Service delivery reform for maternal and newborn health in Kakamega County, Kenya: study protocol for a prospective impact evaluation and implementation science study.


Journal

BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562

Informations de publication

Date de publication:
12 09 2022
Historique:
received: 23 05 2022
accepted: 02 06 2022
entrez: 12 9 2022
pubmed: 13 9 2022
medline: 15 9 2022
Statut: epublish

Résumé

Maternal and neonatal mortality remain elevated in low and middle income countries, and progress is slower than needed to achieve the Sustainable Development Goals. Existing strategies appear to be insufficient. One proposed alternative strategy, Service Delivery Redesign for Maternal and Neonatal Health (SDR), centers on strengthening higher level health facilities to provide rapid, definitive care in case of delivery and post-natal complications, and then promoting delivery in these hospitals, rather than in primary care facilities. However to date, SDR has not been piloted or evaluated. We will use a prospective, non-randomized stepped-wedge design to evaluate the effectiveness and implementation of Service Delivery Redesign for Maternal and Neonatal Health in Kakamega County, Kenya. This protocol describes a hybrid effectiveness/implementation evaluation study with an adaptive design. The impact evaluation ("effectiveness") study focuses on maternal and newborn health outcomes, and will be accompanied by an implementation evaluation focused on program reach, adoption, and fidelity.

Sections du résumé

BACKGROUND
Maternal and neonatal mortality remain elevated in low and middle income countries, and progress is slower than needed to achieve the Sustainable Development Goals. Existing strategies appear to be insufficient. One proposed alternative strategy, Service Delivery Redesign for Maternal and Neonatal Health (SDR), centers on strengthening higher level health facilities to provide rapid, definitive care in case of delivery and post-natal complications, and then promoting delivery in these hospitals, rather than in primary care facilities. However to date, SDR has not been piloted or evaluated.
METHODS
We will use a prospective, non-randomized stepped-wedge design to evaluate the effectiveness and implementation of Service Delivery Redesign for Maternal and Neonatal Health in Kakamega County, Kenya.
DISCUSSION
This protocol describes a hybrid effectiveness/implementation evaluation study with an adaptive design. The impact evaluation ("effectiveness") study focuses on maternal and newborn health outcomes, and will be accompanied by an implementation evaluation focused on program reach, adoption, and fidelity.

Identifiants

pubmed: 36096770
doi: 10.1186/s12889-022-13578-y
pii: 10.1186/s12889-022-13578-y
pmc: PMC9465958
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1727

Informations de copyright

© 2022. The Author(s).

Références

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Auteurs

Kevin Croke (K)

Harvard T.H. Chan School of Public Health, Boston, MA, USA. kcroke@hsph.harvard.edu.

Anna Gage (A)

Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Isabel Fulcher (I)

Harvard Medical School, Boston, MA, USA.

Kennedy Opondo (K)

Harvard T.H. Chan School of Public Health, Kisumu, Kenya.

Jacinta Nzinga (J)

Kenya Medical Research Institute (KEMRI)/Wellcome Trust Research Programme, Nairobi, Kenya.

Benjamin Tsofa (B)

Kenya Medical Research Institute (KEMRI)/Wellcome Trust Research Programme, Nairobi, Kenya.

Sebastien Haneuse (S)

Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Margaret Kruk (M)

Harvard T.H. Chan School of Public Health, Boston, MA, USA.

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Classifications MeSH