In this adapted model and adjusting for clustering by site, we saw significant improvements in a number of critical areas including the following: screening for pregnancy-associated complications (maternal blood pressure, 0 to 16 %, and temperature measured, 0 to 9 %); infection control (proper hand hygiene, 1 to 21 %); oxytocin immediately after delivery (36 to 97 %); and post-partum care of the newborn (weight taken, 70 to 86 %, and breastfeeding within 1 h of delivery, 3 to 64 %), all p < 0.001. The gene discussed is OXT; the disease is infection.