Odendaal, WillemTomlinson, MarkGoga, Ameena EbrahimSingh, YagesKauchli, ShuaibMarshall, CarolPillay, YoganMakua, ManalaChetty, TerushaHunt, Xanthe2025-05-222025-05-222024-11-19Odendaal, W., Tomlinson, M., Goga, A., Singh, Y., Kauchali, S., Marshall, C., et al. (2024) Good practices to optimise the performance of maternal and neonatal quality improvement teams: Results from a longitudinal qualitative evaluation in South Africa, before, and during COVID-19. PLoS ONE 19(11): e0314024. https://doi.org/10.1371/journal. pone.0314024.1932-6203 (online)10.1371/journal. pone.0314024http://hdl.handle.net/2263/102480DATA AVAILABILITY STATEMENT : The full data set cannot be shared publicly because of the regulations imposed by the three respective Human Research Ethics Committee’s (HRECs) who approved the study. Access to the data can be requested from the South African Medical Research Council, Human Research Ethics Committee, Chairperson, Prof. Danie du Toit.SUPPORTING INFORMATION : TABLE S1. Mphatlalatsane partnerships. TABLE S2. Socio-economic and health indicators of the selected health districts. TABLE S3. Services delivered at participating health facilities. TABLE S4. Consolidated Framework for Implementation Research, Domain 3. TABLE S5. Interview foci. TABLE S6. Assessment evidence per facility. TABLE S7. Indexing and charting Mphatlalatsane CFIR constructs. TABLE S8. Maternal and neonatal health issues addressed through change ideas.Many maternal and neonatal deaths can be avoided if quality healthcare is provided. To this end, the South African National Department of Health implemented a quality improvement (QI) programme (2018-2022) to improve maternal and neonatal health services in 21 public health facilities. This study sought to identify good practices aimed at improving QI teams' performance by identifying optimal facility-level contextual factors and implementation processes. We purposively selected 14 facilities of the 21 facilities for a longitudinal qualitative process evaluation. We interviewed 17 team leaders, 47 members, and five QI advisors who provided technical support to the teams. The data were analysed using framework analysis. We choose the Consolidated Framework for Implementation Research as framework given that it explicates contexts and processes that shape programme implementation. Six quality improvement teams were assessed as well-performing, and eight as less well-performing. This research conceptualises a 'life course lens' for setting up and managing a QI team. We identified eight good practices, six related to implementation processes, and two contextual variables that will optimise team performance. The two most impactful practices to improve the performance of a QI team were (i) selecting healthcare workers with quality improvement-specific characteristics, and (ii) appointing advisors whose interpersonal skills match their technical quality improvement competencies.en© 2024 Odendaal et al. This is an open access article distributed under the terms of the Creative Commons Attribution License.Maternal and neonatal health care (MNH)DeathsSouth African National Department of Health (NDoH)Quality healthcareArticle