Interventions for improving quality of care with respect to clean delivery: systematic literature review

Hundreds of thousands of women still die during pregnancy or childbirth each year, 90% of them in Africa and Asia. The majority of women are dying from severe bleeding, infections, eclampsia, obstructed labour and the consequences of unsafe abortions – all causes for which there are highly effective interventions. In this context, a focus on quality in health care is important. High quality helps to ensure safe, effective, and timely treatment that is responsive to those seeking care and ensures their equity. Furthermore, it disposes of adequate physical and human resources. Good quality maternal health services include a variety of components: skilled care for both routine and complicated cases, including emergency obstetric services for life-threatening complications, and a functioning referral system to ensure timely access to appropriate care.

This review aimed to assess the effects of interventions including elements aiming at behavioural changes in healthcare professionals for achieving clean childbirth practices on medical outcomes (mortality and sepsis), quality indicators (including behaviour / practice change) and perceived quality (satisfaction).