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Kamala BA, Ersdal H, Moshiro R, Mduma E, Baker U, Guga G, Kvaløy JT, Bishanga DR, Bundala F, Marwa B, Rutachunzibwa T, Simeo J, Rutatinisibwa HF, Ndungile Y, Kayera D, Kalabamu FS, Mdoe P. Improvements in Obstetric and Newborn Health Information Documentation following the Implementation of the Safer Births Bundle of Care at 30 Facilities in Tanzania. Healthcare (Basel) 2024; 12:319. [PMID: 38338204 PMCID: PMC10855407 DOI: 10.3390/healthcare12030319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/12/2024] [Accepted: 01/20/2024] [Indexed: 02/12/2024] Open
Abstract
This paper examines changes in the completeness of documentation in clinical practice before and during the implementation of the Safer Births Bundle of Care (SBBC) project. This observational study enrolled parturient women with a gestation age of at least 28 weeks at the onset of labour. Data collectors extracted information from facility registers and then a central data manager summarised and reported weekly statistics. Variables of clinical significance for CQI were selected, and the proportion of non-documentation was analysed over time. A Pearson chi-square test was used to test for significant differences in non-documentation between the periods. Between 1 March 2021 and 31 July 2022, a total of 138,442 deliveries were recorded. Overall, 75% of all patient cases had at least one missing variable among the selected variables across both periods. A lack of variable documentation occurred more frequently at the district hospital level (81% of patient cases) and health centres (74%) than at regional referral hospitals (56%) (p < 0.001). Non-documentation decreased significantly from 79% to 70% after the introduction of the SBBC (p < 0.001). A tendency towards negative correlations was noted for most variables. We noted an increased attention to data quality and use which may have a positive impact on the completeness of documentation. However, halfway through the project's implementation, the completeness of documentation was still low. Our findings support the recommendation to establish short-spaced feedback loops of locally collected data using one data platform.
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Affiliation(s)
- Benjamin Anathory Kamala
- Department of Research, Haydom Lutheran Hospital, Haydom P.O. Box 9000, Tanzania; (R.M.); (E.M.); (G.G.); (P.M.)
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania; (D.R.B.); (F.B.); (F.S.K.)
| | - Hege Ersdal
- Faculty of Health Sciences, University of Stavanger, 4021 Stavanger, Norway;
- Department of Anesthesia, Stavanger University Hospital, 4011 Stavanger, Norway
| | - Robert Moshiro
- Department of Research, Haydom Lutheran Hospital, Haydom P.O. Box 9000, Tanzania; (R.M.); (E.M.); (G.G.); (P.M.)
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania; (D.R.B.); (F.B.); (F.S.K.)
| | - Estomih Mduma
- Department of Research, Haydom Lutheran Hospital, Haydom P.O. Box 9000, Tanzania; (R.M.); (E.M.); (G.G.); (P.M.)
| | - Ulrika Baker
- UNICEF Tanzania Country Office, Dar es Salaam P.O. Box 4076, Tanzania;
| | - Godfrey Guga
- Department of Research, Haydom Lutheran Hospital, Haydom P.O. Box 9000, Tanzania; (R.M.); (E.M.); (G.G.); (P.M.)
| | - Jan Terje Kvaløy
- Department of Mathematics and Physics, University of Stavanger, 4021 Stavanger, Norway;
- Department of Research, Stavanger University Hospital, 4011 Stavanger, Norway
| | - Dunstan R. Bishanga
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania; (D.R.B.); (F.B.); (F.S.K.)
- Ifakara Health Institute, Dar es Salaam P.O. Box 78373, Tanzania
| | - Felix Bundala
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania; (D.R.B.); (F.B.); (F.S.K.)
- Ministry of Health, Dodoma P.O. Box 743, Tanzania
| | - Boniphace Marwa
- President’s Office, Regional Administration and Local Government, Dodoma P.O. Box 1923, Tanzania; (B.M.); (T.R.); (J.S.); (H.F.R.); (Y.N.); (D.K.)
| | - Thomas Rutachunzibwa
- President’s Office, Regional Administration and Local Government, Dodoma P.O. Box 1923, Tanzania; (B.M.); (T.R.); (J.S.); (H.F.R.); (Y.N.); (D.K.)
| | - Japhet Simeo
- President’s Office, Regional Administration and Local Government, Dodoma P.O. Box 1923, Tanzania; (B.M.); (T.R.); (J.S.); (H.F.R.); (Y.N.); (D.K.)
| | - Honoratha Faustine Rutatinisibwa
- President’s Office, Regional Administration and Local Government, Dodoma P.O. Box 1923, Tanzania; (B.M.); (T.R.); (J.S.); (H.F.R.); (Y.N.); (D.K.)
| | - Yudas Ndungile
- President’s Office, Regional Administration and Local Government, Dodoma P.O. Box 1923, Tanzania; (B.M.); (T.R.); (J.S.); (H.F.R.); (Y.N.); (D.K.)
| | - Damas Kayera
- President’s Office, Regional Administration and Local Government, Dodoma P.O. Box 1923, Tanzania; (B.M.); (T.R.); (J.S.); (H.F.R.); (Y.N.); (D.K.)
| | - Florence Salvatory Kalabamu
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania; (D.R.B.); (F.B.); (F.S.K.)
- Department of Pediatrics, Hubert Kairuki Memorial University, Dar es Salaam P.O. Box 65300, Tanzania
| | - Paschal Mdoe
- Department of Research, Haydom Lutheran Hospital, Haydom P.O. Box 9000, Tanzania; (R.M.); (E.M.); (G.G.); (P.M.)
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Mathenge V, Onuekwe C, Nass S, Akim C, Msunyaro E, Mfinanga E, Mambo WP, Mwabulambo SG, Manozas S, Kayera D, Tinuga F, Tegegne S, Mwengee W, Atuhebwe P, Zabulon Y. Strategies to improve COVID-19 vaccination coverage in Manyara region, Tanzania, July to September 2022: best practices and lessons learned. Pan Afr Med J 2023; 45:3. [PMID: 37538365 PMCID: PMC10395112 DOI: 10.11604/pamj.supp.2023.45.1.39608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/24/2023] [Indexed: 08/05/2023] Open
Affiliation(s)
- Violet Mathenge
- World Health Organization, Tanzania Country Office, Dar es Salaam, Tanzania
| | - Chima Onuekwe
- World Health Organization, Tanzania Country Office, Dar es Salaam, Tanzania
- World Health Organization, Inter-Country Support Team - East and Southern Africa, Harare, Zimbabwe
| | - Shafique Nass
- World Health Organization, Inter-Country Support Team - East and Southern Africa, Harare, Zimbabwe
| | - Caroline Akim
- World Health Organization, Tanzania Country Office, Dar es Salaam, Tanzania
| | - Erick Msunyaro
- Health Promotion Section, Ministry of Health, Dodoma, Tanzania
| | | | | | | | - Suleiman Manozas
- Office of the Regional Commissioner, Manyara Region, Babati, Tanzania
| | - Damas Kayera
- Office of the Regional Commissioner, Manyara Region, Babati, Tanzania
| | - Florian Tinuga
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Sisay Tegegne
- World Health Organization, Tanzania Country Office, Dar es Salaam, Tanzania
| | - William Mwengee
- World Health Organization, Tanzania Country Office, Dar es Salaam, Tanzania
| | - Phionah Atuhebwe
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Yoti Zabulon
- World Health Organization, Tanzania Country Office, Dar es Salaam, Tanzania
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Mdoe P, Mduma E, Rivenes Lafontan S, Ersdal H, Massay C, Daudi V, Kayera D, Mwashemela S, Moshiro R, Kamala B. Healthcare Workers' Perceptions on the "SaferBirths Bundle of Care": A Qualitative Study. Healthcare (Basel) 2023; 11:healthcare11111589. [PMID: 37297729 DOI: 10.3390/healthcare11111589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/15/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
Background: SaferBirths Bundle of Care (SBBC) is a package of innovative clinical and training tools coupled with low-dose high-frequency simulation-based on-job training guided by local data. This bundle of care is a new initiative being implemented in 30 health facilities from five regions of Tanzania aiming at improving birth outcomes. Objective: To assess the perception of healthcare workers and facility leaders on the "SaferBirths Bundle of Care" towards saving women's and newborns' lives at birth. Method: We used a qualitative approach using focused group discussion (FGD) and individual interviews. A total of 21 FGD and 43 individual interviews were conducted between August and November 2022. In total, 94 midwives and 12 doctors were involved, some of whom were in leadership roles. The framework method for the analysis of qualitative data was used for analysis. Results: Healthcare workers and facility leaders received the bundle well and regarded it as effective in saving lives and improving healthcare provision. Five themes emerged as facilitators to the acceptance of the bundle: (1) the bundle is appropriate to our needs, (2) the training modality and data use fit our context, (3) use of champions and periodic mentorship, (4) learning from our mistakes, and (5) clinical and training tools are of high quality but can be further improved. Conclusion: The relevance of SaferBirths Bundle of Care in addressing maternal and perinatal deaths, the quality and modality of training, and the culture that enhances learning from mistakes were among the facilitators of the acceptability of the SBBC. A well-accepted intervention has huge potential for bringing the intended impact in health provision.
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Affiliation(s)
| | | | | | - Hege Ersdal
- Department of Simulation, Stavanger University Hospital, 4068 Stavanger, Norway
- Faculty of Health Sciences, University of Stavanger, 4021 Stavanger, Norway
| | - Catherine Massay
- Haydom Lutheran Hospital, Haydom 9000, Tanzania
- Kilimanjaro Christian Medical University College, Tumaini University Makumira, Moshi 25102, Tanzania
| | - Vickfarajaeli Daudi
- Haydom Lutheran Hospital, Haydom 9000, Tanzania
- Kilimanjaro Christian Medical University College, Tumaini University Makumira, Moshi 25102, Tanzania
| | - Damas Kayera
- Kilimanjaro Christian Medical University College, Tumaini University Makumira, Moshi 25102, Tanzania
| | | | - Robert Moshiro
- Haydom Lutheran Hospital, Haydom 9000, Tanzania
- Department of Pediatrics, Muhimbili National Hospital, Dar es Salaam 65000, Tanzania
| | - Benjamin Kamala
- Haydom Lutheran Hospital, Haydom 9000, Tanzania
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam 65001, Tanzania
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