Megan Marx Delaney|Kate Miller|Lauren Bobanski|Shambhavi Singh|Vishwajeet Kumar|Ami Karlage|Danielle E Tuller|Atul A. Gawande|Katherine Semrau
Unpacking the null: a post-hoc analysis of a cluster-randomised controlled trial of the WHO Safe Childbirth Checklist in Uttar Pradesh, India (BetterBirth)
Ariadne Diagnostics (United States)|Ariadne Diagnostics (United States)|Ariadne Diagnostics (United States)|Ariadne Diagnostics (United States)|Ariadne Diagnostics (United States)|Harvard University|Ariadne Diagnostics (United States)|Brigham and Women's Hospital|Harvard University|Ariadne Diagnostics (United States)|Brigham and Women's Hospital
h3backgroundh3 coachingbased implementation safe childbirth checklist uttar pradesh india improved adherence evidencebased practices reduce perinatal mortality maternal morbidity maternal mortality examined facilitylevel correlates outcomes varied widely across 120 study facilities h3methodsh3 posthoc analysis coachingbased implementation safe childbirth checklist uttar pradesh used multivariable modelling identify correlations 30 facilitylevel characteristics health outcome perinatal mortality maternal morbidity maternal mortality identify contexts intervention might effect ran models data restricted period intensive coaching among patients referred facilities h3findingsh3 multivariable context perinatal mortality associated 3 30 variables female literacy district level geographical location previous neonatal mortality maternal morbidity associated geographical location facilitylevel predictors associated maternal mortality among facilities lowest tertile birth volume 95 births per month models estimated perinatal mortality 17 95 ci 117248 per 1000 births intervention group versus 38 316448 per 1000 control group p00001 h3interpretationh3 mortality directly associated measured facilitylevel indicators associated general risk factors absence correlation expected predictors patient outcomes association improved outcomes intervention smaller facilities suggest need additional measures quality care take account complexity h3fundingh3 bill melinda gates foundation