Optimizing the development and evaluation of complex interventions: lessons learned from the BetterBirth Program and associated trial.

This threshold was based on hypothesis that there may be a “threshold effect” in which most or all EBPs must be successfully completed to ensure comprehensive high-quality care for each woman and neonate and avoid potential adverse health events and on evidence from a previously successful implementation of the checklist in a hospital in Karnataka, India, where EBP adherence increased from 34 to 86% and researchers observed a marginally significant halving of stillbirths [ 22 ].

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