• Jeffrey Michael Smith, Shivam Gupta, Emma Williams, Kate Brickson, Keth Ly Sotha, Navuth Tep, Anthony Calibo, Mary Christine Castro, Bernabe Marinduque, and Mark Hathaway.
• Jhpiego, Maternal and Child Survival Program (MCSP), 1776 Massachusetts Avenue, NW, Suite 300, Washington, DC 20036, USA.
• Int J Qual Health Care. 2016 Dec 1; 28 (6): 682-688.

ObjectiveTo determine whether a simple quality improvement initiative consisting of a technical update and regular audit and feedback sessions will result in increased use of antenatal corticosteroids among pregnant women at risk of imminent preterm birth delivering at health facilities in the Philippines and Cambodia.DesignNon-randomized, observational study using a pre-/post-intervention design conducted between October 2013 and June 2014.SettingA total of 12 high volume facilities providing Emergency Obstetric and Newborn Care services in Cambodia (6) and Philippines (6).InterventionA technical update on preterm birth and use of antenatal corticosteroids, followed by monthly audit and feedback sessions.Main Outcome MeasureThe proportion of women at risk of imminent preterm birth who received at least one dose of dexamethasone.ResultsCoverage of at least one dose of dexamethasone increased from 35% at baseline to 86% at endline in Cambodia (P < 0.0001) and from 34% at baseline to 56% at endline in the Philippines (P < 0.0001), among women who had births at 24-36 weeks. In both settings baseline coverage and magnitude of improvement varied notably by facility. Availability of dexamethasone, knowledge of use and cost were not major barriers to coverage.ConclusionsA simple quality improvement strategy was feasible and effective in increasing use of dexamethasone in the management of preterm birth in 12 hospitals in Cambodia and Philippines.© The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care.

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