Objective
Identifying and implementing sustainable interventions to improve the quality of hospital care in sub-Saharan Africa is challenging. Maternal and perinatal mortality ratios stagnate at a high level; improving hospitals' responsiveness to obstetric emergencies is thought to be an important potential contribution to decrease them. WHO will soon launch an initiative to promote a range of quality assurance strategies, including several types of facility-based audits. While audits certainly hold promise, the evidence for their effectiveness is mixed.
All randomised controlled trials of audits have been undertaken in industrialised countries, but the effectiveness of health services intervention is likely to vary according to context. We propose a cluster-randomised controlled trial 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). WHO guidelines on the management of obstetric complications and enhanced routine documentation including the WHO pantographs will be introduced in all 36 participating hospitals, while CBCA or PCCR will be set up in 12 hospitals each.
The 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. A concurrent anthropological study will improve our understanding of how audits work or why they fail and identify barriers and facilitators for their successful integration into routine practice. An economic evaluation will assess the cost-effectiveness of both interventions. We are confident that the trial results will not only provide essential data for policy making in safe motherhood, but will provide lessons for quality assurance in district hospital in developing countries in general.
Fields of science (EuroSciVoc)
CORDIS classifies projects with EuroSciVoc, a multilingual taxonomy of fields of science, through a semi-automatic process based on NLP techniques. See: The European Science Vocabulary.
CORDIS classifies projects with EuroSciVoc, a multilingual taxonomy of fields of science, through a semi-automatic process based on NLP techniques. See: The European Science Vocabulary.
- social sciences sociology demography mortality
- social sciences sociology anthropology social anthropology
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Programme(s)
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Multi-annual funding programmes that define the EU’s priorities for research and innovation.
Topic(s)
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Calls for proposals are divided into topics. A topic defines a specific subject or area for which applicants can submit proposals. The description of a topic comprises its specific scope and the expected impact of the funded project.
Call for proposal
Procedure for inviting applicants to submit project proposals, with the aim of receiving EU funding.
Procedure for inviting applicants to submit project proposals, with the aim of receiving EU funding.
FP6-2004-INCO-DEV-3
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Funding Scheme
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Funding scheme (or “Type of Action”) inside a programme with common features. It specifies: the scope of what is funded; the reimbursement rate; specific evaluation criteria to qualify for funding; and the use of simplified forms of costs like lump sums.
Coordinator
LONDON
United Kingdom
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