Results

The following charts show results for the original five sites where the Improvement Collaborative was introduced during a 16-month period from September 2009 to December 2010.

Although counseling was not available in all the hospitals at the start of the intervention, the data (Figure 5) shows a marked increase in the proportion of women counseled for family planning use immediately after delivery or miscarriage. The hospital in Aden is highlighted for its steady improvement, since it assigned a midwife to counsel women in the postpartum room. In contrast, Sana’a did not improve much due to the low number of midwives working afternoon and night shifts.

Figure 5. Improvement in family planning counseling

 

The percentage of women receiving a family planning method before leaving the five hospitals rose from 4% to 25% (Figure 6). This was impressive given that family planning methods were not offered to women after delivery or miscarriage. Taiz Hospital serves as an example of steady improvement in family planning distribution. In contrast, the Ibb Hospital team believed that a woman’s stress during the immediate postpartum period interfered with her receptiveness to accepting a contraceptive, so they chose not to offer family planning methods until six weeks postpartum. After other hospitals presented their success in the uptake of family planning methods before discharge, however, the Ibb team decided to change their approach. This example illustrates the advantages of shared learning in the Improvement Collaborative.

Figure 6. Increase in percentage of women receiving a family planning method before leaving the hospital

Figure 7 shows an increase in the number of women receiving counseling on exclusive breastfeeding, which rose from 36% to 73% in the five hospitals during the intervention. In contrast to the previous chart, the Ibb team was a strong proponent of exclusive breast feeding from the beginning of the intervention and led all hospitals in counseling.

Figure 7. Increase in number of women receiving counseling on exclusive breastfeeding before discharge