Table 2 Monitoring and evaluation methods

Monitoring Methods

Open Birth Days observations and brief interviews

To determine the acceptability of the Open Birth Days intervention, study staff conducted periodic observations of OBD sessions and conducted brief interviews with participants.

22 interviews

Pre and Post-Tests for Open Birth Days

Women who attended OBD completed a short survey immediately before and after their OBD session to measure changes in knowledge about the labor and delivery process and their rights as patients. In addition, women were asked about their level of comfort with their future birth at the facility.

362

Pre and Post-Tests for RMC Workshop

Participants in the RMC Workshop completed short surveys immediately before and after the workshop to assess changes in their knowledge of patients’ rights, views towards patients, and attitudes towards their jobs.

76

RMC Workshop Action Plan

Progress towards implementation of the action plan developed at the end of the RMC Workshop was regularly monitored by study staff through discussions with key facility staff, including the head of the obstetrics and gynecology department and the Nurse Matron of the maternity block.

Monthly monitoring, 8 times from April-October

Evaluation Methods

Direct observation

A team of trained nurse-midwife observers rotated for twenty-four hour coverage at the registration desk of the study facility. Every second woman registering for labor and delivery was selected for observation. The observer followed the woman from the time of registration to two hours post-delivery or until transfer to the postnatal ward if this occurred after two hours. Women who presented at the study facility who had attended OBD were purposefully selected for observation and 57 women who attended OBD were observed. All observers were unaffiliated with the study facility.

459, including 57 women who attended OBD

Community follow-up interviews

Interviews with women who gave birth at the facility were conducted four to six weeks post-delivery in the woman’s home. Women were selected for interview systematically from both the Open Birth Days register and the list of women who were directly observed during labor and delivery. Interviews were conducted by trained social scientists. The tool used from the baseline assessment was used and additional questions specific to OBD participation were included.

149, including 28 women who attended OBD

Structured provider interviews

Providers and administrators working in the maternity block at the study facility were interviewed about their job satisfaction and perceptions of quality of care. Interviews were conducted in a private room at the facility by trained social scientists. Questions from the baseline assessment were replicated, and modules on the two discrete interventions (RMC Workshop and OBD) were added.

55, including 25 who participated in the RMC Workshop