Completed Pregnancy, Children & Inherited Conditions Public Health & Healthcare

Improving the ability of health systems to deliver essential, hospital services - Examining strategies targeting seriously ill children and newborns in Kenya.

In plain English

AI plain-English summary

A nurse practice leader in a Kenyan hospital will receive specific performance data on how many newborns survive their first week, then work with peers to fix what is broken. This matters because seriously ill children and newborns in low-resource hospitals often die from preventable causes—not because treatments don't exist, but because systems fail to deliver them consistently. Previous work by this team showed that a multi-faceted intervention can improve paediatric care in rural Kenyan hospitals, and basic components are already being scaled up with government partners. But scaling requires knowing which specific strategies actually work and why. Over four years, the researchers will track inputs, services, and outcomes across ten hospitals. They will test, using an experimental design, whether giving clinical managers targeted performance feedback combined with mentorship improves care. A nested randomised sub-study will examine whether a dedicated nurse practice leader boosts neonatal care implementation. If successful, this research will produce adaptable, evidence-based models for strengthening hospital services—not just in Kenya, but across health systems struggling to turn best practices into routine care for the most vulnerable patients.

View original technical description
Work in my previous senior fellowship established that a multi-faceted intervention can improve paediatric care in rural Kenyan hospitals and began to develop the capacity within Kenya to undertake multi-methods research around a founder quantitative trial. The close working relationship established with government and other local institutions has seen basic components of the intervention being taken to scale. To assess new, adaptable and scalable models that further promote uptake of best-pract ices and improve delivery of essential services I will use a multi-level, multi-method, longitudinal health systems research framework to: 1. Provide comprehensive information on basic inputs, service provision and outcomes related to paediatric and neonatal care in 10 hospitals over 4 years 2. Examine with an experimental design whether paediatric and neonatal care is improved by providing specific performance feedback linked to basic mentorship and peer to peer support for relevant clinical and nursing managers 3. Examine whether a nurse practice leader role enhances implementation success for neonatal care in a nested, randomised sub-study 4. Examine the process and evolution of intervention implementation within Kenya's health system and explore reasons for variability in intervention success

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Researchers

Michael English (EPMC Awardee)

Related Research

Grants with similar aims, by meaning.

Rethinking neonatal post-discharge care: Learning from family and healthcare workers experiences of preterm care in Kenya.
Can a system intervention employing team-based case review help improve quality and safety of paediatric hospital care in Kenya?
Patient behaviour: Investigating new determinants and exploring effects on maternal and neonatal health in Kenya
Health Services that Deliver: Improving Care for Sick Newborns (HSD-N)
Increasing newborn survival in low resource settings: harnessing real-time data, digital innovation and community engagement to improve newborn healthcare.

Original classification

Senior Research Fellowship Clinical Renewal

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