A Prospective Quality Improvement Initiative to Address the Barriers to Postpartum Tubal Ligation Among Multiparous Women.
contraception
developing countries
family planning
low resource countries
postpartum tubal ligation
quality improvement
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
accepted:
27
09
2022
entrez:
2
11
2022
pubmed:
3
11
2022
medline:
3
11
2022
Statut:
epublish
Résumé
Unmet need for postpartum tubal ligation (PPTL) is still high in low-middle income countries. The commonly observed barriers are issues with the consent forms, non-availability of operation theater, lack of knowledge, patient desire for more children, partner opposition and social non-acceptance. Considering the unmet need and the barriers, this quality improvement (QI) initiative was conducted to increase the frequency of PPTL among multiparous women by 50% from baseline. This QI was conducted at a tertiary care teaching hospital over a period of 18 months. The study consisted of three phases. Baseline observations during the pre-intervention phase over six months, intervention phase consisting of three Plan-Do-Study-Act (PDSA) cycles over 12 months and post-intervention surveillance phase over a period of three months. In the first PDSA cycle, hospital and provider barriers were focused on. The patient barrier was addressed in the second cycle. The barrier at the level of partner and family members was addressed in the third cycle. The baseline prevalence of PPTL in the studied population over a period of six months was 30.2%. After the first PDSA cycle, the prevalence of PPTL performed increased from 30.2% to 49.5%. The prevalence increased to 68.8% after the second cycle. A further increase to 74.4% was observed after the third intervention. There was a satisfactory continuation rate of 72% at the end of the post-intervention follow-up phase conducted over four months. This QI initiative proved effective and sustainable over time. There was continuous motivation among the service providers to educate and counsel women for PPTL. Ultimately, we were able to address the low prevalence of PPTL through minor modifications in our hospital strategies.
Sections du résumé
BACKGROUND
BACKGROUND
Unmet need for postpartum tubal ligation (PPTL) is still high in low-middle income countries. The commonly observed barriers are issues with the consent forms, non-availability of operation theater, lack of knowledge, patient desire for more children, partner opposition and social non-acceptance. Considering the unmet need and the barriers, this quality improvement (QI) initiative was conducted to increase the frequency of PPTL among multiparous women by 50% from baseline.
MATERIALS AND METHODS
METHODS
This QI was conducted at a tertiary care teaching hospital over a period of 18 months. The study consisted of three phases. Baseline observations during the pre-intervention phase over six months, intervention phase consisting of three Plan-Do-Study-Act (PDSA) cycles over 12 months and post-intervention surveillance phase over a period of three months. In the first PDSA cycle, hospital and provider barriers were focused on. The patient barrier was addressed in the second cycle. The barrier at the level of partner and family members was addressed in the third cycle.
RESULTS
RESULTS
The baseline prevalence of PPTL in the studied population over a period of six months was 30.2%. After the first PDSA cycle, the prevalence of PPTL performed increased from 30.2% to 49.5%. The prevalence increased to 68.8% after the second cycle. A further increase to 74.4% was observed after the third intervention. There was a satisfactory continuation rate of 72% at the end of the post-intervention follow-up phase conducted over four months.
CONCLUSION
CONCLUSIONS
This QI initiative proved effective and sustainable over time. There was continuous motivation among the service providers to educate and counsel women for PPTL. Ultimately, we were able to address the low prevalence of PPTL through minor modifications in our hospital strategies.
Identifiants
pubmed: 36321020
doi: 10.7759/cureus.29641
pmc: PMC9608020
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e29641Informations de copyright
Copyright © 2022, Sarkar et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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