title: Methodology and tools for quality improvement in maternal and newborn health care.
abstract: OBJECTIVE
  To gain an overview of approaches, methodologies, and tools used in quality improvement of maternal and newborn health in low-income countries.
  
  
  METHODS
  Electronic search of MEDLINE and organizational databases for literature describing approaches, methodologies, and tools used to improve the quality of maternal and newborn health care in low-income countries. Relevant papers and reports were reviewed and summarized.
  
  
  RESULTS
  Developing a culture of quality is an important requisite for successful quality improvement. Methodologies to improve quality include the development of standards and guidelines and the performance of mortality, near-miss, and criterion-based audits. Tools for data collection and process description were identified, and examples of work to improve quality of care are provided.
  
  
  CONCLUSIONS
  The documented experience with the identified approaches, methodologies, and tools indicates that none is sufficient by itself to achieve a desirable improvement in quality of care. The choice of methodologies and tools depends on the healthcare system and its available resources. There is a lack of studies that describe the process of quality improvement and a need for research to provide evidence of the effectiveness of the identified methods and tools.
authors.affiliation: Maternal and Newborn Health Unit, Liverpool School of Tropical Medicine, Liverpool, UK. j.raven@liverpool.ac.uk
authors.forename: Joanna
authors.initials: J
authors.lastname: Raven
authors.forename: Jan
authors.initials: J
authors.lastname: Hofman
authors.forename: Adetoro
authors.initials: A
authors.lastname: Adegoke
authors.forename: Nynke
authors.initials: N
authors.lastname: van den Broek
mesh_terms: D002662:Child Health Services / Q000458:organization & administration* / Q000592:standards; D003906:Developing Countries; D005260:Female; D006801:Humans; D007229:Infant Welfare / Q000706:statistics & numerical data; D007231:Infant, Newborn; D008427:Maternal Health Services / Q000458:organization & administration* / Q000592:standards; D008429:Maternal Welfare / Q000706:statistics & numerical data; D011247:Pregnancy; D011785:Quality Assurance, Health Care