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Table 6 Case study characteristics and programme implementation details

From: Effect of collaborative quality improvement on stillbirths, neonatal mortality and newborn care practices in hospitals of Telangana and Andhra Pradesh, India: evidence from a quasi-experimental mixed-methods study

  Case study 1 Case study 2 Case study 3 Case study 4
Key characteristics
Type and level Public—medical college** Private—secondary Public—medical college** Public—secondary
Area Urban Urban Urban Rural/tribal
Monthly admissions to NCU 103 59 152 145
No. beds in NCU 11 18 18 Missing
Paediatricians per 10 beds in NCU [state average 2] 2.7 1.7 1.1 n/a
Nurse per 10 bed in NCU [state average 7] 11.8 6.7 6.1 n/a
Monthly deliveries 1153 n/a 375 325
Baseline performance in NCU (selected indicators)
% of occasions when hand hygiene was followed in NCU [state average 16%] 15 42 0 0
% observed babies on exclusive breastfeeding [state average 72%] 91 100 96 75
Implementation
Duration of implementation (months) April 2017
January 2018
(10)
June–December 2017
(6)
July 2017
July 2018
(13)
July 2017
July 2018
(13)
Total no. EBPs at programme end (based on interview) 2 0 6 9
Total no. EBP^ (based on programme reports) 5 2 5 8
NCU
QI team Active No QI team Active Active
Focus EBP (based on participants’ interviews) Hand hygiene
ANTT
0 Hand-hygiene
TMA
KMC
Hand hygiene ANTT
Exclusive BF
KMC
TMA
Labour room
QI team Not formed No labour room Formed but unstructured QI work Active
Focus EBP (based on participants’ interviews) None n/a ANCS
HRC
[Vitamin K administration]
NRP at delivery
HRC
Early BF
ANCS
  1. ANTT anti-septic non-touch technique for IV line insertion, ANCS ante-natal corticosteroid administration, BF breastfeeding, HRC high risk categorisation at admission, KMC Kangaroo Mother Care, NCU newborn care unit, NRP neonatal resuscitation trained personnel, TMA temperature monitoring at admission
  2. #At baseline
  3. *These were public secondary facilities at baselines, then accredited as medical colleges while the programme was ongoing
  4. ^Discrepancies are as follows:
  5. - Case study 1: qualitative interviews did not confirm QI activities on 3 practices in the labour room. Participants referred to additional practices, but suggested they had been working on these before this programme and were supported by concurrent programmes
  6. - Case study 2: programme reports include practices for which the facility provided monthly data; however, use of the QI approach was not confirmed by qualitative interviews
  7. - Case study 3: vitamin K was not in the SCSL change package. It was introduced in LR to rationalise over-admission in NCU where the only reason for referral to NCU was vitamin K administration
  8. - Case study 4: interview participants also referred to exclusive breastfeeding, for which the facility did not collect data