Update of: Marx Delaney et al., Improving Adherence to Essential Birth Practices Using the WHO Safe Childbirth Checklist With Peer Coaching: Experience From 60 Public Health Facilities in Uttar Pradesh, India

Abstract Background In 2014, 16 women died following female sterilization operations in Bilaspur, a district in central India. In addition to those 16 deaths, 70 women were hospitalized for critical conditions (Sharma, Lancet 384,2014). Although the government of India’s guidelines for female sterilization mandate infection prevention practices, little is known about the extent of infection prevention preparedness and practice during sterilization procedures that are part of the country’s primary health care services. This study assesses facility readiness for infection prevention and adherence to infection prevention practices during female sterilization procedures in rural northern India. Method The data for this study were collected in 2016–2017 as part of a family planning quality of care survey in selected public health facilities in Bihar (n = 100), and public (n = 120) and private health facilities (n = 97) in Uttar Pradesh. Descriptive analysis examined the extent of facility readiness for infection prevention (availability of handwashing facilities, new or sterilized gloves, antiseptic lotion, and equipment for sterilization). Correlation and multivariate statistical methods were used to examine the role of facility readiness and provider behaviors on infection prevention practices during female sterilization. Result Across the three health sectors, 62% of facilities featured all four infection prevention components. Sterilized equipment was lacking in all three health sectors. In facilities with all four components, provider adherence to infection prevention practices occurred in only 68% of female sterilization procedures. In Bihar, 76% of public health facilities evinced all four components of infection prevention, and in those facilities provider’s adherence to infection prevention practices was almost universal. In Uttar Pradesh, where only 55% of public health facilities had all four components, provider adherence to infection prevention practices occurred in only 43% of female sterilization procedures. Conclusion The findings suggest that facility preparedness for infection prevention does play an important role in provider adherence to infection prevention practices. This phenomenon is not universal, however. Not all doctors from facilities prepared for infection prevention adhere to the practices, highlighting the need to change provider attitudes. Unprepared facilities need to procure required equipment and supplies to ensure the universal practice of infection prevention.

Download Full-text

Patient-experience during delivery in public health facilities in Uttar Pradesh, India

Health Policy and Planning ◽

10.1093/heapol/czz125 ◽

2019 ◽

Vol 35 (2) ◽

pp. 244-244

Author(s):

Dominic Montagu ◽

Amanda Landrian ◽

Vishwajeet Kumar ◽

Beth S Phillips ◽

Shreya Singhal ◽

...

Keyword(s):

Public Health ◽

Patient Experience ◽

Uttar Pradesh ◽

Health Facilities ◽

Public Health Facilities

Download Full-text

“Neither we are satisfied nor they”-users and provider’s perspective: a qualitative study of maternity care in secondary level public health facilities, Uttar Pradesh, India

BMC Health Services Research ◽

10.1186/s12913-015-1077-8 ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 27

Author(s):

Sanghita Bhattacharyya ◽

Anns Issac ◽

Preety Rajbangshi ◽

Aradhana Srivastava ◽

Bilal I. Avan

Keyword(s):

Public Health ◽

Qualitative Study ◽

Maternity Care ◽

Uttar Pradesh ◽

Secondary Level ◽

Health Facilities ◽

Public Health Facilities

Download Full-text

Introduction of DMPA in public health facilities of Uttar Pradesh and Rajasthan: An evaluation

10.31899/rh9.1076 ◽

2015 ◽

Cited By ~ 1

Author(s):

M.E. Khan ◽

Anvita Dixit ◽

Jaleel Ahmad ◽

G. Pillai

Keyword(s):

Public Health ◽

Uttar Pradesh ◽

Health Facilities ◽

Public Health Facilities

Download Full-text

Can changes to improve person-centred maternity care be spread across public health facilities in Uttar Pradesh, India?

Sexual and Reproductive Health Matters ◽

10.1080/26410397.2021.1892570 ◽

2021 ◽

Vol 29 (1) ◽

pp. 1-15

Author(s):

May Sudhinaraset ◽

Katie Giessler ◽

Michelle Kao Nakphong ◽

Kali Prosad Roy ◽

Ananta Basudev Sahu ◽

...

Keyword(s):

Public Health ◽

Maternity Care ◽

Uttar Pradesh ◽

Health Facilities ◽

Public Health Facilities

Download Full-text

Nurses' and auxiliary nurse midwives' adherence to essential birth practices with peer coaching in Uttar Pradesh, India: a secondary analysis of the BetterBirth trial

Implementation Science ◽

10.1186/s13012-019-0962-7 ◽

2020 ◽

Vol 15 (1) ◽

Cited By ~ 5

Author(s):

Rose L. Molina ◽

Brandon J. Neal ◽

Lauren Bobanski ◽

Vinay Pratap Singh ◽

Bridget A. Neville ◽

...

Keyword(s):

Peer Coaching ◽

Secondary Analysis ◽

Uttar Pradesh ◽

Staff Nurses ◽

Birth Attendants ◽

Coaching Intervention ◽

Safe Childbirth Checklist ◽

Auxiliary Nurse ◽

Nurse Midwives ◽

Safe Childbirth

Abstract Background The BetterBirth trial tested the effect of a peer coaching program around the WHO Safe Childbirth Checklist for birth attendants in primary-level facilities in Uttar Pradesh, India on a composite measure of perinatal and maternal mortality and maternal morbidity. This study aimed to examine the adherence to essential birth practices between two different cadres of birth attendants—nurses and auxiliary nurse midwives (ANMs)—during and after a peer coaching intervention for the WHO Safe Childbirth Checklist. Methods This is a secondary analysis of birth attendant characteristics, coaching visits, and behavior uptake during the BetterBirth trial through birth attendant surveys, coach observations, and independent observations. Descriptive statistics were calculated overall, and by staffing cadre (staff nurses and ANMs) for demographic characteristics. Logistic regression using the Pearson overdispersion correction (to account for clustering by site) was used to assess differences between staff nurses and ANMs in the intervention group during regular coaching (2-month time point) and 4 months after the coaching program ended (12-month time point). Results Of the 570 birth attendants who responded to the survey in intervention and control arms, 474 were staff nurses (83.2%) and 96 were ANMs (16.8%). In the intervention arm, more staff nurses (240/260, 92.3%) received coaching at all pause points compared to ANMs (40/53, 75.5%). At baseline, adherence to practices was similar between ANMs and staff nurses (~ 30%). Overall percent adherence to essential birth practices among ANMs and nurses was highest at 2 months after intervention initiation, when frequent coaching visits occurred (68.1% and 64.1%, respectively, p = 0.76). Practice adherence tapered to 49.2% among ANMs and 56.1% among staff nurses at 12 months, which was 4 months after coaching had ended (p = 0.68). Conclusions Overall, ANMs and nurses responded similarly to the coaching intervention with the greatest increase in percent adherence to essential birth practices after 2 months of coaching and subsequent decrease in adherence 4 months after coaching ended. While coaching is an effective strategy to support some aspects of birth attendant competency, the structure, content, and frequency of coaching may need to be customized according to the birth attendant training and competency. Trial registration ClinicalTrials.gov: NCT2148952; Universal Trial Number: U1111–1131-5647.

Download Full-text