Transcript July 2012 HBB GDA Meeting - Gupta

HBB Status update –
Performance
Evaluation in Malawi
Shivam Gupta
Johns Hopkins University –
Institute for International
Programs
Intervention
• Start in March – April 2011
• Thirteen districts selected for the roll-out of HBB
– Northern Region: Chitipa, Rumphi & Nkhatabay
– Central Region: Nkhotakota, Kasungu, Dowa & Lilongwe
– Southern Region: Thyolo, Machinga, Zomba, Phalombe, Nsanje &
Mwanza
• 481 health workers trained till end of Feb 2012
–
–
–
–
2
Registered nurse midwife
Nurse midwife technician
Clinicians
Anesthetic clinical officer
Specific questions
• Are newborn resuscitation service delivery guidelines and supplies
available according to the national rollout plan?
• Are the HBB trained health workers able to apply the newborn
resuscitation and essential newborn care skills after 12 and 18 months of
training?
• Is the coverage of HBB implementation at facility level consistent with the
national roll out plan?
• What barriers exist in the implementation of HBB at the facility level?
• What factors have facilitated implementation of HBB at the facility level?
• What recommendations can be made for improved availability and quality
of neonatal health services in Malawi?
Methods - Design
• Quasi-experimental Non-randomized controlled study
– 13 intervention districts
– 15 comparison districts
• Baseline measures using secondary data
• Two rounds of primary data
– 12 and 18 months after phased intervention roll out
• Additional descriptive studies
Methods - Instruments
Tool
Health Care Worker
Questionnaire (1 tool)
Description
Assess knowledge and practice of HBB to collect information that will
inform on the constraints and facilitators to delivery of quality of care
and recommendations for ways to improve quality of care.
Health Care Worker
Two clinical case studies/ simulations for the providers to assess their
Tools (2 tools)
clinical decision making pertaining to screening, management and
treatment pertaining to newborn resuscitation.
Direct Observation of
Two quantitative observation checklists to (1) observe the provider
Patient Care (2 tools)
performing labor, delivery, newborn and immediate postpartum and
(2) newborn resuscitation skills.
Key informant Interview Tool will guide the key informant interviews. The respondents will be
(1 tool)
asked questions related to strengths, weaknesses and recommendation
for improvement for the HBB roll out.
Facility Assessment (2
Verification of availability of trained staff and storage conditions of
tools)
medications, supplies and equipment. Data related to the numbers of
newborns that need resuscitation and the type of treatment they
received.
HBB Malawi Evaluation - Timeline
Jan – Mar
2012
Task
Submit the study protocol for JHU IRB
COMREC IRB Approval
Apr – June
2012
Jul – Sep
2012
Oct 2012 –
Sep 2013
X
X
Pre-test and finalize study tools
X
Train of data collectors
X
Conduct first round of facility assessment
X
Data cleaning, entry, and analysis
X
Dissemination of findings and report
preparation
Training and preparation for second round
X
Conduct second round of facility assessment
X
Data cleaning, entry and analysis
X
Dissemination of findings and report
preparation
Final Dissemination
X
Manuscript preparation and submission
X
X
X
Questions
7
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