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Improving Quality of Care for Mothers and Newborns in Health Facilities: New Standards and Measures From the World Health Organization (WHO)

first_imgPosted on September 2, 2016May 12, 2017By: Sarah Hodin, Project Coordinator II, Women and Health Initiative, Harvard T.H. Chan School of Public HealthClick to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window)The average proportion of women in developing countries with skilled attendance at birth increased from 56% in 1990 to 68% in 2012. While skilled birth attendance is one factor affecting health outcomes for mothers and newborns, gaps in quality of care have been identified as contributing causes of maternal and newborn mortality and morbidity in numerous countries. In its groundbreaking publication, Crossing the Quality Chasm, the Institute of Medicine proposed that high quality health care should be safe, effective, patient-centered, timely, efficient and equitable. Defining characteristics are not sufficient for identifying gaps in quality of care; specific, operationalized measures that can be used by health care workers in diverse settings are crucial for improving quality of care.To combat preventable perinatal morbidity and mortality, WHO recently published a framework for measuring and improving quality of maternal and newborn health care in facilities across the globe. The framework summarized below includes eight standards of high quality care and a comprehensive list of measures to identify quality gaps throughout the continuum of care for women and newborns:Standard 1: Evidence-based practices for routine care and management of complicationsTimely, routine assessment of mother during labor and deliveryRoutine postnatal care for mothers and newbornsAppropriate, timely treatment for pre-eclampsia/eclampsia and postpartum hemorrhageAppropriate interventions for obstructed or delayed laborImmediate stimulation and resuscitation of newborns unable to breathe on their ownAppropriate interventions for mother and baby in cases of preterm deliveryAppropriate, timely interventions for women and newborns to prevent infectionsNo unnecessary or harmful practices for women or newbornsStandard 2: Actionable information systemsComplete, accurate, standardized medical recordsMechanism for data collection, analysis and feedback at every hospitalStandard 3: Functional referral systemsTimely assessments upon admission, during labor and during the early postnatal period to determine whether referral is requiredReferrals follow a pre-established plan and can be implemented without delayAppropriate exchange of information and feedback between health facilities in case of referralStandard 4: Effective communicationInformation about care is shared with women and their familiesEffective interactions between women and their families and health care staffCoordinated care among relevant health and social care professionalsStandard 5: Respect and preservation of dignityPrivacy and confidentiality during labor and deliveryNo disrespect, abuse, discrimination, neglect or other maltreatment of women or newbornsWomen can make informed decisions about their careStandard 6: Emotional supportWomen can choose to have a companion of their choice present for labor and deliveryWomen receive support to strengthen capability during deliveryStandard 7: Competent, motivated human resourcesConstant access to at least one skilled birth attendant and support staff for mothers and babiesSkilled birth attendants and support staff have appropriate competencies and skillsAccountability of managerial and clinical leadership for creating and implementing appropriate policies and a supportive environment for staffStandard 8: Essential physical resources availableFunctioning, reliable and safe facilities for water, energy, sanitation, hand hygiene and waste disposalAppropriate design, organization and maintenance of physical infrastructureAdequate stocks of medicines, supplies and equipmentThe comprehensive framework provides clinicians and public health professionals with a guided path toward accurately identifying gaps in quality of maternal and newborn care in facilities around the world. Hopefully its use will facilitate the development of effective interventions that ultimately save mothers’ and babies’ lives. How can facilities in low-resource settings develop the capacity and infrastructure necessary to implement these new WHO standards?—Read the full WHO report for a complete list of measures for each quality standard.Learn more about quality of maternal health care.Share this: ShareEmailPrint To learn more, read:last_img

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