemporaries.
We're also able to compare this research output to 223 others from the same source and published within six weeks on either side of this one. This one is in the 26th percentile – i.e., 26% of its contemporaries scored the same or lower than it.