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Providing Safe, High-Quality Maternity Care in Rural US Hospitals
This IHI Innovation Report examines the challenges and gaps that rural health care organizations in the US face; presents a synthesis of published evidence and effective approaches developed by clinicians and leaders; and describes potential strategies for providing safe, high-quality maternity care in rural areas.
A Quality Improvement Initiative to Increase the Frequency of Vaginal Delivery in Brazilian Hospitals
Four key interventions implemented with quality improvement (QI) methods in Brazilian hospitals were associated with increased vaginal delivery, suggesting that this approach may help address the global C-section delivery epidemic.
The Role of Racism as a Core Patient Safety Issue
Maternal mortality rates in the US are rising, particularly among black women. This article describes three things health care leaders can do to understand the contributing causes of mortality, including racism, and factors to reduce inequities and improve safety in maternal health.
WIHI: Black Women and Maternal Care: Redesigning for Safety, Dignity, and Respect
August 8, 2019 | With a significant rise in maternal deaths in the United States, how can providers partner with community groups to design respectul, dignified pregnancy experiences?
Using a Multicountry Learning Network to Harvest and Rapidly Spread Implementation Knowledge to Reduce Mother-to-Child Transmission of HIV
This article describes the value of creating a quality improvement–driven, multicountry learning network to accelerate the pace of improving care systems in Africa to reduce mother-to-child transmission of HIV.
Applying Quality Improvement Approaches to Reduce Mother-to-Child HIV Transmission and Improve Health and Nutrition Care in Five Countries
This article describes the application of quality improvement (QI) methods, as part of the Partnership for HIV-Free Survival, to support governments and facility staff in five African countries in reducing maternal-to-child transmission of HIV.
A Six-Country Collaborative Quality Improvement Initiative to Improve Nutrition and Decrease Mother-to-Child Transmission of HIV
This article is the first report of the effectiveness of using quality improvement in a large-scale multicountry effort in Africa to improve infant survifal by reducing postnatal maternal-to-child transmission of HIV in breast feeding HIV-positive mothers.
Profiles in Improvement: Dr. Pierre Barker, IHI Chief Global Partnerships and Programs Officer
Dr. Pierre Barker, IHI Chief Global Partnerships and Programs Officer, describes some of IHI’s global work that is helping to improve health and health care worldwide.
Profiles in Improvement: Dr. Hema Magge, IHI Country Director, Ethiopia
Dr. Hema Magge, IHI Country Director in Ethiopia, is leading a program to reduce maternal and newborn mortality in Ethiopia. IHI and its partners are supporting the Ethiopian Federal Ministry of Health in an ambitious agenda to rapidly close gaps in national health outcomes through the coordination of quality planning, quality assurance, and quality improvement.
Tanzania-Kenya Knowledge Exchange for the Partnership for HIV-Free Survival: Reflections and Recommendations
This report describes best practices for scaling up prevention of mother-to-child transmission of HIV, identified through the work of the Partnership for HIV-Free Survival, a six-country learning network across sub-Saharan Africa.
Can a Quality Improvement Project Impact Maternal and Child Health Outcomes at Scale in Northern Ghana?
This paper discusses the impact of a scale-up phase of Project Fives Alive! to improve maternal and child health outcomes, which used quality improvement methods to identify barriers to care and care-seeking, and then identify, test, implement, and scale up simple and low-cost local solutions to address the barriers. The project and this approach demonstrated improved outcomes at scale.
WIHI: Nurturing Trust: Addiction and Maternal and Newborn Health
June 2, 2016 | Addiction is always a complex challenge, but when a woman using substances is pregnant, suddenly two lives are at stake.
Healthy Shelby: A Triple Aim Improvement Story
This Triple Aim improvement story examines the work of the Healthy Shelby Initiative in Tennessee, a community pursuing a regional focus to improve population health by linking public health, hospitals, health care providers, social service providers, academic institutions, the faith community, local government, and funders to work together to tackle some of the county’s most critical health problems: infant mortality, chronic disease management, and end-of-life care.
WIHI: Saving Lives by Design: Lessons for All from Ghana's Project Fives Alive!
July 23, 2015 | One of the biggest ongoing challenges facing health and health care quality improvers is moving from small-scale successes to large-scale ones. That’s why it’s incredibly inspiring to learn from initiatives like Project Fives Alive! that are cracking the code.
Lessons Learned from Ghana's Project Fives Alive! A Practical Guide for Designing and Executing Large-Scale Improvement Initiatives
How do you set up a large-scale improvement project for success? After seven years of rapidly and successfully scaling up high-impact maternal and child health interventions across Ghana using a quality improvement approach, the lessons learned from Project Fives Alive! are documented in this practical guide. Topics include project design, day-to-day project management and leadership, building QI capability, managing complex partner relationships, and deploying a core set of balanced metrics.
Profiles in Improvement: Sodzi Sodzi-Tettey, MD, MPH, IHI Director of Project Fives Alive!
Dr. Sodzi Sodzi-Tettey, IHI Senior Technical Director for the Africa Region, talks about his work in Ghana with Project Fives Alive!, including the encouraging results they're seeing in reducing mortality of children under five years of age (work that is underpinned by strong technical leadership in QI), and IHI's growing portfolio of work in Africa.
Applying a Science-Based Method to Improve Perinatal Care: The IHI Perinatal Improvement Community
This article explores the origins of and the early challenges faced by the IHI Perinatal Improvement Community, the work to reduce early elective deliveries and rates of cesarean sections, IHI’s overall approach to improvement, and the growing role of the IHI Triple Aim in improving perinatal care.
Profiles in Improvement: Nneka Mobisson-Etuk, MD, Executive Director of African Operations, IHI
In this profile, Dr. Nneka Mobisson-Etuk describes her leadership of IHI's work in Africa, building on a near-decade of quality improvement work focused on maternal and child health, prevention of mother-to-child transmission of HIV, quality planning strategy, building improvement capability in the region, and other areas of focus.
Impact Evaluation of a Quality Improvement Intervention on Maternal and Child Health Outcomes in Northern Ghana: Early Assessment of a National Scale-up Project
This study of the early phase of Project Fives Alive! to improve key maternal and child health outcomes in Ghana demonstrates that the quality improvement (QI) approach of testing and implementing simple, low-cost, locally-inspired changes has the potential to lead to improved health outcomes at scale both in Ghana and other low- and middle-income countries.
Using Quality Improvement Methods to Test and Scale Up a New National Policy on Early Post-natal Care in Ghana
This initiative demonstrates the utility of a quality improvement (QI) approach in testing, implementing, and subsequent scaling up a national policy for early post-natal care in a resource-constrained setting, and provides a model to accelerate the achievement of the Millennium Development Goals in Ghana and other resource-poor countries.
Using a Campaign Approach Among Health Workers to Increase Access to Antiretroviral Therapy for Pregnant HIV-Infected Women in South Africa
A campaign approach among health workers to improve access to antiretroviral therapy (ART) for HIV-infected pregnant women in two districts in South Africa shows a four-fold increase in HIV-infected women initiated on ART.
Effects of Quality Improvement in Health Facilities and Community Mobilization Through Women's Groups on Maternal, Neonatal, and Perinatal Mortality in Three Districts of Malawi
A new article reports that community engagement combined with facility-based clinical QI had a dramatic effect on reducing neonatal mortality in Malawi.
A Nationwide Quality Improvement Project to Accelerate Ghana’s Progress Toward Millennium Development Goal Four
The authors describe the successes to date of a rapid, national scale-up quality improvement intervention to accelerate the achievement of Millennium Development Goal Four (reduce maternal and infant mortality) in Ghana, based on IHI's work in Ghana as part of the Project Fives Alive! initiative.
How-to Guide: Prevent Obstetrical Adverse Events
This How-to Guide describes the essentials elements of preventing obstetrical adverse events, including the safe use of oxytocin and key evidence-based care components in the IHI Perinatal Bundles.
Eliminating Mother-to-Child HIV Transmission Will Require Major Improvements in Maternal and Child Health Services
Researchers modelled how poor access to routine antenatal and postnatal health services contributes three times more to overall mother-to-child HIV transmission than do current suboptimal levels of delivery of anti-HIV-transmission interventions.