Kabo, Ibrahim, Emmanuel Otolorin, Emma Williams et al., “Monitoring Maternal and Newborn Health Outcomes in Bauchi State, Nigeria: An Evaluation of a Standards-Based Quality Improvement Intervention,” International Journal for Quality in Health Care 28, no.5 (August 2016), doi:10.1093/intqhc/mzw083

URL: dx.doi.org/10.1093/intqhc/mzw083

Abstract

Objective: This study assessed the correlation between compliance with set performance standards and maternal and neonatal deaths in health facilities.

Design: Baseline and three annual follow-up assessments were conducted, and each was followed by a quality improvement initiative using the Standards Based Management and Recognition (SBM-R) approach.

Setting: Twenty-three secondary health facilities of Bauchi state, Nigeria.

Participants: Health care workers and maternity unit patients.

Main outcome measures: We examined trends in: (i) achievement of SBM-R set performance standards based on annual assessment data, (ii) the use of maternal and newborn health (MNH) service delivery practices based on data from health facility registers and supportive supervision and (iii) MNH outcomes based on routine service statistics.

Results: At the baseline assessment in 2010, the facilities achieved 4% of SBM-R standards for MNH, on average, and this increased to 86% in 2013. Over the same time period, the study measured an increase in the administration of uterotonic for active management of third stage of labor from 10% to 95% and a decline in the incidence of postpartum hemorrhage from 3.3% to 1.9%. Institutional neonatal mortality rate decreased from 9 to 2 deaths per 1000 live births, while the institutional maternal mortality ratio dropped from 4113 to 1317 deaths per 100 000 live births.

Conclusion: Scaling up SBM-R for quality improvement has the potential to prevent maternal and neonatal deaths in Nigeria and similar settings.

Kabo et al. (2016) assess whether training in the Standards Based Management and Recognition (SBM-R) approach to maternal and newborn healthcare has had an impact on the real and perceived quality of care for women and newborns in Bauchi state, Nigeria, an area known for having below standard quality of care and high maternal and neonatal morality rates. They found that overall, the SBM-R approach brought improvement to maternal and newborn healthcare and lowered mortality rates, yet more assessment and continued improvement of healthcare standards is needed.