2023-09-28 14:46:10 +00:00
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abstract: 'Background: Maternal and newborn health care intervention coverage has
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increased in many low-income countries over the last decade, yet poor
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quality of care remains a challenge, limiting health gains. The World
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Health Organization envisions community engagement as a critical
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component of health care delivery systems to ensure quality services,
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responsive to community needs. Aligned with this, a Participatory
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Community Quality Improvement (PCQI) strategy was introduced in
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Ethiopia, in 14 of 91 rural woredas (districts) where the Last Ten
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Kilometers Project (L10 K) Platform activities were supporting national
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Basic Emergency Obstetric and Newborn Care (BEmONC) strengthening
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strategies. This paper examines the effects of the PCQI strategy in
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improving maternal and newborn care behaviors, and providers'' and
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households'' practices.
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Methods: PCQI engages communities in identifying barriers to access and
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quality of services, and developing, implementing and monitoring
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solutions. Thirty-four intervention kebeles (communities), which
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included the L10 K Platform, BEmONC, and PCQI, and 82 comparison
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kebeles, which included the L10 K Platform and BEmONC, were visited in
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December 2010-January 2011 and again 48 months later. Twelve women with
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children aged 0 to 11 months were interviewed in each kebele. Propensity
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score matching was used to estimate the program''s average treatment
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effects (ATEs) on women''s care seeking behavior, providers'' service
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provision behavior and households'' newborn care practices.
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Results: The ATEs of PCQI were statistically significant (p < 0.05) for
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two care seeking behaviors - four or more antenatal care (ANC) visits
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and institutional deliveries at 14\% (95\% CI: 6, 21) and 11\% (95\% CI:
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4, 17), respectively - and one service provision behavior - complete ANC
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at 17\% (95\% CI: 11, 24). We found no evidence of an effect on
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remaining outcomes relating to household newborn care practices, and
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postnatal care performed by the provider.
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Conclusions: National BEmONC strengthening and government initiatives to
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improve access and quality of maternal and newborn health services,
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together with L10 K Platform activities, appeared to work better for
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some care practices where communities were engaged in the PCQI strategy.
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Additional research with more robust measure of impact and
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cost-effectiveness analysis would be useful to establish effectiveness
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for a wider set of outcomes.'
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affiliation: 'Wereta, T (Corresponding Author), JSI Res \& Training Inst Inc, Last
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Ten Kilometers Project L10K 2020, Kebele 03-05,Hs 2111, Addis Ababa, Ethiopia.
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Wereta, Tewabech; Betemariam, Wuleta; Karim, Ali Mehryar; Zemichael, Nebreed Fesseha;
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Dagnew, Selamawit; Wanboru, Abera, JSI Res \& Training Inst Inc, Last Ten Kilometers
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Project L10K 2020, Kebele 03-05,Hs 2111, Addis Ababa, Ethiopia.
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Bhattacharya, Antoinette, London Sch Hyg \& Trop Med, Fac Infect \& Trop Dis, Dept
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Dis Control, Keppel St, London WC1E 7HT, England.'
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article-number: '364'
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author: Wereta, Tewabech and Betemariam, Wuleta and Karim, Ali Mehryar and Zemichael,
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Nebreed Fesseha and Dagnew, Selamawit and Wanboru, Abera and Bhattacharya, Antoinette
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author-email: weretatewabech@gmail.com
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author_list:
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- family: Wereta
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given: Tewabech
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- family: Betemariam
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given: Wuleta
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- family: Karim
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given: Ali Mehryar
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- family: Zemichael
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given: Nebreed Fesseha
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- family: Dagnew
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given: Selamawit
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- family: Wanboru
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given: Abera
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- family: Bhattacharya
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given: Antoinette
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da: '2023-09-28'
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doi: 10.1186/s12884-018-1977-9
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eissn: 1471-2393
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files: []
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journal: BMC PREGNANCY AND CHILDBIRTH
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keywords: Maternal; Newborn; Quality improvement; Community engagement
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keywords-plus: ALMA-ATA; NEWBORN; DELIVERY; LESSONS
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language: English
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month: SEP 24
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number-of-cited-references: '44'
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papis_id: 1ce3de3dbbd8bc1cb2937c21d02fbfa6
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ref: Wereta2018effectsparticipatory
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researcherid-numbers: Karim, Ali/AAX-4495-2021
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times-cited: '17'
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title: 'Effects of a participatory community quality improvement strategy on improving
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household and provider health care behaviors and practices: a propensity score analysis'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000460333600002
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usage-count-last-180-days: '0'
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usage-count-since-2013: '1'
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volume: '18'
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web-of-science-categories: Obstetrics \& Gynecology
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year: '2018'
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