title: Monitoring maternal and newborn health outcomes in Bauchi State, Nigeria: an evaluation of a standards-based quality improvement intervention.
abstract: OBJECTIVE
  This study assessed the correlation between compliance with set performance standards and maternal and neonatal deaths in health facilities.
  
  
  METHODS
  Baseline and three annual follow-up assessments were conducted, and each was followed by a quality improvement initiative using the Standards Based Management and Recognition (SBM-R) approach.
  
  
  METHODS
  Twenty-three secondary health facilities of Bauchi state, Nigeria.
  
  
  METHODS
  Health care workers and maternity unit patients.
  
  
  METHODS
  We examined trends in: (i) achievement of SBM-R set performance standards based on annual assessment data, (ii) the use of maternal and newborn health (MNH) service delivery practices based on data from health facility registers and supportive supervision and (iii) MNH outcomes based on routine service statistics.
  
  
  RESULTS
  At the baseline assessment in 2010, the facilities achieved 4% of SBM-R standards for MNH, on average, and this increased to 86% in 2013. Over the same time period, the study measured an increase in the administration of uterotonic for active management of third stage of labor from 10% to 95% and a decline in the incidence of postpartum hemorrhage from 3.3% to 1.9%. Institutional neonatal mortality rate decreased from 9 to 2 deaths per 1000 live births, while the institutional maternal mortality ratio dropped from 4113 to 1317 deaths per 100 000 live births.
  
  
  CONCLUSIONS
  Scaling up SBM-R for quality improvement has the potential to prevent maternal and neonatal deaths in Nigeria and similar settings.
authors: Jhpiego, an affiliate of Johns Hopkins University, Plot No. 971 Reuben Okoya Crescent, Off Okonjo Iweala Street, Off Olesegun Obasanjo Way, P.O. Box 14831, Wuye, Abuja FCT, Nigeria.|Targeted States High Impact Project (TSHIP), No. 3 Emir Sulaiman Adamu Street, Off Airport Road, GRA, Bauchi, Nigeria.
authors: Ibrahim
authors: I
authors: Kabo
authors: Jhpiego, an affiliate of Johns Hopkins University, Plot No. 971 Reuben Okoya Crescent, Off Okonjo Iweala Street, Off Olesegun Obasanjo Way, P.O. Box 14831, Wuye, Abuja FCT, Nigeria.
authors: Emmanuel
authors: E
authors: Otolorin
authors: Jhpiego, an affiliate of Johns Hopkins University, Plot No. 971 Reuben Okoya Crescent, Off Okonjo Iweala Street, Off Olesegun Obasanjo Way, P.O. Box 14831, Wuye, Abuja FCT, Nigeria.
authors: Emma
authors: E
authors: Williams
authors: Targeted States High Impact Project (TSHIP), No. 3 Emir Sulaiman Adamu Street, Off Airport Road, GRA, Bauchi, Nigeria.|John Snow Incorporated Research and Training Institute, No. 44 Farnsworth Street, Boston, MA 02210-1211, USA.
authors: Nosa
authors: N
authors: Orobaton
authors: Jhpiego, an affiliate of Johns Hopkins University, Plot No. 971 Reuben Okoya Crescent, Off Okonjo Iweala Street, Off Olesegun Obasanjo Way, P.O. Box 14831, Wuye, Abuja FCT, Nigeria.|Targeted States High Impact Project (TSHIP), No. 3 Emir Sulaiman Adamu Street, Off Airport Road, GRA, Bauchi, Nigeria.
authors: Hannatu
authors: H
authors: Abdullahi
authors: Jhpiego, an affiliate of Johns Hopkins University, Plot No. 971 Reuben Okoya Crescent, Off Okonjo Iweala Street, Off Olesegun Obasanjo Way, P.O. Box 14831, Wuye, Abuja FCT, Nigeria.|Targeted States High Impact Project (TSHIP), No. 3 Emir Sulaiman Adamu Street, Off Airport Road, GRA, Bauchi, Nigeria.
authors: Habib
authors: H
authors: Sadauki
authors: Targeted States High Impact Project (TSHIP), No. 3 Emir Sulaiman Adamu Street, Off Airport Road, GRA, Bauchi, Nigeria.|John Snow Incorporated Research and Training Institute, No. 44 Farnsworth Street, Boston, MA 02210-1211, USA.
authors: Masduk
authors: M
authors: Abdulkarim
authors: John Snow Incorporated Research and Training Institute, No. 44 Farnsworth Street, Boston, MA 02210-1211, USA.
authors: Dele
authors: D
authors: Abegunde
mesh_terms: D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D006801:Humans; D007223:Infant; D000068104:Infant Health; D007226:Infant Mortality; D007231:Infant, Newborn; D000068097:Maternal Health; D009549:Nigeria; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D058996:Quality Improvement
keywords: Nigeria; maternal; newborn; quality improvement