# Pre-post study of an audit and feedback intervention to reduce intrapartum stillbirth in Mombasa, Kenya

> **NIH NIH F32** · UNIVERSITY OF WASHINGTON · 2021 · $70,110

## Abstract

ABSTRACT
Stillbirth disproportionately affects those in low-resource settings, with 10-fold higher stillbirth rates in low-income
countries compared to high-income countries. This disparity is due in part to gaps in health care delivery; even
facilities that are equipped to provide comprehensive emergency obstetric and newborn care (CEmONC) often
fail to deliver care quickly and effectively. A third of intrapartum stillbirths (those occurring after the onset of labor)
could be prevented through improved labor and delivery management and use of interventions that are known
to be efficacious (e.g. cesarean sections). The Every Newborn Action Plan (ENAP) has set a global target
stillbirth rate of 12 per 1000 births by 2030. At Coast Provincial General Hospital (CPGH), a large CEmONC
facility in Mombasa, Kenya, the intrapartum stillbirth rate is substantially higher than this target, at 21.2 per 1000
births. To address this problem, the Mombasa County Ministry of Health wishes to conduct an audit and feedback
quality improvement project within the Labor and Delivery Ward of CPGH. In this proposal, our objectives are to
identify factors associated with stillbirth at CPGH to inform the development of this project, and to evaluate the
effectiveness of this intervention in reducing intrapartum stillbirth. The aims of this proposal are: 1) to identify
factors associated with intrapartum stillbirth that could be addressed by modifying provider behavior; 2) to
conduct a pre-post study using interrupted time series analysis to determine if rates of stillbirth are reduced after
implementation of an audit and feedback intervention; and 3) to determine the incremental cost and budget
impact of the audit and feedback intervention. The proposed research will use quantitative and qualitative
methods to assess change in both process indicators (e.g. time to cesarean section) and intrapartum stillbirth
rates before and after the audit and feedback intervention. Demonstrating how effective the intervention is at
both changing targeted provider behavior and reducing stillbirth rates is critical to determining its public health
impact. Audit and feedback is a flexible approach that allows for context-specific factors to be considered and
addressed. If found to be effective and low-cost, this approach could be expanded to other CEmONC facilities
in sub-Saharan Africa as a cost-effective means of lowering stillbirth rates. To conduct this work, the candidate
will receive training at the University of Washington, which is a world leader in implementation research. Her
training plan will include field experience, coursework, supplementary training, and mentorship in implementation
science, interrupted time series analysis, and cost analysis. The fellowship will also provide ample opportunities
for the candidate to publish original research, present work at international conferences, develop a professional
network, and gain experience with grant writing. This set of skills ...

## Key facts

- **NIH application ID:** 10051312
- **Project number:** 5F32HD100070-02
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Jessica Long
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $70,110
- **Award type:** 5
- **Project period:** 2019-11-01 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10051312

## Citation

> US National Institutes of Health, RePORTER application 10051312, Pre-post study of an audit and feedback intervention to reduce intrapartum stillbirth in Mombasa, Kenya (5F32HD100070-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10051312. Licensed CC0.

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