Category and Specific Examples
Better outcomes
Maternal mortality reduction
Perinatal mortality reduction
More organized, standardized management, or both
Establishment of a maternal mortality audit committee
More organized and efficient management of cases
Formal protocols and better records
Human capacity development
More personnel (nurses, doctors, residents, house officers)
Hospital staffed with more knowledgeable professionals
Better attitudes toward clients
Better doctor–nurse cooperation
Technology
Technology in general has improved
Colposcopy service provided
Cytoscan
Cardiotocography
Fetal monitors or Doppler
New anesthesia machine or new anesthetist
New ultrasound
Laparoscopy
Computerized axial tomography scan, MRI
Other improvements, including delivery beds, suction, heaters for newborns, rehab centers, polymerase chain reaction machine
Teaching improvements
Better medical and postgraduate training and more organized lectures
Better public health-type community training, including antenatal care and infertility clinics
Self-reported better surgical skills
Better midwife training
Negative changes
No change or gotten worse
Too many patients, increased congestion in the hospital
Higher workload, more patients
Decreased number of nurses at hospital
Improved access to care
Reduced referrals out
Increased referrals into hospital
Increased quality of service
Draw patients from a larger radius
Patients have a higher confidence in health care system
More informed patients: increased awareness, patients reporting to hospital earlier than before, more patients delivering at the hospital than at home