@article{fdi:010048328,
  title = {{QUARITE} (quality of care, risk management and technology in obstetrics) : a cluster-randomized trial of a multifaceted intervention to improve emergency obstetric care in {S}enegal and {M}ali},
  author = {{D}umont, {A}lexandre and {F}ournier, {P}. and {F}raser, {W}. and {H}addad, {S}. and {T}raore, {M}. and {D}iop, {I}. and {G}ueye, {M}. and {G}aye, {A}. and {C}outurier, {F}. and {P}asquier, {J}. {C}. and {B}eaudoin, {F}. and {L}alonde, {A}. and {H}atem, {M}. and {A}brahamowicz, {M}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {M}aternal and perinatal mortality are major problems for which progress in sub{S}aharan {A}frica has been inadequate, even though childbirth services are available, even in the poorest countries. {R}educing them is the aim of two of the main {M}illennium {D}evelopment {G}oals. {M}any initiatives have been undertaken to remedy this situation, such as the {A}dvances in {L}abour and {R}isk {M}anagement ({ALARM}) {I}nternational {P}rogram, whose purpose is to improve the quality of obstetric services in low-income countries. {H}owever, few interventions have been evaluated, in this context, using rigorous methods for analyzing effectiveness in terms of health outcomes. {T}he objective of this trial is to evaluate the effectiveness of the {ALARM} {I}nternational {P}rogram ({AIP}) in reducing maternal mortality in referral hospitals in {S}enegal and {M}ali. {S}econdary goals include evaluation of the relationships between effectiveness and resource availability, service organization, medical practices, and satisfaction among health personnel. {M}ethods/{D}esign: {T}his is an international, multi-centre, controlled cluster-randomized trial of a complex intervention. {T}he intervention is based on the concept of evidence-based practice and on a combination of two approaches aimed at improving the performance of health personnel: 1) {E}ducational outreach visits; and 2) the implementation of facility-based maternal death reviews. {T}he unit of intervention is the public health facility equipped with a functional operating room. {O}n the basis of consent provided by hospital authorities, 46 centres out of 49 eligible were selected in {M}ali and {S}enegal. {U}sing randomization stratified by country and by level of care, 23 centres will be allocated to the intervention group and 23 to the control group. {T}he intervention will last two years. {I}t will be preceded by a pre-intervention one-year period for baseline data collection. {A} continuous clinical data collection system has been set up in all participating centres. {T}his, along with the inventory of resources and the satisfaction surveys administered to the health personnel, will allow us to measure results before, during, and after the intervention. {T}he overall rate of maternal mortality measured in hospitals during the post-intervention period ({Y}ear 4) is the primary outcome. {T}he evaluation will also include cost-effectiveness. {T}rial {R}egistration: {T}he {QUARITE} trial is registered on the {C}urrent {C}ontrolled {T}rials website under the number {ISRCTN}46950658 http://www.controlled-trials.com/.},
  keywords = {},
  booktitle = {},
  journal = {{T}rials},
  volume = {10},
  numero = {},
  pages = {85},
  ISSN = {1745-6215},
  year = {2009},
  DOI = {10.1186/1745-6215-10-85},
  URL = {https://www.documentation.ird.fr/hor/fdi:010048328},
}