Healthcare providers' experiences of comprehensive emergency obstetric care in Somaliland: An explorative study with focus on cesarean deliveries.

Autor: Kiruja J; School of Health and Welfare, Dalarna University, Sweden and College of Medicine and Health Science, University of Hargeisa, Somaliland. Electronic address: kjo@du.se., Essén B; Department of Women's and Children's Health, International Maternal and Child Health (IMCH), Uppsala University, Uppsala, Sweden. Electronic address: Birgitta.Essen@kbh.uu.se., Erlandsson K; School of Health and Welfare, Dalarna University, Sweden. Electronic address: ker@du.se., Klingberg-Allvin M; School of Health and Welfare, Dalarna University, Sweden. Electronic address: mkl@du.se., Osman F; School of Health and Welfare, Dalarna University, Sweden. Electronic address: fos@du.se.
Jazyk: angličtina
Zdroj: Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives [Sex Reprod Healthc] 2022 Dec; Vol. 34, pp. 100768. Date of Electronic Publication: 2022 Aug 22.
DOI: 10.1016/j.srhc.2022.100768
Abstrakt: Objective: This study aimed to explore the experiences of healthcare providers (HCPs) regarding the provision of emergency obstetric care (EmOC) with a focus on cesarean deliveries in a referral hospital and maternal and child health centers in Somaliland.
Methods: An exploratory qualitative approach using focus group discussions was employed at the main referral and teaching hospital and four maternal and child health centers in Hargeisa, Somaliland. Twenty-eight HCPs were divided into groups of 6-8 for discussions lasting 1 to 2 h. All HCPs included in the study had experiences with the provision of EmOC. Data were analyzed using thematic analysis.
Results: Collective family decision making was identified by HCPs as a barrier to the provision of EmOC. This tradition of decision making at a group level was perceived as time-consuming and delayed HCPs from obtaining informed consent for EmOC. Low socioeconomic status and poor knowledge about maternal healthcare among users affected care seeking among women. Suboptimal EmOC at the hospital was reported to be due to miscommunication, inadequate interprofessional collaboration and lack of infrastructure.
Conclusions: HCPs encountered difficulties with the provision of EmOC. A broad array of strategies targeting the community and healthcare system is needed, including training of HCPs on intracultural communication competence, interprofessional collaboration and use of alternative birth methods other than CS. Antenatal care can be used to prepare families for potential obstetric emergencies and as an opportunity to obtain written informed consent.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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