Statewide implementation of a quality improvement initiative for reproductive, maternal, newborn and child health and nutritionin Bihar, India

CARE India designed and implemented a comprehensive, statewide quality improvement (QI) initiative to improve reproductive, maternal, newborn, and child health and nutrition (RMNCHN) services in public facilities in Bihar. We provide a description of this initiative and its key results during 2014-2...

Celý popis

Uložené v:

Podrobná bibliografia
Vydané v:	Journal of global health Ročník 10; číslo 2; s. 021008
Hlavní autori:	Creanga, Andreea A, Srikantiah, Sridhar, Mahapatra, Tanmay, Das, Aritra, Sonthalia, Sunil, Moharana, Prabir Ranjan, Gore, Aboli, Daulatrao, Sanjiv, Durbha, Rohini, Kaul, Sunil, Galavotti, Christine, Laterra, Anne, Pepper, Kevin T, Darmstadt, Gary L, Shah, Hemant
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	Scotland Edinburgh University Global Health Society 01.12.2020 International Society of Global Health
Predmet:	Births Blood pressure Breastfeeding & lactation Child Health Childrens health Data collection Female Global health Health facilities Human resources Humans India Infant Health Infant, Newborn Infrastructure Inventory Inventory management Maternal Health Maternal-Child Health Services Mortality Newborn babies Nutritional Status Obstetrics Pregnancy Prenatal Care Quality assurance Quality control Quality Improvement Reproductive Health Research Theme 6: Learning from Ananya Programme in Bihar Training India Bihar India
ISSN:	2047-2978, 2047-2986, 2047-2986
On-line prístup:	Získať plný text
Tagy:	Pridať tag Žiadne tagy, Buďte prvý, kto otaguje tento záznam!

Abstract	CARE India designed and implemented a comprehensive, statewide quality improvement (QI) initiative to improve reproductive, maternal, newborn, and child health and nutrition (RMNCHN) services in public facilities in Bihar. We provide a description of this initiative and its key results during 2014-2017. We reviewed program documents to identify QI strategies employed and ascertain their coverage. We analysed data from: a) two public facility assessments to ascertain the availability of essential equipment and supplies and the distribution of human resources by facility level; b) a four-phase provider mentoring and training intervention covering 319 facilities to examine changes in emergency obstetric and newborn care (EmONC) practices; and c) four state-representative household surveys to explore changes in selected RMNCHN service utilisation by health sector. Associations of interest were ascertained using χ tests. Thirty-eight District Quality Assurance Committees and QI teams in 98% of facilities were formed to develop an implementation plan for the QI initiative and oversee its execution. QI strategies were to strengthen facilities' infrastructure; build the state's contracting, procurement, and inventory management capacities; rationalise human resources; improve providers' skills; and modernise data systems. Implementation led to facility infrastructure upgrades, improved clinical staff distribution, and higher availability of equipment and supplies over time, especially in higher-level facilities. Following the mentoring and training intervention in facilities offering both basic and comprehensive EmONC, performance of key practices (eg, adequate administration of uterotonics <1 minute after birth, initiation of skin-to-skin care <5 minutes after birth) improved significantly ( < 0.05). CARE India collected program data and assisted with modernising data systems for tracking human resources, supplies, and program progress statewide. Of women seeking antenatal care, the proportion obtaining key screenings (eg, weight, blood pressure measurements) in public facilities increased over time ( < 0.05). A 6-percentage point decline in home deliveries during 2016-2017 was accompanied by a higher increase of deliveries in public than private facilities (5- vs 1-percentage point; < 0.05). Substantial advances were made in improving RMNCHN service quality in Bihar. Continued improvement building on the established QI platform is expected and should be guided by data from now functional data systems.
AbstractList	CARE India designed and implemented a comprehensive, statewide quality improvement (QI) initiative to improve reproductive, maternal, newborn, and child health and nutrition (RMNCHN) services in public facilities in Bihar. We provide a description of this initiative and its key results during 2014-2017.BACKGROUNDCARE India designed and implemented a comprehensive, statewide quality improvement (QI) initiative to improve reproductive, maternal, newborn, and child health and nutrition (RMNCHN) services in public facilities in Bihar. We provide a description of this initiative and its key results during 2014-2017.We reviewed program documents to identify QI strategies employed and ascertain their coverage. We analysed data from: a) two public facility assessments to ascertain the availability of essential equipment and supplies and the distribution of human resources by facility level; b) a four-phase provider mentoring and training intervention covering 319 facilities to examine changes in emergency obstetric and newborn care (EmONC) practices; and c) four state-representative household surveys to explore changes in selected RMNCHN service utilisation by health sector. Associations of interest were ascertained using χ2 tests.METHODSWe reviewed program documents to identify QI strategies employed and ascertain their coverage. We analysed data from: a) two public facility assessments to ascertain the availability of essential equipment and supplies and the distribution of human resources by facility level; b) a four-phase provider mentoring and training intervention covering 319 facilities to examine changes in emergency obstetric and newborn care (EmONC) practices; and c) four state-representative household surveys to explore changes in selected RMNCHN service utilisation by health sector. Associations of interest were ascertained using χ2 tests.Thirty-eight District Quality Assurance Committees and QI teams in 98% of facilities were formed to develop an implementation plan for the QI initiative and oversee its execution. QI strategies were to strengthen facilities' infrastructure; build the state's contracting, procurement, and inventory management capacities; rationalise human resources; improve providers' skills; and modernise data systems. Implementation led to facility infrastructure upgrades, improved clinical staff distribution, and higher availability of equipment and supplies over time, especially in higher-level facilities. Following the mentoring and training intervention in facilities offering both basic and comprehensive EmONC, performance of key practices (eg, adequate administration of uterotonics <1 minute after birth, initiation of skin-to-skin care <5 minutes after birth) improved significantly (P < 0.05). CARE India collected program data and assisted with modernising data systems for tracking human resources, supplies, and program progress statewide. Of women seeking antenatal care, the proportion obtaining key screenings (eg, weight, blood pressure measurements) in public facilities increased over time (P < 0.05). A 6-percentage point decline in home deliveries during 2016-2017 was accompanied by a higher increase of deliveries in public than private facilities (5- vs 1-percentage point; P < 0.05).RESULTSThirty-eight District Quality Assurance Committees and QI teams in 98% of facilities were formed to develop an implementation plan for the QI initiative and oversee its execution. QI strategies were to strengthen facilities' infrastructure; build the state's contracting, procurement, and inventory management capacities; rationalise human resources; improve providers' skills; and modernise data systems. Implementation led to facility infrastructure upgrades, improved clinical staff distribution, and higher availability of equipment and supplies over time, especially in higher-level facilities. Following the mentoring and training intervention in facilities offering both basic and comprehensive EmONC, performance of key practices (eg, adequate administration of uterotonics <1 minute after birth, initiation of skin-to-skin care <5 minutes after birth) improved significantly (P < 0.05). CARE India collected program data and assisted with modernising data systems for tracking human resources, supplies, and program progress statewide. Of women seeking antenatal care, the proportion obtaining key screenings (eg, weight, blood pressure measurements) in public facilities increased over time (P < 0.05). A 6-percentage point decline in home deliveries during 2016-2017 was accompanied by a higher increase of deliveries in public than private facilities (5- vs 1-percentage point; P < 0.05).Substantial advances were made in improving RMNCHN service quality in Bihar. Continued improvement building on the established QI platform is expected and should be guided by data from now functional data systems.CONCLUSIONSubstantial advances were made in improving RMNCHN service quality in Bihar. Continued improvement building on the established QI platform is expected and should be guided by data from now functional data systems. BackgroundCARE India designed and implemented a comprehensive, statewide quality improvement (QI) initiative to improve reproductive, maternal, newborn, and child health and nutrition (RMNCHN) services in public facilities in Bihar. We provide a description of this initiative and its key results during 2014-2017.MethodsWe reviewed program documents to identify QI strategies employed and ascertain their coverage. We analysed data from: a) two public facility assessments to ascertain the availability of essential equipment and supplies and the distribution of human resources by facility level; b) a four-phase provider mentoring and training intervention covering 319 facilities to examine changes in emergency obstetric and newborn care (EmONC) practices; and c) four state-representative household surveys to explore changes in selected RMNCHN service utilisation by health sector. Associations of interest were ascertained using χ2 tests.ResultsThirty-eight District Quality Assurance Committees and QI teams in 98% of facilities were formed to develop an implementation plan for the QI initiative and oversee its execution. QI strategies were to strengthen facilities’ infrastructure; build the state’s contracting, procurement, and inventory management capacities; rationalise human resources; improve providers’ skills; and modernise data systems. Implementation led to facility infrastructure upgrades, improved clinical staff distribution, and higher availability of equipment and supplies over time, especially in higher-level facilities. Following the mentoring and training intervention in facilities offering both basic and comprehensive EmONC, performance of key practices (eg, adequate administration of uterotonics <1 minute after birth, initiation of skin-to-skin care <5 minutes after birth) improved significantly (P < 0.05). CARE India collected program data and assisted with modernising data systems for tracking human resources, supplies, and program progress statewide. Of women seeking antenatal care, the proportion obtaining key screenings (eg, weight, blood pressure measurements) in public facilities increased over time (P < 0.05). A 6-percentage point decline in home deliveries during 2016-2017 was accompanied by a higher increase of deliveries in public than private facilities (5- vs 1-percentage point; P < 0.05).ConclusionSubstantial advances were made in improving RMNCHN service quality in Bihar. Continued improvement building on the established QI platform is expected and should be guided by data from now functional data systems. CARE India designed and implemented a comprehensive, statewide quality improvement (QI) initiative to improve reproductive, maternal, newborn, and child health and nutrition (RMNCHN) services in public facilities in Bihar. We provide a description of this initiative and its key results during 2014-2017. We reviewed program documents to identify QI strategies employed and ascertain their coverage. We analysed data from: a) two public facility assessments to ascertain the availability of essential equipment and supplies and the distribution of human resources by facility level; b) a four-phase provider mentoring and training intervention covering 319 facilities to examine changes in emergency obstetric and newborn care (EmONC) practices; and c) four state-representative household surveys to explore changes in selected RMNCHN service utilisation by health sector. Associations of interest were ascertained using χ tests. Thirty-eight District Quality Assurance Committees and QI teams in 98% of facilities were formed to develop an implementation plan for the QI initiative and oversee its execution. QI strategies were to strengthen facilities' infrastructure; build the state's contracting, procurement, and inventory management capacities; rationalise human resources; improve providers' skills; and modernise data systems. Implementation led to facility infrastructure upgrades, improved clinical staff distribution, and higher availability of equipment and supplies over time, especially in higher-level facilities. Following the mentoring and training intervention in facilities offering both basic and comprehensive EmONC, performance of key practices (eg, adequate administration of uterotonics <1 minute after birth, initiation of skin-to-skin care <5 minutes after birth) improved significantly ( < 0.05). CARE India collected program data and assisted with modernising data systems for tracking human resources, supplies, and program progress statewide. Of women seeking antenatal care, the proportion obtaining key screenings (eg, weight, blood pressure measurements) in public facilities increased over time ( < 0.05). A 6-percentage point decline in home deliveries during 2016-2017 was accompanied by a higher increase of deliveries in public than private facilities (5- vs 1-percentage point; < 0.05). Substantial advances were made in improving RMNCHN service quality in Bihar. Continued improvement building on the established QI platform is expected and should be guided by data from now functional data systems.
Author	Kaul, Sunil Daulatrao, Sanjiv Moharana, Prabir Ranjan Durbha, Rohini Pepper, Kevin T Srikantiah, Sridhar Laterra, Anne Mahapatra, Tanmay Sonthalia, Sunil Darmstadt, Gary L Gore, Aboli Das, Aritra Shah, Hemant Galavotti, Christine Creanga, Andreea A
Author_xml	– sequence: 1 givenname: Andreea A surname: Creanga fullname: Creanga, Andreea A organization: Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA – sequence: 2 givenname: Sridhar surname: Srikantiah fullname: Srikantiah, Sridhar organization: CARE India Solutions for Sustainable Development, Patna, Bihar, India – sequence: 3 givenname: Tanmay surname: Mahapatra fullname: Mahapatra, Tanmay organization: CARE India Solutions for Sustainable Development, Patna, Bihar, India – sequence: 4 givenname: Aritra surname: Das fullname: Das, Aritra organization: CARE India Solutions for Sustainable Development, Patna, Bihar, India – sequence: 5 givenname: Sunil surname: Sonthalia fullname: Sonthalia, Sunil organization: CARE India Solutions for Sustainable Development, Patna, Bihar, India – sequence: 6 givenname: Prabir Ranjan surname: Moharana fullname: Moharana, Prabir Ranjan organization: CARE India Solutions for Sustainable Development, Patna, Bihar, India – sequence: 7 givenname: Aboli surname: Gore fullname: Gore, Aboli organization: CARE India Solutions for Sustainable Development, Patna, Bihar, India – sequence: 8 givenname: Sanjiv surname: Daulatrao fullname: Daulatrao, Sanjiv organization: CARE India Solutions for Sustainable Development, Patna, Bihar, India – sequence: 9 givenname: Rohini surname: Durbha fullname: Durbha, Rohini organization: CARE India Solutions for Sustainable Development, Patna, Bihar, India – sequence: 10 givenname: Sunil surname: Kaul fullname: Kaul, Sunil organization: CARE India Solutions for Sustainable Development, Patna, Bihar, India – sequence: 11 givenname: Christine surname: Galavotti fullname: Galavotti, Christine organization: CARE USA, Atlanta, Georgia, USA – sequence: 12 givenname: Anne surname: Laterra fullname: Laterra, Anne organization: CARE USA, Atlanta, Georgia, USA – sequence: 13 givenname: Kevin T surname: Pepper fullname: Pepper, Kevin T organization: Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA – sequence: 14 givenname: Gary L surname: Darmstadt fullname: Darmstadt, Gary L organization: Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA – sequence: 15 givenname: Hemant surname: Shah fullname: Shah, Hemant organization: CARE India Solutions for Sustainable Development, Patna, Bihar, India
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/33425332$$D View this record in MEDLINE/PubMed
BookMark	eNpdkUtP3DAUhS0E4tXZdllZYsNiZupXYnuDBKgUpJFYtF1Hju0Qjxx7cJJB_Al-cx06RYA31z7n0_G99gnYDzFYAL5itORYyO_r-NAu8wERjJDYA8cEMb4gUpT7b3sujsCs79coL44pEeUhOKKUkYJScgxefg1qsE_OWOi6jbedDVlwMcDYQAUfR-Xd8Dx5KW5fXeiCG1xmthY2McFks2VGPQlz2OW0FJSfw2Cf6pgCVMFA3TpvYGuVH9pXIYxDctM1LsAr16o0h3fBOPUFHDTK93a2q6fgz82P39e3i9X9z7vry9Vig6mUi7outeS4qEVjiJa1KBEVupCKWKk5Z4jWjTbCTBTSVrGiEaVGDHMhS4Ibegou_uVuxrqzRue5kvLVJrlOpecqKld9dIJrq4e4rTgvJMIyB5zvAlJ8HG0_VJ3rtfVeBRvHviKMl4KVjE_o2Sd0HcfpjTJVyAJzJhjO1Lf3Hb218v-r6F-8zpwc
ContentType	Journal Article
Copyright	Copyright © 2020 by the Journal of Global Health. All rights reserved. Copyright © 2020 by the Journal of Global Health. All rights reserved. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. Copyright © 2020 by the Journal of Global Health. All rights reserved. 2020
Copyright_xml	– notice: Copyright © 2020 by the Journal of Global Health. All rights reserved. – notice: Copyright © 2020 by the Journal of Global Health. All rights reserved. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. – notice: Copyright © 2020 by the Journal of Global Health. All rights reserved. 2020
DBID	CGR CUY CVF ECM EIF NPM 3V. 7X7 7XB 88E 8FI 8FJ 8FK ABUWG AEUYN AFKRA AZQEC BENPR CCPQU DWQXO EHMNL FYUFA GHDGH K9. M0S M1P PHGZM PHGZT PIMPY PJZUB PKEHL PPXIY PQEST PQQKQ PQUKI PRINS 7X8 5PM
DOI	10.7189/jogh.10.021008
DatabaseName	Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed ProQuest Central (Corporate) Health & Medical Collection ProQuest Central (purchase pre-March 2016) Medical Database (Alumni Edition) ProQuest Hospital Collection Hospital Premium Collection (Alumni Edition) ProQuest Central (Alumni) (purchase pre-March 2016) ProQuest Central (Alumni) ProQuest One Sustainability ProQuest Central UK/Ireland ProQuest Central Essentials - QC ProQuest Central ProQuest One Community College ProQuest Central Korea UK & Ireland Database ProQuest Health & Medical Collection Health Research Premium Collection (Alumni) ProQuest Health & Medical Complete (Alumni) ProQuest Health & Medical Collection Medical Database Proquest Central Premium ProQuest One Academic Publicly Available Content Database ProQuest Health & Medical Research Collection ProQuest One Academic Middle East (New) ProQuest One Health & Nursing ProQuest One Academic Eastern Edition (DO NOT USE) ProQuest One Academic (retired) ProQuest One Academic UKI Edition ProQuest Central China MEDLINE - Academic PubMed Central (Full Participant titles)
DatabaseTitle	MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) Publicly Available Content Database ProQuest One Academic Middle East (New) ProQuest Central Essentials ProQuest Health & Medical Complete (Alumni) ProQuest Central (Alumni Edition) ProQuest One Community College ProQuest One Health & Nursing ProQuest Central China ProQuest Central ProQuest One Sustainability ProQuest Health & Medical Research Collection Health Research Premium Collection Health and Medicine Complete (Alumni Edition) ProQuest Central Korea Health & Medical Research Collection ProQuest Central (New) ProQuest Medical Library (Alumni) ProQuest One Academic Eastern Edition ProQuest Hospital Collection Health Research Premium Collection (Alumni) ProQuest Hospital Collection (Alumni) ProQuest Health & Medical Complete ProQuest Medical Library UK & Ireland Database ProQuest One Academic UKI Edition ProQuest One Academic ProQuest One Academic (New) ProQuest Central (Alumni) MEDLINE - Academic
DatabaseTitleList	MEDLINE - Academic Publicly Available Content Database MEDLINE
Database_xml	– sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: PIMPY name: Publicly Available Content Database url: http://search.proquest.com/publiccontent sourceTypes: Aggregation Database
DeliveryMethod	fulltext_linktorsrc
Discipline	Public Health
DocumentTitleAlternate	Creanga et al. Statewide implementation of health quality improvement initiative
EISSN	2047-2986
ExternalDocumentID	PMC7759019 33425332
Genre	Journal Article Review
GeographicLocations	India Bihar India
GeographicLocations_xml	– name: India – name: Bihar India
GroupedDBID	04C 44B 53G 5VS 7X7 88E 8FI 8FJ AAKDD ABUWG ADBBV ADOJX ADRAZ AEUYN AFKRA AHMBA ALIPV ALMA_UNASSIGNED_HOLDINGS AOIJS BCNDV BENPR BMSDO BPHCQ BVXVI CCPQU CGR CUY CVF C~G DIK DYU ECF ECGQY ECM ECT EHMNL EIF EIHBH FYUFA GROUPED_DOAJ HMCUK HYE IPNFZ KQ8 M1P M48 NPM OK1 PGMZT PHGZM PHGZT PIMPY PJZUB PPXIY PQQKQ PROAC PSQYO RIG RNS RPM UKHRP 3V. 7XB 8FK AZQEC DWQXO K9. PKEHL PQEST PQUKI PRINS 7X8 PUEGO 5PM AFFHD
ID	FETCH-LOGICAL-p1399-bb6c9715b8fd2c9b86038c59a2e9c77403bfcd8d6c970cea45f86c041789621f3
IEDL.DBID	PIMPY
ISSN	2047-2978 2047-2986
IngestDate	Tue Nov 04 02:02:13 EST 2025 Thu Oct 02 10:20:34 EDT 2025 Tue Oct 07 06:44:53 EDT 2025 Mon Jul 21 05:57:24 EDT 2025
IsDoiOpenAccess	true
IsOpenAccess	true
IsPeerReviewed	true
IsScholarly	true
Issue	2
Language	English
License	Copyright © 2020 by the Journal of Global Health. All rights reserved. This work is licensed under a Creative Commons Attribution 4.0 International License.
LinkModel	DirectLink
MergedId	FETCHMERGED-LOGICAL-p1399-bb6c9715b8fd2c9b86038c59a2e9c77403bfcd8d6c970cea45f86c041789621f3
Notes	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Review-3 content type line 23
OpenAccessLink	https://www.proquest.com/publiccontent/docview/2595174841?pq-origsite=%requestingapplication%
PMID	33425332
PQID	2595174841
PQPubID	2045580
ParticipantIDs	pubmedcentral_primary_oai_pubmedcentral_nih_gov_7759019 proquest_miscellaneous_2476846479 proquest_journals_2595174841 pubmed_primary_33425332
PublicationCentury	2000
PublicationDate	20201201
PublicationDateYYYYMMDD	2020-12-01
PublicationDate_xml	– month: 12 year: 2020 text: 20201201 day: 1
PublicationDecade	2020
PublicationPlace	Scotland
PublicationPlace_xml	– name: Scotland – name: Edinburgh
PublicationTitle	Journal of global health
PublicationTitleAlternate	J Glob Health
PublicationYear	2020
Publisher	Edinburgh University Global Health Society International Society of Global Health
Publisher_xml	– name: Edinburgh University Global Health Society – name: International Society of Global Health
SSID	ssj0000713286
Score	2.1259923
SecondaryResourceType	review_article
Snippet	CARE India designed and implemented a comprehensive, statewide quality improvement (QI) initiative to improve reproductive, maternal, newborn, and child health... BackgroundCARE India designed and implemented a comprehensive, statewide quality improvement (QI) initiative to improve reproductive, maternal, newborn, and...
SourceID	pubmedcentral proquest pubmed
SourceType	Open Access Repository Aggregation Database Index Database
StartPage	021008
SubjectTerms	Births Blood pressure Breastfeeding & lactation Child Health Childrens health Data collection Female Global health Health facilities Human resources Humans India Infant Health Infant, Newborn Infrastructure Inventory Inventory management Maternal Health Maternal-Child Health Services Mortality Newborn babies Nutritional Status Obstetrics Pregnancy Prenatal Care Quality assurance Quality control Quality Improvement Reproductive Health Research Theme 6: Learning from Ananya Programme in Bihar Training
Title	Statewide implementation of a quality improvement initiative for reproductive, maternal, newborn and child health and nutritionin Bihar, India
URI	https://www.ncbi.nlm.nih.gov/pubmed/33425332 https://www.proquest.com/docview/2595174841 https://www.proquest.com/docview/2476846479 https://pubmed.ncbi.nlm.nih.gov/PMC7759019
Volume	10
hasFullText	1
inHoldings	1
isFullTextHit
isPrint
journalDatabaseRights	– providerCode: PRVPQU databaseName: Health & Medical Collection customDbUrl: eissn: 2047-2986 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0000713286 issn: 2047-2978 databaseCode: 7X7 dateStart: 20150101 isFulltext: true titleUrlDefault: https://search.proquest.com/healthcomplete providerName: ProQuest – providerCode: PRVPQU databaseName: ProQuest Central customDbUrl: eissn: 2047-2986 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0000713286 issn: 2047-2978 databaseCode: BENPR dateStart: 20150101 isFulltext: true titleUrlDefault: https://www.proquest.com/central providerName: ProQuest – providerCode: PRVPQU databaseName: Publicly Available Content Database customDbUrl: eissn: 2047-2986 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0000713286 issn: 2047-2978 databaseCode: PIMPY dateStart: 20150101 isFulltext: true titleUrlDefault: http://search.proquest.com/publiccontent providerName: ProQuest – providerCode: PRVPQU databaseName: UK & Ireland Database customDbUrl: eissn: 2047-2986 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0000713286 issn: 2047-2978 databaseCode: EHMNL dateStart: 20150101 isFulltext: true titleUrlDefault: https://search.proquest.com/ukireland providerName: ProQuest
link	http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV1Lj9MwEB6xLQckxPtRWCojcWxoYiexfUIs2hV7oKoQSOVUxY5Dg4RT2i6IP8FvZsZOC4sQJy452HNw7PH4s2fmG4BnRWHwGMurpMylSHKnZWLI_17ztKqtaaRrmlBsQs5marHQ8z49etuHVe5tYjDUke2Z4rbRCE_rztKL-RRBO1Esqzx7sf6SUA0p8rX2BTWOYEjEW2oAw_n5m_mHw5sL3ch4KP7IA0EB3qAijyMaaD391H1cPadIL06EN39DnH8GTv52Ep3d_L__cAtu9IiUvYwqdBuuOH8HrsfnPBazlO7CjwBKv7W1Y-3nfcg5rSnrGlaxmJr5nfo2XWAg37GWwpICrThDYMyIPTOQy2LDhCFODuTTE4awHtXQs8rXLGSWs5iaGRr8vlZA69lJu6o2E3buUaPvwfuz03evXid9KYdkjRBTJ8aUVsusMKqpudVGlalQttAVd9oiAk2FaWytapJKravyolGlTfNMKl3yrBH3YeA77x4CS1OHZqTmmVBljgBSFSbjWcWNMMJJWYzgeD_5y34_bpe_5noETw_duJPIPVJ5112gTE5OSdRZPYIHcZ2X60j5sRQCbZsQfATykgYcBIil-3KPb1eBrRuHhJhLP_r3sB7DNU43-RAocwyD3ebCPYGr9uuu3W7GcCQXMnzVGIYnp7P523Gv3D8B-e8LLg
linkProvider	ProQuest
linkToHtml	http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMw1V1Lb9QwEB6VggQS4v1YKGAkuG1oYiexfUCIV9VVy4pDkfYWYsdhU6nOsrul6p_gp_AbmXE2C0WIWw9c7VFkxTPjz-OZbwCeZZnBYywtozyVIkqdlpGh9_eKx2VlTS1dXYdmE3I8VpOJ_rgBP_paGEqr7H1icNRVaylGvo0wnUiVVZq8mn2NqGsUva72LTQ6tdhzpyd4ZVu8HL3D_X3O-c77g7e70aqrQDRDtKMjY3KrZZIZVVfcaqPyWCib6ZI7bREMxcLUtlIVScXWlWlWq9zGaSKVznlSC_zuBbiIflxSCpmcyHVMh258PDSX5IEAASU6nkg8APT2Yftl-oIyyTgR6vwN0f6ZmPnbSbdz_X_7Rzfg2gpTs9edEdyEDedvwdUuIMm6Oqvb8D3A6pOmcqw56pPmSStZW7OSdcWlpzQ3bwOH-pI1lFgViNEZQntG_J-BHhcHhgyRfqDPHjK8mKAheVb6ioXaeNYVl4YB33c7aDx700zL-ZCNPNrkHfh0Lr_kLmz61rv7wOLYoSOseCJUniIEVplJeFJyI4xwUmYD2Oq3t1h5lEXxa28H8HQ9jb6AHnhK79pjlEnpWRWtTg_gXqdJxawjLSmEQO8sBB-APKNjawHiGT8745tp4BvHJSFq1A_-vawncHn34MN-sT8a7z2EK5ziEiHtZws2l_Nj9wgu2W_LZjF_HIyGwefz1sCfq_FXNA
linkToPdf	http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMw1V3NjtMwEB4tC0JIiP-fwgJGgltDEzuJ7QNCwFJRLar2AFJvIXYcGiSc0nZZ7UvwQDwdM05TWIS47YGrbUVWPDP-ZjzzDcCTLDN4jaVllKdSRKnTMjL0_l7xuKysqaWr69BsQk6najbThzvwo6-FobTK3iYGQ121lmLkI4TpRKqs0mRUb9IiDvfHLxZfI-ogRS-tfTuNTkQO3Mkxum-r55N9POunnI_fvH_9Ntp0GIgWiHx0ZExutUwyo-qKW21UHgtlM11ypy0Co1iY2laqolWxdWWa1Sq3cZpIpXOe1AK_ew7OSyEktY2QM7mN75D3x0OjSR7IENBb6zgj8TLQo8_tp_kzyirjRK7zN3T7Z5Lmb7fe-Or__L-uwZUN1mYvO-W4DjvO34DLXaCSdfVXN-F7gNvHTeVY86VPpidpZW3NStYVnZ7Q3LIN3Opr1lDCVSBMZwj5GfGCBtpcHBgy9AACrfaQocOCCuZZ6SsWauZZV3QaBnzfBaHx7FUzL5dDNvGoq7fgw5n8ktuw61vv7gKLY4cGsuKJUHmK0FhlJuFJyY0wwkmZDWCvP-piY2lWxa9zHsDj7TTaCHr4Kb1rj3BNSs-tqI16AHc6qSoWHZlJIQRabSH4AOQpedsuIP7x0zO-mQcectwSokl979_begQXUfCKd5PpwX24xClcEbKB9mB3vTxyD-CC_bZuVsuHQX8YfDxrAfwJl49f6A
openUrl	ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Statewide+implementation+of+a+quality+improvement+initiative+for+reproductive%2C+maternal%2C+newborn+and+child+health+and+nutritionin+Bihar%2C+India&rft.jtitle=Journal+of+global+health&rft.au=Creanga%2C+Andreea+A&rft.au=Srikantiah%2C+Sridhar&rft.au=Mahapatra%2C+Tanmay&rft.au=Das%2C+Aritra&rft.date=2020-12-01&rft.issn=2047-2986&rft.eissn=2047-2986&rft.volume=10&rft.issue=2&rft.spage=021008&rft_id=info:doi/10.7189%2Fjogh.10.021008&rft.externalDBID=NO_FULL_TEXT
thumbnail_l	http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=2047-2978&client=summon
thumbnail_m	http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=2047-2978&client=summon
thumbnail_s	http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=2047-2978&client=summon