T2L9WDR8
type: UserItem
resource: s13012-020-01029-4
access date: 2020-11-14 17:53:58
repository: Crossref

s13012-020-01029-4
type: AcademicArticle
title: Implementation and evaluation of nonclinical interventions for appropriate use of cesarean section in low- and middle-income countries: protocol for a multisite hybrid effectiveness-implementation type III trial
abstract: Background While cesarean sections (CSs) are a life-saving intervention, an increasing number are performed without medical reasons in low- and middle-income countries (LMICs). Unnecessary CS diverts scarce resources and thereby reduces access to healthcare for women in need. Argentina, Burkina Faso, Thailand, and Vietnam are committed to reducing unnecessary CS, but many individual and organizational factors in healthcare facilities obstruct this aim. Nonclinical interventions can overcome these barriers by helping providers improve their practices and supporting women’s decision-making regarding childbirth. Existing evidence has shown only a modest effect of single interventions on reducing CS rates, arguably because of the failure to design multifaceted interventions effectively tailored to the context. The aim of this study is to design, adapt, and test a multifaceted intervention for the appropriate use of CS in Argentina, Burkina Faso, Thailand, and Vietnam. Methods We designed an intervention (QUALIty DECision-making—QUALI-DEC) with four components: (1) opinion leaders at heathcare facilities to improve adherence to best practices among clinicians, (2) CS audits and feedback to help providers identify potentially avoidable CS, (3) a decision analysis tool to help women make an informed decision on the mode of birth, and (4) companionship to support women during labor. QUALI-DEC will be implemented and evaluated in 32 hospitals (8 sites per country) using a pragmatic hybrid effectiveness-implementation design to test our implementation strategy, and information regarding its impact on relevant maternal and perinatal outcomes will be gathered. The implementation strategy will involve the participation of women, healthcare professionals, and organizations and account for the local environment, needs, resources, and social factors in each country. Discussion There is urgent need for interventions and implementation strategies to optimize the use of CS while impro…
doi: 10.1186/s13012-020-01029-4
short title: Implementation and evaluation of nonclinical interventions for appropriate use of cesarean section in low- and middle-income countries
language: en
creator: Person
author list: Person
is part of: Issue
  date: 2020-12
  volume: 15
  issue: 1
  is part of: Implementation Science
    type: Journal
    issn: 1748-5908

Person
given name: Alexandre
surname: Dumont

Person
given name: Ana Pilar
surname: Betrán

Person
given name: Charles
surname: Kaboré

Person
given name: Myriam
surname: de Loenzien

Person
given name: Pisake
surname: Lumbiganon

Person
given name: Meghan A.
surname: Bohren

Person
given name: Quoc Nhu Hung
surname: Mac

Person
given name: Newton
surname: Opiyo

Person
given name: Guillermo
surname: Carroli

Person
given name: Kristi Sidney
surname: Annerstedt

Person
given name: Valery
surname: Ridde

Person
given name: Ramón
surname: Escuriet

Person
given name: Michael
surname: Robson

Person
given name: Claudia
surname: Hanson

Person
surname: The QUALI-DEC research group