Quality of Midwife-provided Intrapartum Care in Amhara Regional State, Ethiopia

Autor: Young Mi Kim, Yewulsew Assaye, Jelle Stekelenburg, Ashebir Kidane, Desalegn Ademie, Tegbar Yigzaw, Lalem Belay, Equlinet Misganaw, Fantu Abebe, Jos van Roosmalen
Přispěvatelé: Public Health Research (PHR), Athena Institute
Rok vydání: 2017
Předmět:
Quality management
0302 clinical medicine
Pregnancy
Competence
Medicine
Childbirth
Infection control
030212 general & internal medicine
Performance and quality improvement
Labor
Obstetric
030219 obstetrics & reproductive medicine
Postpartum Period
Obstetrics and Gynecology
EDUCATION
childbirth and immediate postpartum care
Female
HEALTH
Physical resources
Enabling environment
SDG 9 - Industry
Research Article
medicine.medical_specialty
Labor
childbirth and immediate postpartum care
Reproductive medicine
Medical equipment
IMPROVEMENT
Midwifery
lcsh:Gynecology and obstetrics
03 medical and health sciences
SDG 17 - Partnerships for the Goals
Nursing
SYSTEMS
CALL
Humans
Maternal Health Services
Innovation
Competence (human resources)
lcsh:RG1-991
Quality of Health Care
business.industry
Infant
Newborn
Delivery
Obstetric
Labor
Cross-Sectional Studies
Family medicine
Structured interview
and Infrastructure
SDG 9 - Industry
Innovation
and Infrastructure
Ethiopia
business
Postpartum period
Zdroj: BMC Pregnancy and Childbirth
BMC Pregnancy and Childbirth, 17(1):261. BMC
BMC Pregnancy and Childbirth, 17:261, 1-12. BioMed Central
BMC Pregnancy and Childbirth, Vol 17, Iss 1, Pp 1-12 (2017)
Yigzaw, T, Abebe, F, Belay, L, Assaye, Y, Misganaw, E, Kidane, A, Ademie, D, van Roosmalen, J, Stekelenburg, J & Kim, Y M 2017, ' Quality of Midwife-provided Intrapartum Care in Amhara Regional State, Ethiopia ', BMC Pregnancy and Childbirth, vol. 17, 261, pp. 1-12 . https://doi.org/10.1186/s12884-017-1441-2
ISSN: 1471-2393
DOI: 10.1186/s12884-017-1441-2
Popis: Background Despite much progress recently, Ethiopia remains one of the largest contributors to the global burden of maternal and newborn deaths and stillbirths. Ethiopia’s plan to meet the sustainable development goals for maternal and child health includes unprecedented emphasis on improving quality of care. The purpose of this study was to assess the quality of midwifery care during labor, delivery and immediate postpartum period. Methods A cross-sectional study using multiple data collection methods and a 2-stage cluster sampling technique was conducted from January 25 to February 14, 2015 in government health facilities of the Amhara National Regional State of Ethiopia. Direct observation of performance was used to determine competence of midwives in providing care during labor, delivery, and the first 6 h after childbirth. Inventory of drugs, medical equipment, supplies, and infrastructure was conducted to identify availability of resources in health facilities. Structured interview was done to assess availability of resources and performance improvement opportunities. Data analysis involved calculating percentages, means and chi-square tests. Results A total of 150 midwives and 56 health facilities were included in the study. The performance assessment showed 16.5% of midwives were incompetent, 72.4% were competent, and 11.1% were outstanding in providing routine intrapartum care. Forty five midwives were observed while managing 54 obstetric and newborn complications and 41 (91%) of them were rated competent. Inventory of resources found that the proportion of facilities with more than 75% of the items in each category was 32.6% for drugs, 73.1% for equipment, 65.4% for supplies, 47.9% for infection prevention materials, and 43.6% for records and forms. Opportunities for performance improvement were inadequate, with 31.3% reporting emergency obstetric and newborn care training, and 44.7% quarterly or more frequent supportive supervision. Health centers fared worse in provider competence, physical resources, and quality improvement practices except for supportive supervision visits and in-service training. Conclusions Although our findings indicate most midwives are competent in giving routine and emergency intrapartum care, the major gaps in the enabling environment and the significant proportion of midwives with unsatisfactory performance suggest that the conditions for providing quality intrapartum care are not optimal. Electronic supplementary material The online version of this article (doi:10.1186/s12884-017-1441-2) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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