Explaining the effects of a multifaceted intervention to improve inpatient care in rural Kenyan hospitals - interpretation based on retrospective examination of data from participant observation, quantitative and qualitative studies

Implementation Science

Volumn 6, Issue 1, 2011, Pages

  English, Mike ^a,b   Nzinga, Jacinta ^a   Mbindyo, Patrick ^a   Ayieko, Philip ^a   Irimu, Grace ^a,c   Mbaabu, Lairumbi ^a  

^a KEMRI WELLCOME TRUST RESEARCH PROGRAMME   (Kenya)

^b UNIVERSITY OF OXFORD   (United Kingdom)

^c UNIVERSITY OF NAIROBI   (Kenya)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CLINICAL COMPETENCE; CLUSTER ANALYSIS; HEALTH CARE QUALITY; HOSPITAL; HOSPITAL PATIENT; HUMAN; INFORMATION PROCESSING; KENYA; MOTIVATION; POVERTY; PUBLIC HEALTH; QUALITATIVE RESEARCH; RETROSPECTIVE STUDY; RURAL POPULATION; SOCIOECONOMICS; STANDARD;

CLINICAL COMPETENCE; CLUSTER ANALYSIS; DATA COLLECTION; HOSPITALS, RURAL; HUMANS; INPATIENTS; KENYA; MOTIVATION; POVERTY; PUBLIC HEALTH; QUALITATIVE RESEARCH; QUALITY OF HEALTH CARE; RETROSPECTIVE STUDIES; RURAL POPULATION; SOCIOECONOMIC FACTORS;

EID: 82455168224     PISSN: None     EISSN: 17485908     Source Type: Journal    
DOI: 10.1186/1748-5908-6-124     Document Type: Article

References (59)

1. United Nations Development Programme UNDP. United Nations Development Programme., http://www.undp.org/mdg/
2. Friberg IK, Kinney MV, Lawn J, Kerber K, Odubanjo MO. Sub-Saharan Afrca's mothers, newborns and children: How many lives could be saved with targeted health interventions. PLoS Med 2010, 7:e1000295. 10.1371/journal.pmed.1000295, 2888572, 20574515.
3. Whitworth J, Sewankambo NK, Snewin VA. Improving implementation: building research capacity in maternal, neonatal, and child health in Africa. PLoS Med 2010, 7:e1000299. 10.1371/journal.pmed.1000299, 2897765, 20625547.
4. Rowe A, de Savigny D, Lanata C, Victora C. How can we achieve and maintain high quality performance of health workers in low resource settings?. The Lancet 2005, 366:1026-1035.
5. Zurovac D, Rowe AK. Quality of treatment for febrile illness among children at outpatient facilities in sub-Saharan Africa. Ann Trop Med Parasitol 2006, 100:283-296. 10.1179/136485906X105633, 16762109.
6. Schellenberg JA, Bryce J, de Savigny D, Lambrechts T, Mbuya C, Mgalula L, Wilczynska K. The effect of Intergrated Management of Childhood Illness on observed quality of care of under-fives in rural Tanzania. Health Policy and Planning 2004, 19:1-10.
7. Arifeen S, Blum L, Hoque D, Chowdhury E, Khan R, Black R, Victora C, Bryce J. Integrated management of childhood illness (IMCI) in Bangladesh: early findings from a cluster-randomised study. The Lancet 2004, 364:1595-1602.
8. Bryce, Victoria CG, Habitch J, Vaughan JP, Black RE. The multi-country evaluation of the intergrated management of childhood illness strategy:lessons for the evaluation of public health interventions. American Journal of Public Health 2004, 94:406. 10.2105/AJPH.94.3.406, 1448266, 14998804.
9. Huicho L, Da'Vila M, Campos M, Drasbek C, Bryce J, Victora C. Scaling up intergrated management of childhood illness to the national level: achievements and challenges in Peru. Health Policy and Planning 2005, 20:14-24. 10.1093/heapol/czi002, 15689426.
10. World Health Organisation 'Hospitals and Health for All.' Report of the WHO Expert Committee on the Role of Hospitals at the First Referral Level. 1987, Geneva: WHO, World Health Organisation.
11. English M, Esamai F, Wasunna A, Were F, Ogutu B, Wamae A, Snow RW, Peshu N. Assessment of inpatient paediatric care in first referral level hospitals in 13 districts in Kenya. The Lancet 2004, 363:1948-1953.
12. Nolan T, Angos P, Cunha AJ, Muhe L, Qazi S, Simoes EA, Tamburlini G, Weber M, Pierce NF. Quality of hospital care for seriously ill children in less-developed countries. The Lancet 2000, 357:106-110.
13. Reyburn H, Mwakasungula E, Chonya S, Mtei F, Bygbjerg I, Poulsen A, Olomi R. Clinical Assessment and treatment in paediatric wards in the north-east of the United Republic of Tanzania. Bull World Health Organ 2008, 86:132-139. 2647389, 18297168.
14. Opondo C, Ntoburi S, Wagai J, Wafula J, Wasunna A, Were F, Wamae A, Migiro S, Irimu G, English M. Are hospitals prepared to support newborn survival? - An evaluation of eight first-referral level hospitals in Kenya. Tropical Medicine & International Health 2009, 14:1165-72. 10.1111/j.1365-3156.2009.02358.x, 22140593.
15. Gao Y, Barclay L. Availability and quality of emergency obstetric care in Shanxi Province, China. Int J Gynaecol Obstet 2010, 110:181-185. 10.1016/j.ijgo.2010.05.001, 20570261.
16. Kingham TP, Thaim KB, Meena CN, Richard GA, Simkins M, Meissner C, Foray-Rahall L, Kisito DS, Soccoh KA, Adam KL. Quantifying Surgical Capacity in Sierra Leone. Archives of Surgery 2009, 144:122-127. 10.1001/archsurg.2008.540, 19221322.
17. Ferlie EB, Shortell SM. Improving the quality of health care in the United Kingdom and the United States: A framework for change. Millbank Quarterly 2001, 79:281-315.
18. de Savigny D, Adam T, . Eds Systems Thinking for Health System Strengthening. 2009, Geneva: World Health Organisation, Eds.
19. Medical Research Council (UK) Developing and evaluating complex interventions. 2009, MRC (UK), Medical Research Council (UK).
20. Mackenzie M, O'Donnell C, Halliday E, Sridharan S, Platt S. Evaluating complex interventions: one size does not fit all. BMJ 2010, 340:c185. 10.1136/bmj.c185, 20123834.
21. English M, Irimu G, Wamae A, Were F, Wasunna A, Fegan G, Peshu N. Health systems research in a low-income country: easier said than done. Archives of Diseases in Childhood 2008, 93:540-544.
22. Grimshaw J, Thomas RE, MacLennan G, Fraser C, Ramsay CR, Vale L, Whitty P, Eccles MP, L M, Shirran L, et al. Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technology Assessment 2004, 8.
23. Choi M, Ruona WE. Individual readiness for organisational change and its implications for human resource and organisation development. Human Resource Development Review 2010, SAGE.
24. Ayieko P, Ntoburi S, Wagai J, Opondo C, Opiyo N, Migiro S, Wamae A, Mogoa W, Were F, Wasunna A, et al. A multifaceted intervention to implement guidelines and improve admission paediatric care in Kenyan district hospitals: a cluster randomized trial. PLoS Med 2011, 8:e1001018. 10.1371/journal.pmed.1001018, 3071366, 21483712.
25. Irimu G, Wamae A, Wasunna A, Were F, Ntoburi S, Opiyo N, Ayieko P, Peshu N, English M. Developing and introducing evidence based clincial practice guidelines for serious illness in Kenya. Archives of Diseases in Childhood 2008, 93:799-804.
26. English M, Ntoburi S, Wagai J, Mbindyo P, Opiyo N, Ayieko P, Opondo C, Migiro S, Wamae A, Irimu G. An intervention to improve paediatric and newborn care in Kenyan district hospitals: Understanding the context. Implementation Science 2009, 4.
27. Mbindyo P, Gilson L, Blaauw D, English E. Contextual influences on health worker motivation in district hospitals in Kenya. Implementation Science 2009, 4.
28. Nzinga J, Mbindyo P, Mbaabu L, Warira A, English M. Documenting the experiences of health workers expected to implement guidelines during an intervention study in Kenyan hospitals. Implementation Science 2009, 4.
29. Nzinga J, Ntoburi S, Wagai J, Mbindyo P, Mbaabu L, Migiro S, Wamae A, Irimu G, English M. Implementation experience during an eighteen month intervention to improve and newborn care in Kenyan district hospitals. Implementation Science 2009, 4.
30. Teddlie C, Tashokkori A. An overview of contemporary issues in mixed methods research. Mixed Methods in Social and Behavioral Research 2009, 1-45. Thousand Oaks: SAGE, Tashakkori A, C T, Second.
31. Scales DC, Dainty K, Hales B, Pinto R, Fowler RA, Adhikari NKJ, Zwarenstein M. A Multifaceted Intervention for Quality Improvement in a Network of Intensive Care Units. JAMA: The Journal of the American Medical Association 2011, 305:363-372.
32. Plano-Clark VL, Badiee M. Research questions in mixed methods research. Mixed Methods in Social and Behavioral Research 2009, 275-304. Thousand Oaks: SAGE, Tashakkori A, C T, Second.
33. Cresswell JW. Mapping the developing landscape of mixed methods research. Mixed Methods in Social and Behavioral Research 2009, 45-68. Thousand Oaks: SAGE, Tashakkori A, C T, Second.
34. English M, Esamai F, Wasunna A, Were F, Ogutu B, Wamae A, Snow RW, Peshu N. Delivery of paediatric care at the first-referral level in Kenya. The Lancet 2004, 364:1622-1629.
35. Murphy E, Dingwall R, Greatbatch D, Parker S, Watson P. Qualitative research methods in health technology assessment: a review of the literature. Health Technology Assessment 1998, 2.
36. Stroebel CK, McDaniel RR, Crabtree BF, Miller WL, Nutting PA, Stange KC. How complexity science can inform a reflective process for improvement in primary care practices. Jt Comm J Qual Patient Saf 2005, 31:438-446.
37. O'Cathain A, Murphy E, Nicholl J. Three techniques for integrating data in mixed methods studies. BMJ 2010, 341:c4587. 10.1136/bmj.c4587, 20851841.
38. Eisenhardt KM. Building Theories from Case Study Research. Academy of Management Review 1989, 14:532-550.
39. Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q 2004, 82:581-629. 10.1111/j.0887-378X.2004.00325.x, 15595944.
40. Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A, . on behalf of the 'Psychological Theory' Group Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care 2005, 14:26-33. 10.1136/qshc.2004.011155, 1743963, 15692000, on behalf of the 'Psychological Theory' Group.
41. Ajzen I. The Theory of Planned Behaviour. Organizational Behavior and Human Decision Processes 1991, 50:179-211.
42. Blaauw D, Gilson L, Penn-Kekana L, Schneider H. Organisational relationships and the 'software' of health sector reform. Disease Control Priorities Project Background Paper 2003, Washington, DC..
43. Franco LM, Bennett S, Kanfer R. Health sector reform and public sector health worker motivation: a conceptual framework. Social Science & Medicine 2002, 54:1255-1266. 10.1016/S0277-9536(01)00094-6, 22140328.
44. Barach P, Johnson JK. Understanding the complexity of redesigning care around the clinical microsystem. Qual Saf Health Care 2006, 15:i10-i16. 10.1136/qshc.2005.015859, 2464878, 17142602.
45. Balding C. Embedding organisational quality improvement through middle manager ownership. Int J Health Care Qual Assur Inc Leadersh Health Serv 2005, 18:271-288.
46. Pawson R, Tilley N. Realistic Evaluation 1996, London: SAGE.
47. Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci 2009, 4.
48. Newell S, Edelman L, Scarborough H, Swan J, Bresnen M. 'Best practice' development and transfer in the NHS: the importance of process as well as product knowledge. Health Services Management Research 2003, 16:1-12. 10.1258/095148403762539095, 12626022.
49. Green LW, Ottoson JM, Garcia C, Hiatt RA. Diffusion theory and knowledge dissemination, utilization, and integration in public health. Annu Rev Public Health 2009, 30:151-174. 10.1146/annurev.publhealth.031308.100049, 19705558.
50. Weber V, Joshi MS. Effecting and leading change in health care organisations. The Joint Commission on Healthcare Organisations 2000, 26:388-399.
51. Remme JH, Adam T, Becerra-Posada F, D'Arcangues C, Devlin M, Gardner C, Ghaffar A, Hombach J, Kengeya JF, Mbewu A, et al. Defining research to improve health systems. PLoS Med 2010, 7:e1001000. 10.1371/journal.pmed.1001000, 2993153, 21124816.
52. Althabe F, Bergel E, Cafferata ML, Gibbons L, Ciapponi A, Aleman A, Colantonio L, Palacios AR. Strategies for improving the quality of health care in maternal and child health in low and middle income countries: an overview of systematic reviews. Pediatric and Perinatal Epidemiology 2008, 22:42-60. 10.1111/j.1365-3016.2007.00912.x, 18237352.
53. Mbindyo PM, Blaauw D, Gilson L, English M. Developing a tool to measure health worker motivation in district hospitals in Kenya. Hum Resour Health 2009, 7:40. 10.1186/1478-4491-7-40, 2692978, 19457237.
54. Marchal B, Dedzo M, Kegels G. Turning around an ailing district hospital: a realist evaluation of strategic changes at Ho Municipal Hospital (Ghana). BMC Public Health 2010, 10:787. 10.1186/1471-2458-10-787, 3019197, 21184678.
55. McPake B, Blaauw D, Sheaff R. Recognising patterns: health systems research beyond controlled trials. Health Systems Development 2006, Health Systems Development Programme.
56. Plsek PE, Greenhalgh T. Complexity science: The challenge of complexity in health care. BMJ 2001, 323:625-628. 10.1136/bmj.323.7313.625, 1121189, 11557716.
57. Chandler C, Jones C, Boniface G, Juma K, Reyburn H, Whitty C. Guidelines and mindlines: why do clinical staff over-diagnose malaria in Tanzania? A qualitative study. Malaria Journal 2008, 7:53. 10.1186/1475-2875-7-53, 2323020, 18384669.
58. Bjorkman M, Svensson J. Power to the People: Evidence from a Randomized Field Experiment on Community-Based Monitoring in Uganda*. Quarterly Journal of Economics 2009, 124:735-769.
59. Dopson S, Fitzgerald L. The role of the middle manager in the implementation of evidence-based health care. J Nurs Manag 2006, 14:43-51. 10.1111/j.1365-2934.2005.00612.x, 16359445.