Using implementation science to define the model and outcomes for improving quality in NEST360, a multicountry alliance for reducing newborn mortality in sub-Saharan Africa.
Background Improving small and sick newborn care (SSNC) is crucial in resource-limited settings. Newborn Essential Solutions and Technologies (NEST360), a multicountry alliance, aims to reduce newborn mortality through evidence-based interventions. NEST360 developed a multipronged approach to improv...
| Published in: | BMJ Quality & Safety Vol. 35; no. 2; pp. 83 - 95 |
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| Main Authors: | , , , , , , , , , , , , , , , |
| Format: | pictorial research tables/charts Journal Article |
| Published: |
BMJ Publishing Group
Feb2026
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=191687981&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 191687981 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 20445415 BFNQ jtl: BMJ Quality & Safety issn: 20445415 maglogo: N pubinfo: dt: Feb2026 vid: 35 iid: 2 pid: 8280 pub: BMJ Publishing Group artinfo: ui: 191687981 191687981 191687981 10.1136/bmjqs-2024-018471 191687981 ppf: 83 ppct: 12 formats: tig: atl: Using implementation science to define the model and outcomes for improving quality in NEST360, a multicountry alliance for reducing newborn mortality in sub-Saharan Africa. aug: au: Dougherty, Kylie Hailemariam, Nebiyou Jenkins, Georgia Chen, Junwei Ilangali, Jackson Mwangi, John Thomas, Julius Mwaniki, Hannah Mwaniki Dosunmu, Olabisi Tillya, Robert Ngwala, Samuel Lawn, Joy E. Richards-Kortum, Rebecca Oden, Z. Maria Bohne, Christine Hirschhorn, Lisa R. affil: Department of Medical Social Science, Northwestern University, Evanston, Illinois, USA sug: subj: Infant Mortality Prevention and Control Quality of Health Care Quality Improvement Collaboration International Relations Implementation Science Outcomes (Health Care) Evaluation Medical Practice, Evidence-Based Human Male Female Infant, Newborn Africa South of the Sahara Retrospective Design Descriptive Statistics Funding Source Infant, Newborn: birth-1 month Male Female ab: Background Improving small and sick newborn care (SSNC) is crucial in resource-limited settings. Newborn Essential Solutions and Technologies (NEST360), a multicountry alliance, aims to reduce newborn mortality through evidence-based interventions. NEST360 developed a multipronged approach to improving quality. We use implementation research (IR) to describe this approach and report emerging implementation outcomes. Methods The implementation research logic model (IRLM) was applied to link contextual factors, implementation strategies, mechanisms and implementation outcomes, capturing successes and challenges of the improving quality approach. Data sources included programme data, peer-reviewed publications and team input. Contextual factors were organised by the NEST360-UNICEF SSNC implementation toolkit. Strategies were grouped by the Expert Recommendations for Implementation Change list, and implementation outcomes were measured using Proctor's implementation outcomes. Results We developed an IRLM to describe the implementation of NEST360's improving quality model. This IRLM included 33 contextual factors; 42% were barriers, 42% were facilitators, and 15% were both a barrier and facilitator. Additionally, we identified 10 implementation strategies that NEST360 used. The logic model also describes the connections between the contextual factors, the strategies that address them, and the preliminary implementation outcomes. Examples of the outcomes measured include Reach with 100% of units logging into the NEST360-Implementation Tracker (NEST-IT) at least once (October 2023 to March 2024), Adoption with 100% of units conducting a quality improvement (QI) project (April 2024 to June 2024), and Feasibility with 93% of units reporting NEST-IT data in their QI project documentation (April 2024 to June 2024). Finally, this study identified sustainability strategies as a critical need. Conclusions Integrating IR and QI enhances SSNC in resource-limited settings. Addressing barriers, leveraging facilitators and using structured IR frameworks advanced QI efforts, thereby improving intervention reach, adoption and feasibility while building scalable systems for high-quality healthcare. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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