The purpose of this Quality Improvement initiative is to reduce severe morbidity and mortality among premature infants through proven and cost-effective clinical management during the antenatal, intrapartum, and postpartum periods. In order to reduce neonatal mortality and morbidity due to preterm birth complications, health facilities must be able to identify and manage women in preterm labor, accurately administer medications, and provide high-quality postnatal care.
The purpose of this Quality Improvement initiative is to reduce severe morbidity and mortality among premature infants through proven and cost-effective clinical management during the antenatal, intrapartum, and postpartum periods. In order to reduce neonatal mortality and morbidity due to preterm birth complications, health facilities must be able to identify and manage women in preterm labor, accurately administer medications, and provide high-quality postnatal care. The study will provide evidence of implementing a package of clinical interventions coupled with quality improvement and monitoring strategy aimed at reducing neonatal mortality in 3 resource-limited health facilities, leveraging on an existing strengthened birth registry to provide neonatal outcomes up to 28 days after delivery. Additionally, using a multifaceted approach through an interdisciplinary team, the investigators will identify the social and cultural barriers that contribute to home-based deliveries. These findings will be helpful to the Ministry of Health in shaping future policies regarding the scale-up of newborn care clinical protocols as part of Government's efforts to reducing neonatal mortality in Zambia.
Study Type
OBSERVATIONAL
Enrollment
11,195
Chawama 1st Level Hospital, Chipata 1st Level Hospital, and George Clinic
Lusaka, Zambia
University Teaching Hospital
Lusaka, Zambia
10% relative risk reduction in 28-day neonatal mortality rate in preterm infants
Rate of 28-day neonatal mortality at the end of the study compared to that at baseline
Time frame: Baseline to 36 months
20% relative risk reduction in all-cause 7-day neonatal mortality in preterm infants
Rate of 7-day neonatal mortality at the end of the study compared to that at baseline
Time frame: Baseline to 36 months
Factors that contribute to home and facility deliveries within the PREEMI facility catchment areas through the use of pre-determined questionnaire.
Number of study participants who delivered at home and at a health facility
Time frame: Baseline to 36 months
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