| Project/Area Number |
19KK0333
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| Research Category |
Fund for the Promotion of Joint International Research (Fostering Joint International Research (A))
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| Allocation Type | Multi-year Fund |
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| Review Section |
Basic Section 58030:Hygiene and public health-related: excluding laboratory approach
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| Research Institution | University of Yamanashi |
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Principal Investigator |
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| Project Period (FY) |
2021 – 2023
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| Project Status |
Completed (Fiscal Year 2023)
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| Budget Amount *help |
¥15,210,000 (Direct Cost: ¥11,700,000、Indirect Cost: ¥3,510,000)
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| Keywords | 医療の質 / 低中所得国 / 医療ケアの質 / 緊急産科ケア / 緊急新生児ケア / 母子保健 / トレーニング |
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| Outline of Research at the Start |
In recent years, it has been recognized that improving the service coverage rate alone is not enough to improve health outcomes, and importance of quality improvement is emphasized. Also, potential to use of digital device in low- and middle-income countries is getting higher because of the COVID-19 outbreak. This research is to synthesize evidence for continuing professional education in resuscitation and emergency care for mothers and children in the setting of low resource and low burden of cases, and summarize what aspects of continuous education can be covered by digital device.
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| Outline of Final Research Achievements |
An intervention was developed to improve the quality of newborn care in district hospitals in Lao PDR, a resource-limited country. District-level healthcare providers performed self-practise, and feedback was provided via a mobile application by educators. To assess the feasibility of the new intervention, a pilot study (cluster randomised controlled trial) was conducted in four district hospitals in Lao PDR from October 2023 to February 2024. After analysing 44 district-level healthcare providers, we observed higher skill scores in the intervention group than in the control group at endline. Both district-level healthcare providers and educators had positive affective attitudes towards the intervention. Based on these results, modifications to the intervention will be made and a large cluster randomised controlled trial will be conducted to assess its effectiveness.
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| Academic Significance and Societal Importance of the Research Achievements |
世界の低中所得国において、新生児は医療にアクセスできないことよりも、アクセス後に十分な質のケアを受けられないことで亡くなっている。新生児死亡率低減に向けた新生児ケアの改善を目指すにあたり、特に地方の医療従事者が継続的に研修を受けられないことが課題となっている。本研究では、郡病院医療従事者による反復自己練習と、県病院の指導者によるモバイル遠隔モニタリングによって、訪問指導のように資金をかけずに新生児医療のスキルを維持できる可能性を示した。さらに大規模な研究によって、本介入の有効性を示すことができれば、資源の限られた国において、医療の質を改善を後押しをするための有力な介入となりうる。
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