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  1. Article ; Online: Towards a harmonised framework for developing quality of care indicators for global health: a scoping review of existing conceptual and methodological practices.

    Dudley, Lilian / Mamdoo, Puni / Naidoo, Selvan / Muzigaba, Moise

    BMJ health & care informatics

    2022  Volume 29, Issue 1

    Abstract: Objectives: Despite significant advances in the science of quality of care measurement over the last decade, approaches to developing quality of care indicators for global health priorities are not clearly defined. We conducted a scoping review of ... ...

    Abstract Objectives: Despite significant advances in the science of quality of care measurement over the last decade, approaches to developing quality of care indicators for global health priorities are not clearly defined. We conducted a scoping review of concepts and methods used to develop quality of healthcare indicators to better inform ongoing efforts towards a more harmonised approach to quality of care indicator development in global health.
    Methods: We conducted a systematic search of electronic databases, grey literature and references for articles on developing quality of care indicators for routine monitoring in all healthcare settings and populations, published in English between 2010 and 2020. We used well-established methods for article screening and selection, data extraction and management. Results were summarised using a descriptive analysis and a narrative synthesis.
    Results: The 221 selected articles were largely from high-income settings (89%), particularly the USA (46%), Canada (9%), UK (9%) and Europe (17%). Quality of care indicators were developed mainly for healthcare providers (56%), for benchmarking or quality assurance (37%) and quality improvement (29%), in hospitals (32%) and primary care (26%), across many diseases. The terms 'quality indicator' and 'quality measure' were the most frequently encountered terms (50% and 21%, respectively). Systematic approaches for quality of care indicator development emerged within national quality of care systems or through cross-country collaborations in high-income settings. Maternal, neonatal and child health (33%), mental health (26%) and primary care (57%) studies applied most components of systematic approaches, but not consistently or rigorously.
    Discussion: The current evidence shows variations in concepts and approaches to developing quality of care indicators, with development and application mainly in high-income countries.
    Conclusion: Additional efforts are needed to propose 'best-practice' conceptual frameworks and methods for developing quality of care indicators to improve their utility in global health measurement.
    MeSH term(s) Child ; Delivery of Health Care ; Global Health ; Humans ; Infant, Newborn ; Primary Health Care ; Quality Improvement ; Quality Indicators, Health Care
    Language English
    Publishing date 2022-01-25
    Publishing country England
    Document type Journal Article ; Review
    ISSN 2632-1009
    ISSN (online) 2632-1009
    DOI 10.1136/bmjhci-2021-100469
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Regular measurement is essential but insufficient to improve quality of healthcare.

    Agweyu, Ambrose / Hill, Kathleen / Diaz, Theresa / Jackson, Debra / Hailu, Binyam G / Muzigaba, Moise

    BMJ (Clinical research ed.)

    2023  Volume 380, Page(s) e073412

    MeSH term(s) Humans ; Delivery of Health Care ; Health Facilities ; Quality of Health Care
    Language English
    Publishing date 2023-03-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 1362901-3
    ISSN 1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    ISSN (online) 1756-1833
    ISSN 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    DOI 10.1136/bmj-2022-073412
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: The effectiveness of an m-Health intervention on the sexual and reproductive health of in-school adolescents: a cluster randomized controlled trial in Nigeria.

    Akande, Oluwatosin Wuraola / Muzigaba, Moise / Igumbor, Ehimario Uche / Elimian, Kelly / Bolarinwa, Oladimeji Akeem / Musa, Omotosho Ibraheem / Akande, Tanimola Makanjuola

    Reproductive health

    2024  Volume 21, Issue 1, Page(s) 6

    Abstract: Background: The implementation of the country-wide comprehensive sexuality education (CSE) curriculum among in-school adolescents remains abysmally low and mHealth-based interventions are promising. We assessed the effect of a mHealth-based CSE on the ... ...

    Abstract Background: The implementation of the country-wide comprehensive sexuality education (CSE) curriculum among in-school adolescents remains abysmally low and mHealth-based interventions are promising. We assessed the effect of a mHealth-based CSE on the sexual and reproductive health (SRH) knowledge, attitude and behaviour of in-school adolescents in Ilorin, northcentral Nigeria.
    Methods: Using schools as clusters, 1280 in-school adolescents were randomised into intervention and control groups. Data was collected at baseline (T
    Results: In the intervention group, there was a statistically significant main effect on mean knowledge score (F = 2117.252, p =  < 0.001) and mean attitude score (F = 148.493, p =  < 0.001) from T
    Conclusion: The mHealth-based CSE was effective in improving SRH knowledge and attitude among in-school adolescents. This strategy should be strengthened to bridge the SRH knowledge and attitude gap among in-school adolescents. Trial registration Retrospectively registered on the Pan African Clinical Trial Registry (pactr.samrc.ac.za) on 19 October 2023. Identification number: PACTR202310485136014.
    MeSH term(s) Humans ; Male ; Adolescent ; Female ; Reproductive Health ; Nigeria ; Health Knowledge, Attitudes, Practice ; Sexual Behavior ; Telemedicine
    Language English
    Publishing date 2024-01-13
    Publishing country England
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 2149029-6
    ISSN 1742-4755 ; 1742-4755
    ISSN (online) 1742-4755
    ISSN 1742-4755
    DOI 10.1186/s12978-023-01735-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Measuring experience of and satisfaction with newborn care: a scoping review of tools and measures.

    Minckas, Nicole / Kharel, Rashmi / Ryan-Coker, Marcella / Lincetto, Ornella / Tunçalp, Özge / Sacks, Emma / Muzigaba, Moise / Portela, Anayda

    BMJ global health

    2023  Volume 8, Issue Suppl 2

    Abstract: Background: Standardised measures on experience of care are essential to understanding the care women and newborns receive and to designing appropriate interventions and responses. This review builds on ongoing work in the realm of maternity care and ... ...

    Abstract Background: Standardised measures on experience of care are essential to understanding the care women and newborns receive and to designing appropriate interventions and responses. This review builds on ongoing work in the realm of maternity care and complements it by reviewing existing tools and measures to assess experience of and satisfaction with the care of the newborn.
    Methods: We conducted a scoping review of published literature to identify measures and tools of experience (physiological or indirect) and satisfaction with newborn care. We systematically searched five bibliographic databases from 1 January 2010 through 1 December 2022 and contacted professional networks. Using a predefined evidence template, we extracted data on the studies and the tools' characteristics. We mapped the tools and measures against the WHO quality of care frameworks to identify the most frequent measured domains of care and to highlight existing gaps.
    Result: We identified 18 292 records of which 72 were eligible. An innovative finding of this review is the inclusion of newborn perspectives through behavioural responses, physiological signals, pain profiles as well as other non-verbal cues as markers of newborn experience. Domains related to parental participation and decision-making, ensuring continuity of care and receiving coordinated care, were the most measured across the included tools.
    Conclusion: Comprehensive and validated instruments measuring all aspects of care are needed. Developing a robust theoretical ground will be fundamental to the design and utilisation of standardised tools and measures.
    Protocol registration details: This review was registered and published on protocol.io (dx.doi.org/10.17504/protocols.io.bvk7n4zn).
    MeSH term(s) Female ; Humans ; Infant, Newborn ; Male ; Pregnancy ; Maternal Health Services ; Personal Satisfaction
    Language English
    Publishing date 2023-05-02
    Publishing country England
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ISSN 2059-7908
    ISSN 2059-7908
    DOI 10.1136/bmjgh-2022-011104
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Women's perceptions of telephone interviews about their experiences with childbirth care in Nigeria: A qualitative study.

    Umar, Nasir / Hill, Zelee / Schellenberg, Joanna / Tuncalp, Özge / Muzigaba, Moise / Sambo, Nuraddeen Umar / Shuaibu, Abdulrahman / Marchant, Tanya

    PLOS global public health

    2023  Volume 3, Issue 4, Page(s) e0001833

    Abstract: Our objective is to investigate women's perceptions of phone interviews about their experiences with facility childbirth care. The study was conducted between October 2020 and January 2021, in Gombe State, Nigeria. Participants were women aged 15-49 ... ...

    Abstract Our objective is to investigate women's perceptions of phone interviews about their experiences with facility childbirth care. The study was conducted between October 2020 and January 2021, in Gombe State, Nigeria. Participants were women aged 15-49 years, who delivered in ten study Primary Health Care centres, provided phone numbers, and consented to a follow-up telephone interview about their childbirth experience. The phone interviews took place 14 months after the delivery and consisted of a quantitative survey about women's experiences of facility childbirth followed by a set of structured qualitative questions about their experiences with the phone survey. Three months later 20 women were selected, based on their demographic characteristics, for a further in-depth qualitative phone interview to explore the answers to the structured qualitative questions in more depth. The qualitative interviews were analysed using a thematic approach. We found that most of the women appreciated being called to discuss their childbirth experiences as it made them feel privileged and valued, they were motivated to participate as they viewed the topic as relevant and thought that their interview could lead to improvements in care. They found the interview procedures easy and perceived that the call offered privacy. Poor network connectivity and not owning the phone they were using presented challenges to some women. Women felt more able to re-arrange interview times on the phone compared to a face-to-face interview, they valued the increased autonomy as they were often busy with household chores and could rearrange to a more convenient time. Views about interviewer gender diverged, but most participants preferred a female interviewer. The preferred interview length was a maximum of 30 minutes, though some women said duration was irrelevant if the subject of discussion was important. In conclusion, women had positive views about phone interviews on experiences with facility childbirth care.
    Language English
    Publishing date 2023-04-19
    Publishing country United States
    Document type Journal Article
    ISSN 2767-3375
    ISSN (online) 2767-3375
    DOI 10.1371/journal.pgph.0001833
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Strengthening the policy, implementation, and accountability environment for quality care: experiences from quality of care network countries.

    Maliqi, Blerta / Cocoman, Olive / Dohlsten, Martin / Dussey, Selina / Hinton, Rachael / Mannah, Margaret T / Muzigaba, Moise / Rammal, Tala / Sabiiti, Jesca / Yaqub, Nuhu / Banerjee, Anshu

    Frontiers in health services

    2024  Volume 3, Page(s) 1292510

    Abstract: Despite global commitment to universal health coverage with quality, poor quality of care (QOC) continues to impact health outcomes for mothers and newborns, especially in low-and-middle income countries. Although there is much experience from small- ... ...

    Abstract Despite global commitment to universal health coverage with quality, poor quality of care (QOC) continues to impact health outcomes for mothers and newborns, especially in low-and-middle income countries. Although there is much experience from small-scale projects, without a long-term perspective it is unclear how to implement quality of care effectively and consistently for impact. In 2017, ten countries together with the WHO and a coalition of partners established the Network for Improving Quality of Care for Maternal, Newborn and Child Health (the Network). The Network agreed to pursue four strategic objectives-Leadership, Action, Learning and Accountability (LALA) for QOC. This paper describes, analyses and reflects on what has worked and some of the challenges faced in implementation of the LALA framework. The implementation of the LALA framework has served as a catalyst to develop an enabling environment for QOC in the Network countries through strengthening the policy, implementation, accountability and community engagement for quality care. Developing an enabling health system environment takes time, but it is possible and shows results. The implementation shows that health systems continue to face persistent challenges such as capacities to quickly scale up changes across subnational levels, limited workforce capability to implement quality improvement consistently and gaps in quality of relevant data. The implementation has also highlighted the need to develop new mechanisms for community engagement and learning systems that inform scaling up of good QOC practices across programmes and levels of care. Moving forward, the Network countries will build on the experiences and lessons learned and continue to strengthen the implementation of LALA strategic objectives for impact. We hope the Network experience will encourage other countries and partners to adopt the Network implementation model to enable delivery of quality care for everyone, everywhere, and actively collaborate and contribute to the QOC global learning network.
    Language English
    Publishing date 2024-01-16
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2813-0146
    ISSN (online) 2813-0146
    DOI 10.3389/frhs.2023.1292510
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Management of severe acute malnutrition in children under 5 years through the lens of health care workers in two rural South African hospitals.

    Muzigaba, Moise / Van Wyk, Brian / Puoane, Thandi

    African journal of primary health care & family medicine

    2018  Volume 10, Issue 1, Page(s) e1–e8

    Abstract: Background: Despite the widespread implementation of the World Health Organization (WHO) guidelines for the management of severe malnutrition in South Africa, poor treatment outcomes for children under 5 years are still observed in some hospitals, ... ...

    Abstract Background: Despite the widespread implementation of the World Health Organization (WHO) guidelines for the management of severe malnutrition in South Africa, poor treatment outcomes for children under 5 years are still observed in some hospitals, particularly in rural areas.
    Objective: To explore health care workers' perceptions about upstream and proximal factors contributing to poor treatment outcomes for severe acute malnutrition in two district hospitals in South Africa.
    Methods: An explorative descriptive qualitative study was conducted. Four focus group discussions were held with 33 hospital staff (senior clinical and management staff, and junior clinical staff) using interview guide questions developed based on the findings from an epidemiological study that was conducted in the same hospitals. Qualitative data were analysed using the framework analysis.
    Findings: Most respondents believed that critical illness, which was related to early and high case fatality rates on admission, was linked to a web of factors including preference for traditional medicine over conventional care, gross negligence of the child at household level, misdiagnosis of severe malnutrition at the first point of care, lack of specialised skills to deal with complex presentations, shortage of patient beds in the hospital and policies to discharge patients before optimal recovery. The majority believed that the WHO guidelines were effective and relatively simple to implement, but that they do not make much difference among severe acute malnutrition cases that are admitted in a critical condition. Poor management of cases was linked to the lack of continuity in training of rotating clinicians, sporadic shortages of therapeutic resources, inadequate staffing levels after normal working hours and some organisational and system-wide challenges beyond the immediate control of clinicians.
    Conclusion: Findings from this study suggest that effective management of paediatric severe acute malnutrition in the study setting is affected by a multiplicity of factors that manifest at different levels of the health system and the community. A verificatory study is encouraged to collaborate these findings.
    MeSH term(s) Adult ; Attitude of Health Personnel ; Child Abuse ; Child, Preschool ; Delivery of Health Care/standards ; Female ; Focus Groups ; Health Knowledge, Attitudes, Practice ; Hospitals, Rural ; Humans ; Infant ; Male ; Middle Aged ; Pediatrics/standards ; Practice Guidelines as Topic/standards ; Qualitative Research ; Quality of Health Care/standards ; Severe Acute Malnutrition/etiology ; Severe Acute Malnutrition/therapy ; South Africa
    Language English
    Publishing date 2018-01-30
    Publishing country South Africa
    Document type Journal Article
    ZDB-ID 2526836-3
    ISSN 2071-2936 ; 2071-2928
    ISSN (online) 2071-2936
    ISSN 2071-2928
    DOI 10.4102/phcfm.v10i1.1547
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: To call or not to call: exploring the validity of telephone interviews to derive maternal self-reports of experiences with facility childbirth care in northern Nigeria.

    Umar, Nasir / Schellenberg, Joanna / Hill, Zelee / Bhattacharya, Antoinette Alas / Muzigaba, Moise / Tunçalp, Özge / Sambo, Nuraddeen Umar / Shuaibu, Abdulrahman / Marchant, Tanya

    BMJ global health

    2022  Volume 7, Issue 3

    Abstract: Background: To institutionalise respectful maternity care, frequent data on the experience of childbirth care is needed by health facility staff and managers. Telephone interviews have been proposed as a low-cost alternative to derive timely and ... ...

    Abstract Background: To institutionalise respectful maternity care, frequent data on the experience of childbirth care is needed by health facility staff and managers. Telephone interviews have been proposed as a low-cost alternative to derive timely and actionable maternal self-reports of experience of care. However, evidence on the validity of telephone interviews for this purpose is limited.
    Methods: Eight indicators of positive maternity care experience and 18 indicators of negative maternity care experience were investigated. We compared the responses from exit interviews with women about their childbirth care experience (reference standard) to follow-up telephone interviews with the same women 14 months after childbirth. We calculated individual-level validity metrics including, agreement, sensitivity, specificity, area under the receiver operating characteristic curve (AUC). We compared the characteristics of women included in the telephone follow-up interviews to those from the exit interviews.
    Results: Demographic characteristics were similar between the original exit interview group (n=388) and those subsequently reached for telephone interview (n=294). Seven of the eight positive maternity care experience indicators had reported prevalence higher than 50% at both exit and telephone interviews. For these indicators, agreement between the exit and the telephone interviews ranged between 50% and 92%; seven positive indicators met the criteria for validation analysis, but all had an AUC below 0.6. Reported prevalence for 15 of the 18 negative maternity care experience indicators was lower than 5% at exit and telephone interviews. For these 15 indicators, agreement between exit and telephone interview was high at over 80%. Just three negative indicators met the criteria for validation analysis, and all had an AUC below 0.6.
    Conclusions: The telephone interviews conducted 14 months after childbirth did not yield results that were consistent with exit interviews conducted at the time of facility discharge. Women's reports of experience of childbirth care may be influenced by the location of reporting or changes in the recall of experiences of care over time.
    MeSH term(s) Female ; Humans ; Maternal Health Services ; Nigeria ; Parturition ; Pregnancy ; Self Report ; Telephone
    Language English
    Publishing date 2022-03-14
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2059-7908
    ISSN 2059-7908
    DOI 10.1136/bmjgh-2021-008017
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: WHO standards-based tool to measure women's views on the quality of care around the time of childbirth at facility level in the WHO European region: development and validation in Italy.

    Lazzerini, Marzia / Argentini, Giorgia / Mariani, Ilaria / Covi, Benedetta / Semenzato, Chiara / Lincetto, O / Muzigaba, Moise / Valente, Emanuelle Pessa

    BMJ open

    2022  Volume 12, Issue 2, Page(s) e048195

    Abstract: Objectives: A comprehensive WHO standards-based tool to measure women's perceived quality of maternal and newborn care (QMNC) in health facilities is needed to allow for comparisons of data across settings and over time. This paper describes the ... ...

    Abstract Objectives: A comprehensive WHO standards-based tool to measure women's perceived quality of maternal and newborn care (QMNC) in health facilities is needed to allow for comparisons of data across settings and over time. This paper describes the development of such a tool, and its validation in Italy.
    Design: A multiphase, mixed-methods study involving qualitative and quantitative research methods.
    Setting: Nine health facilities in Italy.
    Methods: The questionnaire was developed in six phases: (1) Defining the scope, characteristics and a potential list of measures for the tool; (2) initial content and construct validation; (3) first field testing to assess acceptability and perceived utility for end-users (1244 women, 35 decision makers) and further explore construct validity; (4) content optimisation and score development; (5) assessment of face validity, intrarater reliability and internal consistency and (6) second field testing in nine maternity hospitals (4295 women, 78 decision-makers).
    Results: The final version of the tool included 116 questions accounting for 99 out of the 350 of the extended lists of WHO Quality Measures. Observed face validity was very good, with 100% agreement for 101 (87%) questions and Kappa exceeding 0.60 for remaining ones. Reliability was good, with either high agreement or Kappa exceeding 0.60 for all items. Cronbach alpha values ranged from 0.84 to 0.88, indicating very good internal consistency. Acceptability across seven hospitals was good (mean response rate: 57.4%, 95% CI 44.4% to 70.5%). The questionnaire proved to be useful, driving the development of actions plan to improve the QMNC in each facility.
    Conclusions: Study findings suggest that the tool has good content, construct, face validity, intrarater reliability and internal consistency, while being acceptable and useful. Therefore, it could be used in health facilities in Italy and similar context. More research should investigate how effectively use the tool in different countries for improving the QMNC.
    MeSH term(s) Female ; Humans ; Infant, Newborn ; Parturition ; Pregnancy ; Psychometrics ; Quality of Health Care ; Reproducibility of Results ; Surveys and Questionnaires ; World Health Organization
    Language English
    Publishing date 2022-02-16
    Publishing country England
    Document type Journal Article
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2020-048195
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: National learning systems to sustain and scale up delivery of quality healthcare: a conceptual framework.

    Lattof, Samantha R / Maliqi, Blerta / Livesley, Nigel / Yaqub, Nuhu / Naimy, Zainab / Muzigaba, Moise / Chowdhury, Minara / Waiswa, Peter / Were, Wilson M

    BMJ global health

    2022  Volume 7, Issue 8

    Abstract: All around the world, health systems fail to provide good quality of care (QoC). By developing learning systems, health systems are able to better identify good practices and to explain how to sustain and scale these good practices. To facilitate the ... ...

    Abstract All around the world, health systems fail to provide good quality of care (QoC). By developing learning systems, health systems are able to better identify good practices and to explain how to sustain and scale these good practices. To facilitate the operationalisation of national learning systems, the Network for Improving Quality of Care for Maternal Newborn and Child Health (the Network) developed a conceptual framework for national learning systems to support QoC at scale. The Network facilitated an iterative process to reach consensus on a conceptual framework for national learning systems to sustain and scale up delivery of quality healthcare. Following a landscape analysis, the Network Secretariat and WHO convened two consultative meetings with country partners, technical experts and stakeholders. Based on these inputs, we developed a conceptual framework for national learning systems to support QoC at scale. National learning systems use a variety of approaches to identify practices that have improved QoC at the patient and provider levels. They also facilitate scale up and sustain strategies used successfully to support quality improvement. Despite growing consensus on the importance of learning for QoC, no one has yet detailed how this learning should be operationalised nationally. Our conceptual framework is the first to facilitate the operationalisation of national learning systems so that health systems can begin to develop, adapt and implement mechanisms to learn about what works or fails and to scale up and sustain this learning for QoC.
    MeSH term(s) Child ; Delivery of Health Care ; Humans ; Infant, Newborn ; Quality Improvement ; Quality of Health Care
    Language English
    Publishing date 2022-08-01
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2059-7908
    ISSN 2059-7908
    DOI 10.1136/bmjgh-2022-008664
    Database MEDical Literature Analysis and Retrieval System OnLINE

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