Timeliness of Delivery Care and Maternal and Neonatal Health Outcomes in Private Facilities in Masaka Area, Uganda: A Quasi-Experimental Study.

Autor: Hagey JM; Department of Obstetrics and Gynecology, University of North Carolina, 101 Manning Drive, Chapel Hill, NC, 27514, USA. jill.hagey@unchealth.unc.edu., Kirya J; LifeNet International, Princes Anne Drive, Plot 56, Bugolobi, Kampala, Uganda., Kaggwa J; LifeNet International, Princes Anne Drive, Plot 56, Bugolobi, Kampala, Uganda., Headley J; Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA., Egger JR; Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA., Baumgartner JN; School of Social Work, University of North Carolina, 325 Pittsboro Street, Chapel Hill, NC, 27516, USA.
Jazyk: angličtina
Zdroj: Maternal and child health journal [Matern Child Health J] 2023 Nov; Vol. 27 (11), pp. 2048-2057. Date of Electronic Publication: 2023 Jul 13.
DOI: 10.1007/s10995-023-03754-w
Abstrakt: Objectives: While access to basic emergency obstetric and newborn care is necessary to reduce maternal and neonatal morbidity in low- and middle-income countries, data on the timeliness and quality of care at lower-level facilities is limited. This study examines timeliness of labor and delivery interventions and maternal and neonatal health status following deliveries in Uganda.
Methods: Women were recruited from 6 rural, private facilities in the greater Masaka area, Uganda on admission to the labor ward. Research assistants directly observed timeliness and quality of care from admission through discharge. Research assistants also abstracted medical chart information. All 6 facilities received training from LifeNet International on quality-of-care interventions for maternal and newborn health.
Results: 321 participants were directly observed during delivery, and 304 participants were followed at 28 days postpartum. Labor and delivery processes were overall timely and reflect international guidance on labor interventions. Maternal and neonatal health was good at discharge (90.6% and 88.8%) and 28 days postpartum (93.1% and 87.5%). However, there was no association between health at discharge and at 28 days for mothers or neonates (p = 0.67, p = 1.0, respectively). Demographic characteristics associated with maternal and neonatal health on discharge were different than those associated with maternal and neonatal health at 28 days.
Conclusions for Practice: Evidence on timeliness and quality of care can help inform strategies to further decrease maternal and neonatal morbidity. Additional focus is needed to retain patients in care to identify those developing poor health after delivery.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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