Change in Maternal and Newborn Health Quality of Care Indicators in All Babies Count Initiative Implemented in 2 Districts in Rwanda
| Indicator | Aggregate | South Kayonza | Kirehe | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Baseline | Endpoint | P Value | Median Difference (IQR) | Baseline | Endpoint | P Value | Baseline | Endpoint | P Value | |
| Median (IQR) | Median (IQR) | Median (IQR) | Median (IQR) | Median (IQR) | Median (IQR) | |||||
| 1. Percentage of deliveries where mothers had 4 standard ANC visits | 13.7 (6.7, 44.2) | 30.4 (15.1, 43.1) | .04 | 13.6 (−3.3, 26.4) | 42.4 (19.9, 47.3) | 36.4 (13.5, 66.3) | .78 | 10.2 (2.8–26.8) | 29.6 (18–34.2) | .02 |
| 2. Percentage of pregnant women delivering in facilities | 89.6 (86.3, 94.9) | 92.6 (86.8, 95.8) | .25 | 7.8 (−2.8, 5.1) | 92.2 (87.2, 95.3) | 95.2 (93.0, 96.3) | .33 | 88.4 (86.3–96.7) | 91.0 (86.2–94.6) | .36 |
| 3. Percentage of babies who are provided immediate skin-to-skin after birth | 53.6 (0, 80.9) | 97.4 (96.4, 99.3) | <.001 | 43.6 (17.7, 95.7) | 91.2 (75.9, 100) | 99.6 (96.7, 100) | .18 | 4.3 (0, 53.6) | 97.2 (96.1, 98.8) | <.001 |
| 4. Percentage of newborns checked for danger signs within 24 hours of birth | 46.6 (31.1, 96.7) | 98.7 (96.4, 100) | <.001 | 47.7 (−1.4, 67.1) | 52.3 (33.8, 98.6) | 100 (93.8, 100) | .06 | 45.7 (15.8, 82.1) | 98.6 (97.4, 98.8) | .003 |
| 5. Average hospital time to emergency cesarean delivery (minutes) | 167 | 50 | — | 82 | 61 | — | ||||
| 6. Percentage of women with preterm labor who are treated with antenatal steroids | 0 (0, 0) | 41.7 (0, 100) | .32 | — | 0 (0, 0) | 16.7 (0, 33.3) | — | 0 (0–0) | 75 (0, 100) | .32 |
| 7. Percentage of facilities with at least 2 MNH clinically trained staff | 100 | 100 | — | 15.1 (4, 29.8) | 100 | 100 | — | 100 | 100 | — |
| 8. Percent availability of essential medications for MNH care | 61.2 (45.0, 77.8) | 81.8 (72.7, 81.8) | <.001 | 31.2 (19.5, 37.8) | 35.0 (25.0, 45.0) | 83.3 (75.0, 87.5) | .01 | 66.7 (55.6, 77.8) | 77.8 (72.7, 81.8) | .05 |
| 9. Percent availability of functioning equipment essential for MNH care | 55.6 (48.2, 61.1) | 86.6 (77.8, 88.9) | <.001 | — | 55.6 (47.2, 56.6) | 88.9 (88.9, 94.4) | .01 | 55.6 (48.2, 63.9) | 81.1 (77.8, 88.6) | <.001 |
| 10. Patient satisfactiona: average satisfaction with ANC | — | — | — | — | 2.8 (SD: 1.57) | 3.1 (SD: 1.53) | .11 | 3.3 (SD: 1.62) | 3.6 (SD: 1.52) | .01 |
| 11. Patient satisfaction: average satisfaction with maternity care | — | — | — | — | 2.4 (SD: 1.67) | 2.3 (SD: 1.160 | .95 | 3.5 (SD: 1.59) | 3.4 (SD: 1.52) | .61 |
Abbreviations: ANC, antenatal care; IQR, interquartile range; MNH, maternal and newborn health; SD, standard deviation.
↵a Patient satisfaction scores on a Likert scale: 1=excellent; 2=very good; 3=good; 4=fair; 5=poor.