“Safer Births Bundle of Care” Implementation and Perinatal Impact at 30 Hospitals in Tanzania—Halfway Evaluation
Safer Births Bundle of Care (SBBC) consists of innovative clinical and training tools for improved labour care and newborn resuscitation, integrated with new strategies for continuous quality improvement. After implementation, we hypothesised a reduction in 24-h newborn deaths, fresh stillbirths, an...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-01-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/10/2/255 |
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| author | Hege Ersdal Paschal Mdoe Estomih Mduma Robert Moshiro Godfrey Guga Jan Terje Kvaløy Felix Bundala Boniphace Marwa Benjamin Kamala |
| author_facet | Hege Ersdal Paschal Mdoe Estomih Mduma Robert Moshiro Godfrey Guga Jan Terje Kvaløy Felix Bundala Boniphace Marwa Benjamin Kamala |
| author_sort | Hege Ersdal |
| collection | DOAJ |
| description | Safer Births Bundle of Care (SBBC) consists of innovative clinical and training tools for improved labour care and newborn resuscitation, integrated with new strategies for continuous quality improvement. After implementation, we hypothesised a reduction in 24-h newborn deaths, fresh stillbirths, and maternal deaths by 50%, 20%, and 10%, respectively. This is a 3-year stepped-wedged cluster randomised implementation study, including 30 facilities within five regions in Tanzania. Data collectors at each facility enter labour and newborn care indicators, patient characteristics and outcomes. This halfway evaluation reports data from March 2021 through July 2022. In total, 138,357 deliveries were recorded; 67,690 pre- and 70,667 post-implementations of SBBC. There were steady trends of increased 24-h newborn and maternal survival in four regions after SBBC initiation. In the first region, with 13 months of implementation (<i>n</i> = 15,658 deliveries), an estimated additional 100 newborns and 20 women were saved. Reported fresh stillbirths seemed to fluctuate across time, and increased in three regions after the start of SBBC. Uptake of the bundle varied between regions. This SBBC halfway evaluation indicates steady reductions in 24-h newborn and maternal mortality, in line with our hypotheses, in four of five regions. Enhanced focus on uptake of the bundle and the quality improvement component is necessary to fully reach the SBBC impact potential as we move forward. |
| first_indexed | 2024-03-11T08:59:52Z |
| format | Article |
| id | doaj.art-504c1cf20bf74a418cb28de18e13bab8 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-11T08:59:52Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-504c1cf20bf74a418cb28de18e13bab82023-11-16T19:48:11ZengMDPI AGChildren2227-90672023-01-0110225510.3390/children10020255“Safer Births Bundle of Care” Implementation and Perinatal Impact at 30 Hospitals in Tanzania—Halfway EvaluationHege Ersdal0Paschal Mdoe1Estomih Mduma2Robert Moshiro3Godfrey Guga4Jan Terje Kvaløy5Felix Bundala6Boniphace Marwa7Benjamin Kamala8Department of Anesthesia, Stavanger University Hospital, 4011 Stavanger, NorwayHaydom Lutheran Hospital, Haydom 9000, TanzaniaHaydom Lutheran Hospital, Haydom 9000, TanzaniaSchool of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam 65001, TanzaniaHaydom Lutheran Hospital, Haydom 9000, TanzaniaDepartment of Mathematics and Physics, University of Stavanger, 4021 Stavanger, NorwayReproductive and Child Health Section, Ministry of Health, Dodoma 743, TanzaniaDepartment of Health, President’s Office Regional Authority and Local Government, Dodoma 1923, TanzaniaHaydom Lutheran Hospital, Haydom 9000, TanzaniaSafer Births Bundle of Care (SBBC) consists of innovative clinical and training tools for improved labour care and newborn resuscitation, integrated with new strategies for continuous quality improvement. After implementation, we hypothesised a reduction in 24-h newborn deaths, fresh stillbirths, and maternal deaths by 50%, 20%, and 10%, respectively. This is a 3-year stepped-wedged cluster randomised implementation study, including 30 facilities within five regions in Tanzania. Data collectors at each facility enter labour and newborn care indicators, patient characteristics and outcomes. This halfway evaluation reports data from March 2021 through July 2022. In total, 138,357 deliveries were recorded; 67,690 pre- and 70,667 post-implementations of SBBC. There were steady trends of increased 24-h newborn and maternal survival in four regions after SBBC initiation. In the first region, with 13 months of implementation (<i>n</i> = 15,658 deliveries), an estimated additional 100 newborns and 20 women were saved. Reported fresh stillbirths seemed to fluctuate across time, and increased in three regions after the start of SBBC. Uptake of the bundle varied between regions. This SBBC halfway evaluation indicates steady reductions in 24-h newborn and maternal mortality, in line with our hypotheses, in four of five regions. Enhanced focus on uptake of the bundle and the quality improvement component is necessary to fully reach the SBBC impact potential as we move forward.https://www.mdpi.com/2227-9067/10/2/255newborn resuscitationsimulation-based trainingsafer birthsquality improvementperinatal mortalitynewborn mortality |
| spellingShingle | Hege Ersdal Paschal Mdoe Estomih Mduma Robert Moshiro Godfrey Guga Jan Terje Kvaløy Felix Bundala Boniphace Marwa Benjamin Kamala “Safer Births Bundle of Care” Implementation and Perinatal Impact at 30 Hospitals in Tanzania—Halfway Evaluation Children newborn resuscitation simulation-based training safer births quality improvement perinatal mortality newborn mortality |
| title | “Safer Births Bundle of Care” Implementation and Perinatal Impact at 30 Hospitals in Tanzania—Halfway Evaluation |
| title_full | “Safer Births Bundle of Care” Implementation and Perinatal Impact at 30 Hospitals in Tanzania—Halfway Evaluation |
| title_fullStr | “Safer Births Bundle of Care” Implementation and Perinatal Impact at 30 Hospitals in Tanzania—Halfway Evaluation |
| title_full_unstemmed | “Safer Births Bundle of Care” Implementation and Perinatal Impact at 30 Hospitals in Tanzania—Halfway Evaluation |
| title_short | “Safer Births Bundle of Care” Implementation and Perinatal Impact at 30 Hospitals in Tanzania—Halfway Evaluation |
| title_sort | safer births bundle of care implementation and perinatal impact at 30 hospitals in tanzania halfway evaluation |
| topic | newborn resuscitation simulation-based training safer births quality improvement perinatal mortality newborn mortality |
| url | https://www.mdpi.com/2227-9067/10/2/255 |
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