Health Care Intervention Research- Improving Pre-natal and Maternal Care (QUALMAT)

Health Care Intervention Research-Quality of Prenatal and Maternal Care: Bridging the Know-do Gap (QUALMAT)

Besides a dramatic lack of financial and human resources in developing countries, health care is additionally endangered by quality deficiencies caused by low staff motivation. This lack of motivation leads to an insufficient translation of knowledge into optimal utilization of resources. The "know-do" gap represents a challenge that must be addressed to strengthen health services performance towards achieving the Millennium Development Goals (MDGs). This is in particular true for some sensitive sectors like pre-natal and maternal health care. General objective of this research is to improve maternal health through better pre-natal and maternal care services offered by better motivated health workers. A computer-assisted clinical decision support system (CDSS) will be developed, implemented and tested aiming at (I) quality improvement of maternal and newborn care and (II) assessment of provider's performance. Based on this tool a commonly agreed incentive scheme to increase motivation will be shaped and tested in three SSA - countries, namely Burkina, Ghana, and Tanzania.

The incentive scheme might contain both non-monetary and monetary incentives and will be designed according to the human resource policy in the three countries. The planned approach is an implementation study with control arms containing one hospital and 6 first line health facilities in each of the study districts and an equal number of facilities in the control arm. A set of indicators for measurement of changes in quality of delivered services will be identified in order to follow up the sustainability and effectiveness of the strategies after their implementation. The study findings will allow understanding the important factors of staff motivation and facilitate adequate management for improvement of maternal and neonatal health care. "Knowing is not enough, we must apply; Wanting to do, is not enough, we must do it1"

- J.W. v. Goethe

Study Overview

• Status: Unknown
• Conditions: Antenatal Care and Delivery
• Intervention / Treatment: Other: CDSS

• Study Type: Interventional
• Enrollment (Anticipated): 36
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Rainer Sauerborn, Prof.; Phone Number: 00496221565859; Email: svetla.loukanova@urz.uni-heidelberg.de

Study Locations

• Germany
  • Heidelberg, Germany, 69120
    • Recruiting
    • University of Heidelberg
    • Contact: Rainer Sauerborn, Prof.; Phone Number: 00496221565859; Email: svetla.loukanova@urz.uni-heidelberg.de

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 12 years to 45 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• the patient in the primary health care center

Exclusion Criteria:

• patients outside the research regions

Study Plan

How is the study designed?

Design Details

• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: without CDSS; This arm includes 6 health facilities in each partner country, where the clinical decision support system will not be implemented	Other: CDSS; Clinical Decision Support System
Experimental: with CDSS; This arm includes 6 health facilities in each partner country, where the clinical decision support system will be implemented, parallel to the performance based incentive package	Other: CDSS; Clinical Decision Support System

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
motivation	This research aims to increase the motivation of the health care providers through two parallel intervention packages- implementation of Clinical decision support system and incentive packages, based on the performance.	2 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Improved quality of health services in ANC and delivery	This research aims to improve the quality of the services provided through better motivated health workers	2 years

Collaborators and Investigators

• Sponsor: Heidelberg University
• Collaborators: Karolinska Institutet; University Ghent; Centre de Recherche en Sante de Nouna, Burkina Faso; Muhimbili University of Health and Allied Sciences; Navrongo Health Research Centre, Ghana

Publications and helpful links

General Publications

• Saronga HP, Duysburgh E, Massawe S, Dalaba MA, Wangwe P, Sukums F, Leshabari M, Blank A, Sauerborn R, Loukanova S. Cost-effectiveness of an electronic clinical decision support system for improving quality of antenatal and childbirth care in rural Tanzania: an intervention study. BMC Health Serv Res. 2017 Aug 7;17(1):537. doi: 10.1186/s12913-017-2457-z.
• Blank A, Prytherch H, Kaltschmidt J, Krings A, Sukums F, Mensah N, Zakane A, Loukanova S, Gustafsson LL, Sauerborn R, Haefeli WE. "Quality of prenatal and maternal care: bridging the know-do gap" (QUALMAT study): an electronic clinical decision support system for rural Sub-Saharan Africa. BMC Med Inform Decis Mak. 2013 Apr 10;13:44. doi: 10.1186/1472-6947-13-44.

Helpful Links

• Improving pre-natal and maternal care

Study record dates

Study Major Dates

• Study Start: May 1, 2009
• Primary Completion (Actual): September 1, 2010
• Study Completion (Anticipated): April 1, 2014

Study Registration Dates

• First Submitted: August 3, 2011
• First Submitted That Met QC Criteria: August 3, 2011
• First Posted (Estimate): August 4, 2011

Study Record Updates

• Last Update Posted (Estimate): August 4, 2011
• Last Update Submitted That Met QC Criteria: August 3, 2011
• Last Verified: February 1, 2010

More Information

Terms related to this study

• Keywords: clinical decision support system; performance based incentives; quality of maternal health care services
• Other Study ID Numbers: S-173/2008