Improving the quality of maternity services in Uganda through accelerated implementation of essential interventions by healthcare professional associations.

Autor: Spira C; Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina., Kwizera A; International Federation of Gynecology and Obstetrics, London, UK., Jacob S; International Confederation of Midwives, The Hague, Netherlands., Amongin D; Department of Public Health, Faculty of Health Sciences, Busitema University, Kampala, Uganda., Ngonzi J; Department of Obstetrics and Technology, Mbarara University of Science and Technology, Kampala, Uganda.; Association of Obstetricians and Gynecologists of Uganda, Kampala, Uganda., Namisi CP; St. Francis Hospital Nsambya, Kampala, Uganda.; Infectious Disease Institute, Makerere University College of Health Sciences School of Public Health, Kampala, Uganda.; Uganda Paediatric Association, Kampala, Uganda., Byaruhanga R; St. Francis Hospital Nsambya, Kampala, Uganda., Rushwan H; International Federation of Gynecology and Obstetrics, London, UK., Cooper P; Department of Pediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa., Day-Stirk F; International Confederation of Midwives, The Hague, Netherlands., Berrueta M; Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina., García-Elorrio E; Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina., Belizán JM; Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
Jazyk: angličtina
Zdroj: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2017 Oct; Vol. 139 (1), pp. 107-113. Date of Electronic Publication: 2017 Jul 06.
DOI: 10.1002/ijgo.12241
Abstrakt: Objective: To assess whether the implementation of a package of activities through the joint action of the three international healthcare professionals associations (HCPAs) increased the use of intrapartum and postnatal essential interventions (EIs) in two hospitals in Uganda.
Methods: A non-controlled before-and-after study was undertaken to evaluate the effect of a package of activities designed to change practice relating to nine EIs among providers. Coverage of the EIs was measured in a 3-month pre-implementation period and a 3-month post-implementation period in 2014. Data were obtained for women older than 18 years who delivered vaginally or by cesarean.
Results: Overall, 4816 women were included. Level of use remained high for EIs used widely at baseline. Some EIs that had low use at baseline did not show improvement after the implementation. Promotion of breastfeeding showed a significant improvement in the Kampala hospital, from 8.5% (8/94) to 25.6% (30/117; P=0.001), whereas promotion of hygiene in cord care improved at the Mbarara hospital, from 0.1% (2/1592) to 46.0% (622/1351; P<0.001).
Conclusion: These exploratory results show that a package delivered through the joint work of the three HCPAs was feasible to implement along with rigorous data collection. Although the data show disparities, trends suggest that improvement could be achieved.
(© 2017 International Federation of Gynecology and Obstetrics.)
Databáze: MEDLINE
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