Effect of continuum-of-care intervention package on improving contacts and quality of maternal and newborn healthcare in Ghana: A cluster randomised controlled trial

Sumiyo Okawa, Margaret Gyapong, Hannah Leslie, Akira Shibanuma, Kimiyo Kikuchi, Francis Yeji, Charlotte Tawiah, Sheila Addei, Keiko Nanishi, Abraham Rexford Oduro, Seth Owusu-Agyei, Evelyn Ansah, Gloria Quansah Asare, Junko Yasuoka, Abraham Hodgson, Masamine Jimba

研究成果: ジャーナルへの寄稿記事

抄録

Objective To evaluate the effect of a continuum-of-care intervention package on adequate contacts of women and newborn with healthcare providers and their reception of high-quality care. Design Cluster randomised controlled trial. Setting 32 subdistricts in 3 rural sites in Ghana. Participants The baseline survey involved 1480 women who delivered before the trial, and the follow-up survey involved 1490 women who received maternal and newborn care during the trial. Interventions The intervention package included training healthcare providers, using an educational and recording tool named â € continuum-of-care card', providing the first postnatal care (PNC) by retaining women and newborns at healthcare facility or home visit by healthcare providers. Outcome measures Adequate contacts were defined as at least four contacts during pregnancy, delivery with assistance of skilled healthcare providers at a healthcare facility and three timely contacts within 6 weeks postpartum. High-quality care was defined as receiving 6 care items for antenatal care (ANC), 3 for peripartum care (PPC) and 14 for PNC. Results The difference-in-difference method was used to assess the effects of the intervention on the study outcome. The percentage of adequate contacts with high-quality care in the intervention group in the follow-up survey and the adjusted difference-in-difference estimators were 12.6% and 2.2 (p=0.61) at ANC, 31.5% and 1.9 (p=0.73) at PPC and 33.7% and 12.3 (p=0.13) at PNC in the intention-To-Treat design, whereas 13.0% and 2.8 (p=0.54) at ANC, 34.2% and 2.7 (p=0.66) at PPC and 38.1% and 18.1 (p=0.02) at PNC in the per-protocol design that assigned the study sample by possession of the continuum-of-care card. Conclusions The interventions improved contacts with healthcare providers and quality of care during PNC. However, having adequate contact did not guarantee high-quality care. Maternal and newborn care in Ghana needs to improve its continuity and quality. Trial registration number ISRCTN90618993.â

元の言語英語
記事番号e025347
ジャーナルBMJ open
9
発行部数9
DOI
出版物ステータス出版済み - 9 1 2019

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Postnatal Care
Ghana
Continuity of Patient Care
Quality of Health Care
Health Personnel
Peripartum Period
Randomized Controlled Trials
Mothers
Newborn Infant
Prenatal Care
Delivery of Health Care
Outcome Assessment (Health Care)
House Calls
Postpartum Period
Pregnancy
Surveys and Questionnaires

All Science Journal Classification (ASJC) codes

  • Medicine(all)

これを引用

Effect of continuum-of-care intervention package on improving contacts and quality of maternal and newborn healthcare in Ghana : A cluster randomised controlled trial. / Okawa, Sumiyo; Gyapong, Margaret; Leslie, Hannah; Shibanuma, Akira; Kikuchi, Kimiyo; Yeji, Francis; Tawiah, Charlotte; Addei, Sheila; Nanishi, Keiko; Oduro, Abraham Rexford; Owusu-Agyei, Seth; Ansah, Evelyn; Asare, Gloria Quansah; Yasuoka, Junko; Hodgson, Abraham; Jimba, Masamine.

:: BMJ open, 巻 9, 番号 9, e025347, 01.09.2019.

研究成果: ジャーナルへの寄稿記事

Okawa, S, Gyapong, M, Leslie, H, Shibanuma, A, Kikuchi, K, Yeji, F, Tawiah, C, Addei, S, Nanishi, K, Oduro, AR, Owusu-Agyei, S, Ansah, E, Asare, GQ, Yasuoka, J, Hodgson, A & Jimba, M 2019, 'Effect of continuum-of-care intervention package on improving contacts and quality of maternal and newborn healthcare in Ghana: A cluster randomised controlled trial', BMJ open, 巻. 9, 番号 9, e025347. https://doi.org/10.1136/bmjopen-2018-025347
Okawa, Sumiyo ; Gyapong, Margaret ; Leslie, Hannah ; Shibanuma, Akira ; Kikuchi, Kimiyo ; Yeji, Francis ; Tawiah, Charlotte ; Addei, Sheila ; Nanishi, Keiko ; Oduro, Abraham Rexford ; Owusu-Agyei, Seth ; Ansah, Evelyn ; Asare, Gloria Quansah ; Yasuoka, Junko ; Hodgson, Abraham ; Jimba, Masamine. / Effect of continuum-of-care intervention package on improving contacts and quality of maternal and newborn healthcare in Ghana : A cluster randomised controlled trial. :: BMJ open. 2019 ; 巻 9, 番号 9.
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abstract = "Objective To evaluate the effect of a continuum-of-care intervention package on adequate contacts of women and newborn with healthcare providers and their reception of high-quality care. Design Cluster randomised controlled trial. Setting 32 subdistricts in 3 rural sites in Ghana. Participants The baseline survey involved 1480 women who delivered before the trial, and the follow-up survey involved 1490 women who received maternal and newborn care during the trial. Interventions The intervention package included training healthcare providers, using an educational and recording tool named {\^a} € continuum-of-care card', providing the first postnatal care (PNC) by retaining women and newborns at healthcare facility or home visit by healthcare providers. Outcome measures Adequate contacts were defined as at least four contacts during pregnancy, delivery with assistance of skilled healthcare providers at a healthcare facility and three timely contacts within 6 weeks postpartum. High-quality care was defined as receiving 6 care items for antenatal care (ANC), 3 for peripartum care (PPC) and 14 for PNC. Results The difference-in-difference method was used to assess the effects of the intervention on the study outcome. The percentage of adequate contacts with high-quality care in the intervention group in the follow-up survey and the adjusted difference-in-difference estimators were 12.6{\%} and 2.2 (p=0.61) at ANC, 31.5{\%} and 1.9 (p=0.73) at PPC and 33.7{\%} and 12.3 (p=0.13) at PNC in the intention-To-Treat design, whereas 13.0{\%} and 2.8 (p=0.54) at ANC, 34.2{\%} and 2.7 (p=0.66) at PPC and 38.1{\%} and 18.1 (p=0.02) at PNC in the per-protocol design that assigned the study sample by possession of the continuum-of-care card. Conclusions The interventions improved contacts with healthcare providers and quality of care during PNC. However, having adequate contact did not guarantee high-quality care. Maternal and newborn care in Ghana needs to improve its continuity and quality. Trial registration number ISRCTN90618993.{\^a}",
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T1 - Effect of continuum-of-care intervention package on improving contacts and quality of maternal and newborn healthcare in Ghana

T2 - A cluster randomised controlled trial

AU - Okawa, Sumiyo

AU - Gyapong, Margaret

AU - Leslie, Hannah

AU - Shibanuma, Akira

AU - Kikuchi, Kimiyo

AU - Yeji, Francis

AU - Tawiah, Charlotte

AU - Addei, Sheila

AU - Nanishi, Keiko

AU - Oduro, Abraham Rexford

AU - Owusu-Agyei, Seth

AU - Ansah, Evelyn

AU - Asare, Gloria Quansah

AU - Yasuoka, Junko

AU - Hodgson, Abraham

AU - Jimba, Masamine

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Objective To evaluate the effect of a continuum-of-care intervention package on adequate contacts of women and newborn with healthcare providers and their reception of high-quality care. Design Cluster randomised controlled trial. Setting 32 subdistricts in 3 rural sites in Ghana. Participants The baseline survey involved 1480 women who delivered before the trial, and the follow-up survey involved 1490 women who received maternal and newborn care during the trial. Interventions The intervention package included training healthcare providers, using an educational and recording tool named â € continuum-of-care card', providing the first postnatal care (PNC) by retaining women and newborns at healthcare facility or home visit by healthcare providers. Outcome measures Adequate contacts were defined as at least four contacts during pregnancy, delivery with assistance of skilled healthcare providers at a healthcare facility and three timely contacts within 6 weeks postpartum. High-quality care was defined as receiving 6 care items for antenatal care (ANC), 3 for peripartum care (PPC) and 14 for PNC. Results The difference-in-difference method was used to assess the effects of the intervention on the study outcome. The percentage of adequate contacts with high-quality care in the intervention group in the follow-up survey and the adjusted difference-in-difference estimators were 12.6% and 2.2 (p=0.61) at ANC, 31.5% and 1.9 (p=0.73) at PPC and 33.7% and 12.3 (p=0.13) at PNC in the intention-To-Treat design, whereas 13.0% and 2.8 (p=0.54) at ANC, 34.2% and 2.7 (p=0.66) at PPC and 38.1% and 18.1 (p=0.02) at PNC in the per-protocol design that assigned the study sample by possession of the continuum-of-care card. Conclusions The interventions improved contacts with healthcare providers and quality of care during PNC. However, having adequate contact did not guarantee high-quality care. Maternal and newborn care in Ghana needs to improve its continuity and quality. Trial registration number ISRCTN90618993.â

AB - Objective To evaluate the effect of a continuum-of-care intervention package on adequate contacts of women and newborn with healthcare providers and their reception of high-quality care. Design Cluster randomised controlled trial. Setting 32 subdistricts in 3 rural sites in Ghana. Participants The baseline survey involved 1480 women who delivered before the trial, and the follow-up survey involved 1490 women who received maternal and newborn care during the trial. Interventions The intervention package included training healthcare providers, using an educational and recording tool named â € continuum-of-care card', providing the first postnatal care (PNC) by retaining women and newborns at healthcare facility or home visit by healthcare providers. Outcome measures Adequate contacts were defined as at least four contacts during pregnancy, delivery with assistance of skilled healthcare providers at a healthcare facility and three timely contacts within 6 weeks postpartum. High-quality care was defined as receiving 6 care items for antenatal care (ANC), 3 for peripartum care (PPC) and 14 for PNC. Results The difference-in-difference method was used to assess the effects of the intervention on the study outcome. The percentage of adequate contacts with high-quality care in the intervention group in the follow-up survey and the adjusted difference-in-difference estimators were 12.6% and 2.2 (p=0.61) at ANC, 31.5% and 1.9 (p=0.73) at PPC and 33.7% and 12.3 (p=0.13) at PNC in the intention-To-Treat design, whereas 13.0% and 2.8 (p=0.54) at ANC, 34.2% and 2.7 (p=0.66) at PPC and 38.1% and 18.1 (p=0.02) at PNC in the per-protocol design that assigned the study sample by possession of the continuum-of-care card. Conclusions The interventions improved contacts with healthcare providers and quality of care during PNC. However, having adequate contact did not guarantee high-quality care. Maternal and newborn care in Ghana needs to improve its continuity and quality. Trial registration number ISRCTN90618993.â

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