The role of digital clinical decision support tool in improving quality of intrapartum and postpartum care: experiences from two states of India

Table 3 Univariate and multivariate analysis of providers’ adherence to key clinical practices (%)

Practices	Baseline (August –October 2017)	Latest (December 2019 – March 2020)	p-value (univariate analysis)	p value (multivariate^a analysis)
On admission
Records fetal heart rate at admission	46	96	0.004	< 0.001
Records mother’s BP at admission	46	93	0.007	< 0.001
Conducts PV examination only as indicated (4 hourly or based) on clinical indication	32	90	< 0.001	< 0.001
Performs hand hygiene	43	89	0.007	< 0.001
Provider identifies and manages severe Pre-eclampsia/Eclampsia	2	60	< 0.001	< 0.001
Initiates Partograph plotting once the Cx dilation is > = 4 cm	27	81	< 0.001	< 0.001
Provider interprets partograph correctly and adjusts care according to findings	15	51	< 0.001	< 0.001
Just before pushing or at caesarean section
Preforms hand hygiene	49	96	0.002	< 0.001
Oxytocin within one minute of delivery of baby	59	96	0.05	< 0.001
Immediate newborn care	0	74	< 0.001	< 0.001
Soon after delivery (within 1 h)
Delivers the baby on mother’s abdomen	42	95	0.002	< 0.001
Thermal management of newborn	15	84	< 0.001	< 0.001
Weighs the baby	88	99	0.67	0.048
Initiates breast feeding within one hour of birth	70	99	0.18	0.001
Provider identifies and manages Post-Partum Haemorrhage	4	59	< 0.001	< 0.001
Measures baby’s temperature	19	48	0.006	0.021
Records mother’ s temperature	12	48	< 0.001	0.002
At the time of discharge
Counsels on danger signs to mother at time of discharge	26	65	0.002	< 0.001
Counsels on post-partum family planning to mother at discharge	43	98	0.001	< 0.001
Counsels on exclusive breast feeding to mother at discharge	59	83	0.001	0.001

^aafter adjusting for level of facility, average annual delivery load and resource availability for respective practice

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