GHTM

Global Health and Tropical Medicine

  • GHTM
    • Vision
    • Mission
    • Governance
    • Scientific Advisory Board
  • News
    • Outreach
    • Events
      • GHTM Sessions
      • Workshops
    • Articles
    • Jobs
  • Research
    • Cross-cutting issues
      • Global Pathogen Dispersion and Population Mobility
      • Drug Discovery and Drug Resistance
      • Diagnostics
      • Public Health Information
      • Fair Research Partnerships
    • Research Groups
      • PPS – Population health, policies and services
      • THOP – TB, HIV and opportunistic diseases and pathogens
      • VBD – Vector borne diseases and pathogens
      • IHC – Individual health care
    • Research in numbers
      • 2022
      • 2021
      • 2020
      • 2019
      • 2018
      • 2017
    • Projects
      • Ongoing Projects
      • Completed Projects
    • Members
      • Population health, policies and services
        • PPS PhD members
        • PPS non PhD members
      • TB, HIV and opportunistic diseases and pathogens
        • THOP PhD members
        • THOP non PhD members
      • Vector-borne diseases and pathogens
        • VBD PhD members
        • VBD non PhD members
      • Individual Health Care
        • IHC PhD members
        • IHC non PhD members
      • Technical / administrative support
  • Publications
    • 2023
    • 2022
  • Education
    • Master Theses
    • PhD Theses
  • Services
  • Reports
    • GHTM Reports
    • Scientific Advisory Board Reports
Home / Publicações / Evaluation of a quality improvement intervention for labour and birth care in Brazilian private hospitals: a protocol

Evaluation of a quality improvement intervention for labour and birth care in Brazilian private hospitals: a protocol

  • Autores: Ayres BVS, Belizán JM, Domingues RMSM, Figueiró AC, Gomes ML, Hartz Z, Leal MC, Nakano AR, Oliveira EFV, Pereira APE, Pereira MN, Sandall J, Torres JA
  • Ano de Publicação: 2018
  • Journal: Reproductive Health
  • Link: https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-018-0636-y
Background

In Brazilian private hospitals, caesarean section (CS) is almost universal (88%) and is integrated into the model of birth care. A quality improvement intervention, “Adequate Birth” (PPA), based on four driving components (governance, participation of women and families, reorganisation of care, and monitoring), has been implemented to help 23 hospitals reduce their CS rate. This is a protocol designed to evaluate the implementation of PPA and its effectiveness at reducing CS as a primary outcome of birth care.

Methods

Case study of PPA intervention conducted in 2017/2018. We integrated quantitative and qualitative methods into data collection and analysis. For the quantitative stage, we selected a convenient sample of twelve hospitals. In each of these hospitals, we included 400 women. This resulted in a total sample of 4800 women. We used this sample to detect a 2.5% reduction in CS rate. We interviewed managers and puerperal women, and extracted data from hospital records. In the qualitative stage, we evaluated a subsample of eight hospitals by means of systematic observation and semi-structured interviews with managers, health professionals and women. We used specific forms for each of the four PPA driving components. Forms for managers and professionals addressed the decision-making process, implemented strategies, participatory process in strategy design, and healthcare practice. Forms for women and neonatal care addressed socio-economic, demographic and health condition; prenatal and birth care; tour of the hospital before delivery; labour expectation vs. real experience; and satisfaction with care received. We will estimate the degree of implementation of PPA strategies related to two of the four driving components: “participation of women and families” and “reorganisation of care”. We will then assess its effect on CS rate and secondary outcomes for each of the twelve selected hospitals, and for the total sample. To allow for clinical, socio-demographic and obstetric characteristics in women, we will conduct multivariate analysis. Additionally, we will evaluate the influence of internal context variables (the PPA driving components “governance” and “monitoring”) on the degree of implementation of the components “participation of women and families” and “reorganisation of care”, by means of thematic content analysis. This analysis will include both quantitative and qualitative data.

Discussion

The effectiveness of quality improvement interventions that reduce CS rates requires examination. This study will identify strategies that could promote healthier births.

Share this:

  • Click to share on Facebook (Opens in new window)
  • Click to share on Twitter (Opens in new window)
  • Click to share on LinkedIn (Opens in new window)
  • Click to share on Pinterest (Opens in new window)
  • Click to share on WhatsApp (Opens in new window)
  • Click to print (Opens in new window)

Events

Retention in Care and Virological Failure among Adult HIV-Positive Patients on First-Line Antiretroviral Treatment in Maputo, Mozambique

    “Retention in Care and Virological Failure among Adult HIV-Positive Patients … [Read More...]

European Researchers’ Night 2023: join GHTM researchers to play ‘Hunt for viruses’

  On 29th September, the European Researchers Night reunite Portuguese researchers from all … [Read More...]

Carla Maia awarded by the Journal of Comparative Pathology Education Trust

  Carla Maia, Assistant Researcher and member of VBD-GHTM Research Group, was invited to … [Read More...]

Ciência Viva 2023: “PSI Parasite Scene Investigation – Be a Researcher for a week”

  “PSI Parasite Scene Investigation - Be a Researcher for a week” was the GHTM-IHMT … [Read More...]

Call for PhD Studentships

The Institute of Hygiene and Tropical Medicine (IHMT), Universidade Nova de Lisboa (NOVA), through … [Read More...]

IHMT | GHTM – APPLICATIONS ARE OPEN!

IHMT | GHTM - Applications are open for three research vacancies:   One position - PhD … [Read More...]

About GHTM

GHTM is a R&D Center that brings together researchers from IHMT with a track record in Tropical Medicine and International/Global Health. It aims at strengthening Portugal's role as a leading partner in the development and implementation of a global health research agenda. Our evidence-based interventions contribute to the promotion of equity in health and to improve the health of populations.

Contacts

Rua da Junqueira, 100
1349-008 Lisboa
Portugal
+351 213 652 600
+351 213 632 105

  • Facebook
  • YouTube

Subscribe Newsletter

  • How to get to GHTM/IHMT
  • GHTM Sessions
  • Research Groups
  • Cross-cutting issues
© Copyright 2023 IHMT-UNL Todos os Direitos Reservados.
  • Universidade Nova de Lisboa
  • Fundação para a Ciência e a Tecnologia

    Project UID/Multi/04413/2013