Advancing Obstetric Anesthesia Practices in Georgia Through Clinical Education and Quality Improvement Methodologies

A systematic review of implementation strategies to deliver guidelines on obstetric care practice in low‐ and middle‐income countries

“…The unit of allocation was individual doctors in one RCT, groups of women in another RCT, and institutions or communities in the remaining studies. One study had a controlled before–after design, with interventions allocated by institution. One study was based in Europe (Georgia), one in the Middle East (Syria), two in Asia (China and Pakistan), and three in Africa (Senegal and Mali, Benin, and Malawi).…”

“…One study had a controlled before–after design, with interventions allocated by institution. One study was based in Europe (Georgia), one in the Middle East (Syria), two in Asia (China and Pakistan), and three in Africa (Senegal and Mali, Benin, and Malawi). Two other studies involved two or more countries across Asia, Latin America, and/orAfrica (Mexico and Thailand, and Argentina, Guatemala, India, Pakistan, Kenya, and Zambia).…”

“…Five studies evaluated interventions delivered in hospitals, one in health centers and hospitals, and one in village‐ and township‐level facilities. Two studies described intervention sites simply as health facilities.…”

“…Two studies described intervention sites simply as health facilities. Doctors were targeted in three studies, and doctors and midwives or nurse‐midwives in three; three studies targeted mixed professional groups (e.g. doctors, nurses, anesthetists, and surgical assistants).…”

“…The complexity of targeted behaviors varied across studies. The behaviors targeted in five of the included studies were specific, focusing on performance of one task or treatment, such as interpersonal communication, analgesia and regional anesthesia for cesarean delivery, or a specific obstetric care procedure . Other studies targeted comparatively more complex behavior in terms of the integrated clinical management of obstetric emergencies, requiring coordination across assessment, diagnosis and treatment.…”