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Evaluation of the Spread from Niger to Mali of better care practices for essential obstetric and neonatal care and the implementation of collaborative improvement
Research & Evaluation Study Profiles
Organization:
USAID Health Care Improvment Project/URC
Topics: Maternal, Newborn and Child Health
Region and Country: Africa, Sub Saharan, Mali, Niger
Year:
2011
Language:
English Description:
The USAID Health Care Improvement has demonstrated the efficiency of the dissemination of improved care practices to new regions within a country or health care system. However, while the spread within a country has been studied, there is little or no research on transferring quality improvement processes and improved health practices from one country to another. This study aims to analyze how a list of changes was transferred from the Niger in Mali, the methods used to reproduce the improved care and costs associated with its implementation.
Research questions/objectives:
The objective of this study is to evaluate how a package of changes developed in one country may be transferred to another. Specifically, is the package of changes developed in Niger is appropriate to the context of Mali? The null hypothesis is that the package of changes from Niger had no significant effect on indicators in Mali. This study will also examine the cost-effectiveness of the implementation of Niger’s package of changes in Mali compared to maternal and newborn health care in Mali before the improvement collaborative. The specific research questions are:
1. What changes are appropriate to Mali? What are the perceptions of improvement teams and coaches about the package of changes? How have the changes been adapted by sites in Mali to their local context? What has helped or hindered the ownership of changes by the sites?
2. What improvements have there been in the indicators at sites where the package of changes was introduced?
3. Have the indicators evolved the same way in Mali and Niger?
4. What is the cost of implementing the package of changes in Mali through the collaborative?
5. What is the cost of implementing the package of changes in Mali in terms of quality indicators and clinical outcomes (incidence of bleeding avoided)?
Methodology:
The retrospective study will include quantitative assessment of results and qualitative assessment to better understand the process of implementation and adaptation of best practices. Key information will be obtained through in-depth interviews of improvement teams at 19 sites in Mali. Two focus group discussions with coaches from Mali will be conducted to determine their perceptions and how they were affected by the collaborative. Costs related to collaborative implementation will be extracted from HCI accounting records.
