Cel 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. Dziedzina nauki social sciencessociologydemographymortalitymedical and health sciencesclinical medicineobstetricssocial sciencessociologyanthropologysocial anthropology Program(-y) FP6-INCO - Specific measures in support of international cooperation: Specific activities covering wider field of research under the Focusing and Integrating Community Research programme 2002-2006. Temat(-y) INCO-2004-A1.2 - Health care system, policy and management Zaproszenie do składania wniosków FP6-2004-INCO-DEV-3 Zobacz inne projekty w ramach tego zaproszenia System finansowania STREP - Specific Targeted Research Project Koordynator London School of Hygiene and Tropical Medicine Wkład UE Brak danych Adres Keppel Street LONDON Zjednoczone Królestwo Zobacz na mapie Linki Strona internetowa Opens in new window Koszt całkowity Brak danych Uczestnicy (6) Sortuj alfabetycznie Sortuj według wkładu UE Rozwiń wszystko Zwiń wszystko EAST EUROPEAN INSTITUTE FOR REPRODUCTIVE HEALTH Rumunia Wkład UE Brak danych Adres 1 Moldovei St TARGU-MURES Zobacz na mapie Koszt całkowity Brak danych CENTRE DE RECHERCHE EN REPRODUCTION HUMAINE ET EN DEMOGRAPHIE Benin Wkład UE Brak danych Adres Av Jean Paul ii, rue 232 01 BP 1822 COTONOU Zobacz na mapie Linki Strona internetowa Opens in new window Koszt całkowity Brak danych MINISTERE DE LA SANTE PUBLIQUE Niger Wkład UE Brak danych Adres 623 NIAMEY Zobacz na mapie Koszt całkowity Brak danych CHARITE - UNIVERSITATSMEDIZIN BERLIN Niemcy Wkład UE Brak danych Adres Chariteplatz 1 BERLIN Zobacz na mapie Linki Strona internetowa Opens in new window Koszt całkowity Brak danych Centre Muraz Burkina Faso Wkład UE Brak danych Adres 2054 Av Mamadou Konate 390 BOBO-DIOULASSO Zobacz na mapie Koszt całkowity Brak danych Prince Leopold Institute of Tropical Medicine Belgia Wkład UE Brak danych Adres Nationalestraat 155 ANTWERPEN Zobacz na mapie Linki Strona internetowa Opens in new window Koszt całkowity Brak danych
