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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
QUARITE (quality of care, risk management and technology in obstetrics): A cluster-randomized trial of a multifaceted intervention to improve emergency obstetric care in Senegal and Mali
Trials, Volume 10, Article 85, Year 2009
Notification
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Description
Background: Maternal and perinatal mortality are major problems for which progress in sub-Saharan Africa has been inadequate, even though childbirth services are available, even in the poorest countries. Reducing them is the aim of two of the main Millennium Development Goals. Many initiatives have been undertaken to remedy this situation, such as the Advances in Labour and Risk Management (ALARM) International Program, whose purpose is to improve the quality of obstetric services in low-income countries. However, few interventions have been evaluated, in this context, using rigorous methods for analyzing effectiveness in terms of health outcomes. The objective of this trial is to evaluate the effectiveness of the ALARM International Program (AIP) in reducing maternal mortality in referral hospitals in Senegal and Mali. Secondary goals include evaluation of the relationships between effectiveness and resource availability, service organization, medical practices, and satisfaction among health personnel. Methods/Design: This is an international, multi-centre, controlled cluster-randomized trial of a complex intervention. The intervention is based on the concept of evidence-based practice and on a combination of two approaches aimed at improving the performance of health personnel: 1) Educational outreach visits; and 2) the implementation of facility-based maternal death reviews. Trial Registration: The unit of intervention is the public health facility equipped with a functional operating room. On the basis of consent provided by hospital authorities, 46 centres out of 49 eligible were selected in Mali and Senegal. Using randomization stratified by country and by level of care, 23 centres will be allocated to the intervention group and 23 to the control group. The intervention will last two years. It will be preceded by a pre-intervention one-year period for baseline data collection. A continuous clinical data collection system has been set up in all participating centres. This, along with the inventory of resources and the satisfaction surveys administered to the health personnel, will allow us to measure results before, during, and after the intervention. The overall rate of maternal mortality measured in hospitals during the post-intervention period (Year 4) is the primary outcome. The evaluation will also include cost-effectiveness. The QUARITE trial is registered on the Current Controlled Trials website under the number ISRCTN46950658 http://www.controlled-trials.com/. © 2009 Dumont et al; licensee BioMed Central Ltd.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC2758868/bin/1745-6215-10-85-S1.DOC
Authors & Co-Authors
Dumont, Alexandre
Canada, Montreal
University of Montreal
Canada, Montreal
Chu Sainte-justine - le Centre Hospitalier Universitaire Mère-enfant
Senegal, Dakar
Institut de Recherche Pour le Développement Dakar
Fournier, Pierre
Canada, Montreal
University of Montreal
Canada, Montreal
Centre Hospitalier de L'universite de Montreal
Fraser, William Donald
Canada, Montreal
University of Montreal
Canada, Montreal
Chu Sainte-justine - le Centre Hospitalier Universitaire Mère-enfant
Haddad, Slim
Canada, Montreal
University of Montreal
Canada, Montreal
Centre Hospitalier de L'universite de Montreal
Diop, Idrissa L.
Senegal, Dakar
Hygea
Gueye, Mouhamadou
France, Amiens
Centre Amiénois de Recherche en Education et Formation Caref
Gaye, Alioune
Senegal
Health Centre
Couturier, François
Canada, Sherbrooke
Université de Sherbrooke
Pasquier, Jean Charles
Canada, Sherbrooke
Université de Sherbrooke
Beaudoin, François
Canada, Montreal
University of Montreal
Canada, Montreal
Chu Sainte-justine - le Centre Hospitalier Universitaire Mère-enfant
Lalonde, André B.
Canada, Ottawa
The Society of Obstetricians and Gynaecologists of Canada
Hatem, Marie A.
Canada, Montreal
University of Montreal
Abrahamowicz, Michal
Canada, Montreal
Université Mcgill
Statistics
Citations: 50
Authors: 13
Affiliations: 11
Identifiers
Doi:
10.1186/1745-6215-10-85
ISSN:
17456215
e-ISSN:
17456215
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Randomised Control Trial
Cross Sectional Study
Grounded Theory
Study Locations
Mali
Senegal