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Abstract：
OBJECTIVE: To assess whether the Expanding Maternal and Neonatal Survival (EMAS) program was associated with improved care provided during hospital-based childbirth.
METHODS: A quasi-experimental study with two rounds of data collection examined whether EMAS interventions improved facility-based labor and childbirth care. Direct clinical observations were conducted for 1208 deliveries across 13 hospitals in 12 districts. Primary outcome measures included implementation of standard practices to reduce the risk of complications during labor and childbirth for both women and newborns.
RESULTS: Adjusted difference-in-difference analysis compared the mean difference in quality scores between EMAS intervention hospitals and comparison sites and consistently found significantly better performance in EMAS sites: 14 points higher for labor monitoring (β-coefficient 14.1; 95% confidence interval [CI], 7.1-21.0); 38 points higher for newborn resuscitation readiness (β-coefficient 38.1; 95% CI, 31.1-45.2); and 33 points higher for infection prevention practices (β-coefficient 32.6; 95% CI, 28.5-36.8).
CONCLUSIONS: EMAS approaches emphasizing facility readiness and adherence to performance standards significantly improved labor monitoring and complication prevention practices during childbirth.
METHODS: A quasi-experimental study with two rounds of data collection examined whether EMAS interventions improved facility-based labor and childbirth care. Direct clinical observations were conducted for 1208 deliveries across 13 hospitals in 12 districts. Primary outcome measures included implementation of standard practices to reduce the risk of complications during labor and childbirth for both women and newborns.
RESULTS: Adjusted difference-in-difference analysis compared the mean difference in quality scores between EMAS intervention hospitals and comparison sites and consistently found significantly better performance in EMAS sites: 14 points higher for labor monitoring (β-coefficient 14.1; 95% confidence interval [CI], 7.1-21.0); 38 points higher for newborn resuscitation readiness (β-coefficient 38.1; 95% CI, 31.1-45.2); and 33 points higher for infection prevention practices (β-coefficient 32.6; 95% CI, 28.5-36.8).
CONCLUSIONS: EMAS approaches emphasizing facility readiness and adherence to performance standards significantly improved labor monitoring and complication prevention practices during childbirth.
摘要：
目的：评估扩大孕产妇和新生儿生存（EMAS）计划是否与医院分娩期间提供的改善护理相关。
方法：一项包含两轮数据收集的准实验研究检查了EMAS干预措施是否改善了基于设施的分娩和分娩护理。对12个地区的13家医院的1208例分娩进行了直接临床观察。主要结果指标包括实施标准做法，以降低妇女和新生儿在分娩和分娩期间并发症的风险。
结果：调整后的差异分析比较了EMAS干预医院和比较地点之间质量得分的平均差异，并一致发现EMAS地点的表现明显更好：劳动力监测高出14分（β系数14.1；95％置信区间[CI]，7.1-21.0）；新生儿复苏准备率高38分（β系数38.1；95％CI，31.1-45.2）；感染预防措施高33分（β系数32.6；95％CI，28.5-36.8）。
结论：EMAS方法强调设施准备和对性能标准的坚持，显著改善了分娩期间的产程监测和并发症预防实践。
方法：一项包含两轮数据收集的准实验研究检查了EMAS干预措施是否改善了基于设施的分娩和分娩护理。对12个地区的13家医院的1208例分娩进行了直接临床观察。主要结果指标包括实施标准做法，以降低妇女和新生儿在分娩和分娩期间并发症的风险。
结果：调整后的差异分析比较了EMAS干预医院和比较地点之间质量得分的平均差异，并一致发现EMAS地点的表现明显更好：劳动力监测高出14分（β系数14.1；95％置信区间[CI]，7.1-21.0）；新生儿复苏准备率高38分（β系数38.1；95％CI，31.1-45.2）；感染预防措施高33分（β系数32.6；95％CI，28.5-36.8）。
结论：EMAS方法强调设施准备和对性能标准的坚持，显著改善了分娩期间的产程监测和并发症预防实践。
