Publication Date June 1, 2024 Program & Technical Resources

Quality Improvement Approaches for Safe Surgery in Nigeria: MPCDSR, Robson Classification and the WHO Surgical Safety Checklist

MOMENTUM Safe Surgery in Family Planning and Obstetrics in Nigeria seeks to accelerate reductions in maternal and newborn mortality and morbidity by increasing the capacity of Nigerian institutions and local organizations to introduce, deliver, scale-up, and sustain the use of safe and appropriate surgical obstetric care; prevention and management of obstetric and iatrogenic fistula; and prevention and mitigation of female genital mutilation/cutting in the maternal health context. As part of the efforts to scale-up safe and appropriate surgical obstetric care, the project has worked with partners to strengthen and institutionalize the use of three key quality improvement (QI) approaches: maternal, perinatal and child death surveillance and response (MPCDSR); Robson classification, and the WHO surgical safety checklist. This brief discusses the Team's application of each of these approaches.

Publication Date June 1, 2024 Research & Evidence

“We Restrict Certain Things”: A Cross-Sectional Study of Health Provider Adherence to the WHO’s Recommendation for Intrapartum Oral Intake of Fluid and Food in Greater Accra, Ghana

The World Health Organization recommends oral fluid and food intake for low-risk women during labor to enhance positive childbirth experience and respect for women’s preferences. This article in BMC Pregnancy and Childbirth describes findings from a MOMENTUM Country and Global Leadership study investigating current practices, barriers, and opportunities related to intrapartum oral intake among maternity care providers and women in public health facilities in Greater Accra, Ghana.

Publication Date June 1, 2024 Program & Technical Resources

Seeking Input from Communities, Caregivers, and Frontline Health Workers on the Perceived Barriers and Potential Solutions to Reaching Zero-Dose and Under-Vaccinated Children in Kenya

This study sought to explore and establish key barriers and potential solutions to the uptake of routine vaccines among zero-dose, under-immunized children, and missed communities in Kenya’s Vihiga, Homa Bay, and Nairobi counties. It employed Photovoice as a community-based participatory research approach. Photovoice is a visual research methodology that puts cameras into the participants’ hands so they can document, reflect upon, and communicate issues of concern, while stimulating social change. The photographs formed the basis upon which the researchers conducted in-depth interviews and focus group discussions to identify the solutions and interventions to community members’ health challenges.

Publication Date June 1, 2024 Program & Technical Resources

The Provider Behavior Change Toolkit: A Package to Guide Its Adaptation and Implementation

To develop better insights into provider behaviors, the USAID-funded Breakthrough ACTION project, in collaboration with global stakeholders, created the Provider Behavior Ecosystem Map and a subsequent Provider Behavior Change (PBC) Toolkit. MOMENTUM Integrated Health Resilience has adapted parts of the toolkit for use in fragile and conflict-affected settings. This webpage serves as a focal point for the resources that the project has adapted.

Publication Date June 1, 2024 Research & Evidence

Enhancing COVID-19 Vaccine Uptake Among Tribal Communities: A Case Study on Program Implementation Experiences from Jharkhand and Chhattisgarh States, India

Tribal populations in India face significant healthcare challenges, resulting in poorer health outcomes and lower COVID-19 vaccination rates compared to non-Tribal districts. MOMENTUM Routine Immunization Transformation and Equity aimed to improve vaccine access and uptake among Tribal populations in Chhattisgarh and Jharkhand. Using a qualitative explanatory case study, researchers conducted 90 focus group discussions and interviews with Tribal communities, NGOs, and other stakeholders. Key strategies included community leader involvement, targeted counseling, flexible vaccine sessions, and adapted messaging for booster doses. These efforts increased vaccine awareness and acceptance, but sustaining long-term uptake requires ongoing funding and political support.

Publication Date June 1, 2024 Research & Evidence

Root Causes of COVID-19 Data Backlogs: A Mixed Methods Analysis in Four African Countries

This study identifies the root causes of COVID-19 vaccination data backlogs in the Democratic Republic of the Congo, Kenya, Senegal, and Tanzania. Issues include technology limitations, infrastructure challenges, inefficient processes, and staff shortages. To resolve these, the study recommends a country-led, iterative approach, starting with a minimum viable product, and addressing workforce needs.

Publication Date May 1, 2024 Research & Evidence

Interventions and Adaptations To Strengthen Data Quality and Use for COVID-19 Vaccination: A Mixed Methods Evaluation

This mixed-methods evaluation of COVID-19 vaccine-related data and digital interventions in the Democratic Republic of the Congo, Niger, and Vietnam explores mid-course adaptations. It highlights that adaptations were driven by need and funding availability, leading to improved data availability and quality, although challenges remain in data use and eHealth building blocks.

Publication Date May 1, 2024 Program & Technical Resources

Documenting Adaptive Learning Toolkit: Templates and Resources to Support the Documentation of Adaptive Learning

This toolkit was designed to help users improve how they document adaptive learning and quality improvement activities. The toolkit includes thirteen editable templates that can be used to record notes, decisions, and next steps from various adaptive learning activities, including after-action reviews, data reviews, lessons learned, and causal link monitoring. Additionally, the toolkit includes general quality improvement documentation resources. The resources are summarized in five tables that describe the template, its recommended use, and potential users.

Publication Date May 1, 2024 Research & Evidence

Adolescent Experience of Care in Maternal Health, Reproductive Health, and Family Planning: A Scoping Review

This is a review of adolescent Experience of Care (EOC) in maternal health, reproductive health, and family planning in low- and middle-income countries (LMICs). The purpose of the review was to understand current definitions of patient-reported EOC for adolescents; identify important theoretical domains to measure adolescent EOC; and identify measures of EOC for adolescents in maternal health, reproductive health, and family planning. The main findings were a lack of consistency in the definitions of EOC and scant measurement of EOC in LMICs. There is a need to create a comprehensive definition of the components of EOC for adolescents in LMICs, and to develop a conceptual framework for how adolescent EOC influences health outcomes. Using these new tools, it would be feasible to develop and test a comprehensive measure of EOC for adolescents in LMICs.

Publication Date May 1, 2024 Webinars

Supporting the Fistula Patient’s Journey through the Safe Surgery Ecosystem: Marching Toward 2030

On May 16, 2024, MOMENTUM Safe Surgery in Family Planning and Obstetrics held a webinar in commemoration of International Day to End Obstetric Fistula (IDEOF), bringing together clinical practitioners, community implementers, government partners, and international organization representatives to facilitate collective efforts to “Support the Fistula Patient’s Journey through the Safe Surgery Ecosystem.” With only six years remaining until 2030, this year’s webinar explores challenges at the community level that contribute to developing fistula, clinical interventions to address fistula, and community opportunities available for women post-repair. The webinar also explores effective strategies for government partnership and includes video commentary from women who have experienced fistula and the frontline staff who work to support them.