Improving clinical care for newborns in Kenyan hospitals

Clinical practice guidelines are widely seen as important quality improvement tools that can contribute to evidence-based clinical practices. This thesis explores key processes aimed at improving neonatal care practices in rural hospitals in Kenya through the development and implementation of evidence-informed clinical practice guidelines. The studies presented in this thesis span key areas of evidence synthesis to support clinical guideline development, the translation process linking evidence synthesis to guideline recommendations, and the effects of specific health worker training linked to implementation of emergency care guidelines. The findings presented in this thesis highlight a number of challenges that hinder effective development of, and delivery of evidence-based practices needed to improve the quality of care for newborns and children in Kenya, and similar low-resource settings. The identified challenges in the translation of evidence into guideline recommendations underscore the need to improve skills in evidence-based medicine to support guideline development in low-income countries and create health system contexts that support recommended practices