• Objectives

1. Design and implement interventions at hospitals that improve the quality of care including skilled attendance at birth, emergency obstetric care and sick newborn care
2. Design and implement interventions at these hospitals that improve the quality of birth planning and screening for high risk pregnancies.
3. Develop local capacity for adopting quality improvement processes targeted at the maternal and newborn care.
4. Enhance local capacity to collect and use information for continuous improvement
5. To assess the feasibility, acceptability and sustainability of these quality improvement interventions.

• Timeline

• Location

•  Methods

This is a pre-post, quasi-experimental study method with repeated observation.

The quality improvement interventions at the facility level will support and build the capacity of the service providers and managers for analysis, improvement and monitoring of basic processes of care. Changes in procedures and practices will aim at sustainable improvement for the facility despite turnover of staff. We also propose for a continuum of care approach including screening for high risk pregnancies and appropriate birth planning followed by intrapartum, postpartum care and sick new born care at the referral hospitals in the districts.We propose to focus on four core activities including

• (1) Rapid Cycle Process Improvement
• (2) Mortality and Morbidity Surveillance
• (3) Death and Criterion-based Audits and
• (4) Data improvement

Each activity is intended to improve the delivery of maternal and newborn services to save lives and reduce morbidity, or to improve understanding of the current situation to accelerate improvement. Each of these activities is closely related to the others and as the programme matures the work will increasingly focus on integrating the approaches. Constant linkage with the District and State Health System will accelerate sharing of programme results—both successes and failure—to benefit others at work on this problem.

• Expected Outcomes