scholarly journals Experience of skill labs to improve quality of newborn care at birth in three district of Uttar Pradesh, India

2017 ◽  
Vol 4 (12) ◽  
pp. 4750
Author(s):  
Manoja Kumar Das ◽  
Chetna Chaudhary ◽  
Santosh Kumar Kaushal ◽  
Rajesh Khanna ◽  
Surojit Chatterji
Keyword(s):  
Developing Countries ◽  
Impact Assessment ◽  
Neonatal Resuscitation ◽  
Newborn Care ◽  
Uttar Pradesh ◽  
Improve Quality ◽  
Birth Attendants ◽  
One Year ◽  
Skill Building

Background: Retention of neonatal resuscitation skill among birth attendants have been a challenge in developing countries. The objective of the study was to document the performance of skill labs and its impact on the skill and knowledge of the birth attendants in India.Methods: In three districts of Uttar Pradesh, impact assessment of twelve skill labs was done adopting mixed quantitative and qualitative methodology.Results: Twelve skill labs supported skill building of 606 birth attendants over one year. Six of the units performed well and four moderately and too units poorly. The health functionaries at all levels were positive about their experience about the skill labs. Majority of them hoped sustenance of these units. There was marked retention of resuscitation skill after one year.Conclusions: The skill labs appear to be useful modality for promoting retention of the resuscitation skills of birth attendants. 

scholarly journals Enabling change in public health services: Insights from the implementation of nurse mentoring interventions to improve quality of obstetric and newborn care in two North Indian states

2020 ◽  
Vol 4 ◽  
pp. 61
Author(s):  
Sumit Kane ◽  
Prarthna Dayal ◽  
Tanmay Mahapatra ◽  
Sanjiv Kumar ◽  
Shikha Bhasin ◽  
...  
Keyword(s):  
Public Health ◽  
Health Services ◽  
Newborn Care ◽  
Uttar Pradesh ◽  
Improve Quality ◽  
Public Health Services ◽  
Indian States ◽  
Middle Income ◽  
Implementing Change

Background: Few studies have explicitly examined the implementation of change interventions in low- and middle-income country (LMIC) public health services. We contribute to implementation science by adding to the knowledge base on strategies for implementing change interventions in large, hierarchical and bureaucratic public services in LMIC health systems. Methods: Using a mix of methods, we critically interrogate the implementation of an intervention to improve quality of obstetric and newborn services across 692 facilities in Uttar Pradesh and Bihar states of India to reveal how to go about making change happen in LMIC public health services. Results: We found that focusing the interventions on a discreet part of the health service (labour rooms) ensured minimal disruption of the status quo and created room for initiating change. Establishing and maintaining respectful, trusting relationships is critical, and it takes time and much effort to cultivate such relationships. Investing in doing so allows one to create a safe space for change; it helps thaw entrenched practices, behaviours and attitudes, thereby creating opportunities for change. Those at the frontline of change processes need to be enabled and supported to: lead by example, model and embody desirable behaviours, be empathetic and humble, and make the change process a positive and meaningful experience for all involved. They need discretionary space to tailor activities to local contexts and need support from higher levels of the organisation to exercise discretion. Conclusions: We conclude that making change happen in LMIC public health services, is possible, and is best approached as a flexible, incremental, localised, learning process. Smaller change interventions targeting discreet parts of the public health services, if appropriately contextualised, can set the stage for incremental system wide changes and improvements to be initiated. To succeed, change initiatives need to cultivate and foster support across all levels of the organisation.

scholarly journals Water Quality of River Kosi and Rajera System at Rampur (India): Impact Assessment

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Ashish Kumar ◽  
Yogendra Bahadur
Keyword(s):  
Water Quality ◽  
Impact Assessment ◽  
Industrial Pollution ◽  
Uttar Pradesh ◽  
Major Portion ◽  
Gangetic Plains ◽  
One Year

River Kosi, an important tributary of river Ramganga, is one of the important rivers of Uttaranchal and Uttar Pradesh After traveling for about 100 kms in lower Himalayas with higher velocity, it emerges at Ramnagar in Indo-Gangetic plains. Here, the major portion of city sewage is discharged into it. Then, it flows through the famous rice belt area of Kashipur, where a number of polluting industries discharge their highly polluted effluents into it. To determine the extent of pollution in downstream district Rampur, a study was conducted. The aim of this study was to evaluate the effect of dilution caused by the merger of river Rajera with Kosi River. For this samples, were collected from three stations and analyzed for various parameters for the period of one year. The study revealed higher levels of industrial pollution as compared to domestic pollution. It also shows the alleviating effects of dilution caused by the merger of river Rajera.

scholarly journals Enabling change in public health services: Insights from the implementation of nurse mentoring interventions to improve quality of obstetric and newborn care in two North Indian states

2020 ◽  
Vol 4 ◽  
pp. 61
Author(s):  
Sumit Kane ◽  
Prarthna Dayal ◽  
Tanmay Mahapatra ◽  
Sanjiv Kumar ◽  
Shikha Bhasin ◽  
...  
Keyword(s):  
Public Health ◽  
Health Services ◽  
Newborn Care ◽  
Uttar Pradesh ◽  
Improve Quality ◽  
Public Health Services ◽  
Change Initiatives ◽  
Indian States ◽  
Middle Income

Background: Few studies have explicitly examined the implementation of change interventions in low- and middle-income country (LMIC) public health services. We contribute to implementation science by analyzing the implementation of an organizational change intervention in a large, hierarchical and bureaucratic public service in a LMIC health system. Methods: Using qualitative methods, we critically interrogate the implementation of an intervention to improve quality of obstetric and newborn services across 692 facilities in Uttar Pradesh and Bihar states of India to reveal how to go about making change happen in LMIC public health services. Results: We found that focusing the interventions on a discreet part of the health service (labour rooms) ensured minimal disruption of the status quo and created room for initiating change. Establishing and maintaining respectful, trusting relationships is critical, and it takes time and much effort to cultivate such relationships. Investing in doing so allows one to create a safe space for change; it helps thaw entrenched practices, behaviours and attitudes, thereby creating opportunities for change. Those at the frontline of change processes need to be enabled and supported to: lead by example, model and embody desirable behaviours, be empathetic and humble, and make the change process a positive and meaningful experience for all involved. They need discretionary space to tailor activities to local contexts and need support from higher levels of the organisation to exercise discretion. Conclusions: We conclude that making change happen in LMIC public health services, is possible, and is best approached as a flexible, incremental, localised, learning process. Smaller change interventions targeting discreet parts of the public health services, if appropriately contextualised, can set the stage for incremental system wide changes and improvements to be initiated. To succeed, change initiatives need to cultivate and foster support across all levels of the organisation.

scholarly journals Enabling change in public health services: Insights from the implementation of nurse mentoring interventions to improve quality of obstetric and newborn care in two North Indian states

2021 ◽  
Vol 4 ◽  
pp. 61
Author(s):  
Sumit Kane ◽  
Prarthna Dayal ◽  
Tanmay Mahapatra ◽  
Sanjiv Kumar ◽  
Shikha Bhasin ◽  
...  
Keyword(s):  
Public Health ◽  
Health Services ◽  
Newborn Care ◽  
Uttar Pradesh ◽  
Improve Quality ◽  
Public Health Services ◽  
Change Initiatives ◽  
Indian States ◽  
Middle Income

Background: Few studies have explicitly examined the implementation of change interventions in low- and middle-income country (LMIC) public health services. We contribute to implementation science by analyzing the implementation of an organizational change intervention in a large, hierarchical and bureaucratic public service in a LMIC health system. Methods: Using qualitative methods, we critically interrogate the implementation of an intervention to improve quality of obstetric and newborn services across 692 facilities in Uttar Pradesh and Bihar states of India to reveal how to go about making change happen in LMIC public health services. Results: We found that focusing the interventions on a discreet part of the health service (labour rooms) ensured minimal disruption of the status quo and created room for initiating change. Establishing and maintaining respectful, trusting relationships is critical, and it takes time and much effort to cultivate such relationships. Investing in doing so allows one to create a safe space for change; it helps thaw entrenched practices, behaviours and attitudes, thereby creating opportunities for change. Those at the frontline of change processes need to be enabled and supported to: lead by example, model and embody desirable behaviours, be empathetic and humble, and make the change process a positive and meaningful experience for all involved. They need discretionary space to tailor activities to local contexts and need support from higher levels of the organisation to exercise discretion. Conclusions: We conclude that making change happen in LMIC public health services, is possible, and is best approached as a flexible, incremental, localised, learning process. Smaller change interventions targeting discreet parts of the public health services, if appropriately contextualised, can set the stage for incremental system wide changes and improvements to be initiated. To succeed, change initiatives need to cultivate and foster support across all levels of the organisation.

Factors Influencing Performance of ITES Firms in India

2012 ◽  
Vol 25 (4) ◽  
pp. 46-64 ◽  
Author(s):  
Soni Agrawal ◽  
Kishor Goswami ◽  
Bani Chatterjee
Keyword(s):  
Information Technology ◽  
Developing Countries ◽  
Service Provider ◽  
Business Processes ◽  
Developed Countries ◽  
Offshore Outsourcing ◽  
Competitive Advantages ◽  
Improve Quality ◽  
Factors Influencing

Firms from developed countries are increasingly offshore outsourcing services to developing countries to have cost as well competitive advantages. Although this is a growing practice, there has been limited empirical attention in understanding the outsourcing phenomenon, particularly from the perspective of service provider firms that execute important business processes for their overseas clients. Despite growing trends to outsource, only a few service provider firms report success. This puts the service provider firms under increasing pressure to add value and improve quality of relationship. They have to depend not only on tangible factors but some intangible factors also play an important role in their performance. In this paper, the authors try to find out factors that influence performance of service provider firms. Multiple regressions using four indicators of firm performance are carried out to see the influence of certain factors on information technology enabled service (ITES) firms’ performance.

Can Good Products Drive Out Bad? A Randomized Intervention in the Antimalarial Medicine Market in Uganda

2021 ◽  
Author(s):  
Martina Björkman Nyqvist ◽  
Jakob Svensson ◽  
David Yanagizawa-Drott
Keyword(s):  
Developing Countries ◽  
Simple Model ◽  
Household Survey ◽  
Antimalarial Drugs ◽  
Improve Quality ◽  
Quality Improvements ◽  
High Quality ◽  
Randomized Intervention ◽  
One Year

Abstract How can quality be improved in markets in developing countries, which are known to be plagued by substandard and counterfeit (“fake” , in short) products? We study the market for antimalarial drugs in Uganda, where we randomly assign entry of a retailer (NGO) providing a superior product - an authentic drug priced below the market - and investigate how incumbent firms and consumers respond. We find that the presence of the NGO had economically important effects. Approximately one year after the new market actor entered, the share of incumbent firms selling fake drugs dropped by more than 50% in the intervention villages, with higher quality drugs sold at significantly lower prices. Household survey evidence further shows that the quality improvements were accompanied by consumers expecting fewer fake drugs sold by drug stores. The intervention increased use of the antimalarial drugs overall. The results are consistent with a simple model where the presence of a seller committed to high quality, as opposed to an average firm, strengthens reputational incentives for competing firms to improve quality in order to not be forced out of the market, leading to ‘good driving out bad’.

scholarly journals The NeoTree application: developing an integrated mHealth solution to improve quality of newborn care and survival in a district hospital in Malawi

2019 ◽  
Vol 4 (1) ◽  
pp. e000860 ◽  
Author(s):  
Caroline Crehan ◽  
Erin Kesler ◽  
Bejoy Nambiar ◽  
Queen Dube ◽  
Norman Lufesi ◽  
...  
Keyword(s):  
District Hospital ◽  
Digital Health ◽  
Newborn Care ◽  
Clinical Decision ◽  
Evidence Based ◽  
Improve Quality ◽  
Usability Study ◽  
Resource Poor ◽  
Before And After

More than two-thirds of newborn lives could be saved worldwide if evidence-based interventions were successfully implemented. We developed the NeoTree application to improve quality of newborn care in resource-poor countries. The NeoTree is a fully integrated digital health intervention that combines immediate data capture, entered by healthcare workers (HCW) on admission, while simultaneously providing them with evidence-based clinical decision support and newborn care education. We conducted a mixed-methods intervention development study, codeveloping and testing the NeoTree prototype with HCWs in a district hospital in Malawi. Focus groups explored the acceptability and feasibility of digital health solutions before and after implementation of the NeoTree in the clinical setting. One-to-one theoretical usability workshops and a 1-month clinical usability study informed iterative changes, gathered process and clinical data, System Usability Scale (SUS) and perceived improvements in quality of care. HCWs perceived the NeoTree to be acceptable and feasible. Mean SUS before and after the clinical usability study were high at 80.4 and 86.1, respectively (above average is >68). HCWs reported high-perceived improvements in quality of newborn care after using the NeoTree on the ward. They described improved confidence in clinical decision-making, clinical skills, critical thinking and standardisation of care. Identified factors for successful implementation included a technical support worker. Coproduction, mixed-methods approaches and user-focused iterative development were key to the development of the NeoTree prototype, which was shown to be an agile, acceptable, feasible and highly usable tool with the potential to improve the quality of newborn care in resource-poor settings.

scholarly journals Assessing capacity of health facilities to provide routine maternal and newborn care in low-income settings: what proportions are ready to provide good-quality care, and what proportions of women receive it?

2019 ◽  
Author(s):  
Keith Tomlin ◽  
Della Berhanu ◽  
Meenakshi Gautham ◽  
Nasir Umar ◽  
Joanna Schellenberg ◽  
...  
Keyword(s):  
Low Income ◽  
Quality Care ◽  
Newborn Care ◽  
Uttar Pradesh ◽  
Routine Care ◽  
Health Facilities ◽  
Signal Functions ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Abstract Background Good quality maternal and newborn care at primary health facilities is essential for both mothers and infants, but in settings with high maternal and newborn mortality the evidence for the protective effect of facility delivery is inconsistent. We surveyed samples of health facilities in three settings with high maternal mortality, to assess the quality of routine maternal and newborn care and the proportion of women delivering in facilities with a good standard of care. Surveys were conducted in 2012 and 2015 to assess changes in the quality of care over time. Methods Surveys were conducted in Ethiopia, the Indian state of Uttar Pradesh and Gombe State in North-Eastern Nigeria. 166 and 305 primary care facilities were sampled in 2012 and 2015 respectively. In each year we assessed whether each facility could provide four “signal” functions of routine maternal and newborn care. From facility registers we counted the number of deliveries in the previous six months and calculated the proportion of women giving birth in facilities which could offer good quality routine care. Results In Ethiopia the proportion of deliveries in facilities which provided all four signal functions rose from 40% (95% CI 26-57) in 2012 to 43% (95% CI 31-56) in 2015. In Uttar Pradesh in 2012 an estimated 4% (95% CI 1-24) of facility deliveries occurred in facilities which provided all four signal functions, rising to 39% (95% CI 25-55) in 2015. In Nigeria these estimates were 25% (95% CI 6-66) and zero for 2012 and 2015 respectively. Improvements in signal functions in Ethiopia and Uttar Pradesh were led by improved supplies of commodities while Nigeria experienced declines in supplies of commodities and the number of Skilled Birth Attendants employed. Conclusions This study quantifies how health facilities can provide sub-optimal maternal and newborn care, and may help explain inconsistent outcomes of health facility care in some settings. Signal function methodology can provide a rapid and inexpensive measure of the capacity of facilities to provide such care. Incorporating data on facility deliveries and repeating the analyses highlights the adjustments that could have greatest impact upon maternal and newborn care.

scholarly journals Quality of Basic Care During Neonatal Resuscitation Among Health Care Providers at Three District Hospitals in Kigali

2020 ◽  
Vol 3 (2) ◽  
pp. 225-237
Author(s):  
Kellen Muganwa ◽  
Alice Muhayimana ◽  
Joella Mukashyaka ◽  
Pamela Meharry
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Work Experience ◽  
Neonatal Resuscitation ◽  
Care Providers ◽  
Cross Sectional ◽  
Basic Care ◽  
District Hospitals ◽  
One Year

Background Globally, about 10% of neonates require extra respiratory support to initiate breathing at birth. Over a million neonatal deaths could be prevented with quality basic care during neonatal resuscitation. Objective To determine the quality of care (QoC) of basic NR at birth among health care providers (HCPs) at three district hospitals in Kigali. Methods A descriptive cross-sectional study was conducted. Thirty-six HCPs were observed 2-3 times using a structured checklist. Descriptive and inferential statistics were used to analyze the data.  Results The majority had ‘good’ QoC scores for drying and stimulation (74.7%), and fair scores for airway clearance (85.1%). Some had poor scores for advanced bag and mask ventilation (BMV) (13%). Maternity work experience (1-5 years) was significantly associated with good quality drying and stimulation (p = 0.03), initial BMV (p = 0.02), and advanced BMV (p = 0.03), than HCPs with less than one-year experience.  Conclusion Maternity work experience of more than one year significantly improved the QoC during neonatal resuscitation. More NR support during the first year of work and regular NR refresher training would improve neonatal outcomes.  Rwanda J Med Health Sci 2020;3(2):225-237

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