Table 1

Timeline of interventions tested and other important events during the improvement intervention

PDSA cycle/DatesInterventionParallel activities
Cycle 1 (Sept–Dec 2017)

  • Training of Maya Health Alliance staff on neonatal assessment and warning signs

  • Training of midwives on neonatal assessment and warning signs

Alpha/beta testing of neonatal warning signs mHealth checklist
Cycle 2 (Dec 2017–Feb 2018)

  • Training of all midwives on new neonatal workflow in the mHealth interface

  • Launch of the modified mHealth interface with all midwives

Alpha/beta testing of visual neonatal birth weight input screen
Cycle 3 (Feb–Mar 2018)

  • Individualised feedback to midwives on generated neonatal referrals

  • Production-based incentives for neonatal assessments

Alpha/beta testing of visual neonatal birth weight input screen
Cycle 4 (Apr–Sept 2018)

  • Refresher training to midwives on adequate use of hanging scale to weight neonates

  • Training on the new visual weight entry interface in the application

  • Monthly field visits by project nurses to provide technical and clinical support to midwives

 

  • PDSA, Plan-Do-Study-Act.