Maternal and prenatal care
The 'Quality of maternal and prenatal care: Bridging the know-do gap' (QUALMAT)(opens in new window) project conducted studies of maternal and prenatal care in Burkina Faso, Ghana and Tanzania. The project aimed to understand the 'know-do gap', or the disconnect between the competence of health care workers and the quality of their care. The project also investigated whether a computer-assisted clinical decision support system (CDSS) was an effective tool in improving quality of care. Project results showed that lack of training or knowledge were not the reasons for poor care. Rather, the format of guidelines needs to be prioritised to increase their usability. Other reasons for inadequate care include poor education and counselling, inadequate laboratory investigations, lack of monitoring during childbirth and a shortage of necessary equipment during childbirth. Addressing these issues could reduce maternal and neonatal mortality and morbidity, although counselling does not appear to be an effective way to educate this population. The project addressed the know-do gap through a qualitative study measuring the impact of incentives on motivation. In-depth interviews revealed differences in ideas about motivation, underscoring the need to tailor incentive schemes to each country. Researchers also found that a mix of financial and non-financial incentives was acceptable to most health care workers. Furthermore, they appeared to increase motivation. Project members distributed the final version of the CDSS to the partner countries, with the system designed to provide guidance and clinical decision support during antenatal care visits and delivery. Preliminary results showed that providers are using the CDSS, with more patients entered into the system than expected. Data from more in-depth studies about the system's impact on quality of care and motivation of health care workers are currently being collected and analysed. Findings from the project have the potential to be applied to other developing countries. As a result, project efforts could lead to improvements in maternal health in other countries.
