Readiness of rural health facilities to provide immediate postpartum care in Uganda

Abstract Background Nearly 60% of maternal and 45% of newborn deaths occur within 24 h after delivery. Immediate postpartum monitoring could avert death from preventable causes including postpartum hemorrhage, and eclampsia among mothers, and birth asphyxia, hypothermia, and sepsis for babies. We ai...

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Main Authors: Mariam Namutebi, Gorrette K. Nalwadda, Simon Kasasa, Patience A. Muwanguzi, Cynthia Kuteesa Ndikuno, Dan K. Kaye
Format: Article
Language:English
Published: BMC 2023-01-01
Series:BMC Health Services Research
Subjects:
Online Access:https://doi.org/10.1186/s12913-023-09031-4
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author Mariam Namutebi
Gorrette K. Nalwadda
Simon Kasasa
Patience A. Muwanguzi
Cynthia Kuteesa Ndikuno
Dan K. Kaye
author_facet Mariam Namutebi
Gorrette K. Nalwadda
Simon Kasasa
Patience A. Muwanguzi
Cynthia Kuteesa Ndikuno
Dan K. Kaye
author_sort Mariam Namutebi
collection DOAJ
description Abstract Background Nearly 60% of maternal and 45% of newborn deaths occur within 24 h after delivery. Immediate postpartum monitoring could avert death from preventable causes including postpartum hemorrhage, and eclampsia among mothers, and birth asphyxia, hypothermia, and sepsis for babies. We aimed at assessing facility readiness for the provision of postpartum care within the immediate postpartum period. Methods A cross-sectional study involving 40 health facilities within the greater Mpigi region, Uganda, was done. An adapted health facility assessment tool was employed in data collection. Data were double-entered into Epi Data version 4.2 and analyzed using STATA version 13 and presented using descriptive statistics. Results Facility readiness for the provision of postpartum care was low (median score 24% (IQR: 18.7, 26.7). Availability, and use of up-to-date, policies, guidelines and written clinical protocols for identifying, monitoring, and managing postpartum care were inconsistent across all levels of care. Lack of or non-functional equipment poses challenges for screening, diagnosing, and treating postnatal emergencies. Frequent stock-outs of essential drugs and supplies, particularly, hydralazine, antibiotics, oxygen, and blood products for transfusions were more common at health centers compared to hospitals. Inadequate human resources and sub-optimal supplies inhibit the proper functioning of health facilities and impact the quality of postpartum care. Overall, private not-for-profit health facilities had higher facility readiness scores. Conclusions Our findings suggest sub-optimal rural health facility readiness to assess, monitor, and manage postpartum emergencies to reduce the risk of preventable maternal/newborn morbidity and mortality. Strengthening health system inputs and supply side factors could improve facility capacity to provide quality postpartum care.
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spelling doaj.art-2992ed4655194c23b4b4bd923e2187312023-01-15T12:07:44ZengBMCBMC Health Services Research1472-69632023-01-0123111610.1186/s12913-023-09031-4Readiness of rural health facilities to provide immediate postpartum care in UgandaMariam Namutebi0Gorrette K. Nalwadda1Simon Kasasa2Patience A. Muwanguzi3Cynthia Kuteesa Ndikuno4Dan K. Kaye5Department of Nursing, School of Health Sciences, College of Health Sciences, Makerere UniversityDepartment of Nursing, School of Health Sciences, College of Health Sciences, Makerere UniversityDepartment of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere UniversityDepartment of Nursing, School of Health Sciences, College of Health Sciences, Makerere UniversityDepartment of Nursing, School of Health Sciences, College of Health Sciences, Makerere UniversityDepartment of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere UniversityAbstract Background Nearly 60% of maternal and 45% of newborn deaths occur within 24 h after delivery. Immediate postpartum monitoring could avert death from preventable causes including postpartum hemorrhage, and eclampsia among mothers, and birth asphyxia, hypothermia, and sepsis for babies. We aimed at assessing facility readiness for the provision of postpartum care within the immediate postpartum period. Methods A cross-sectional study involving 40 health facilities within the greater Mpigi region, Uganda, was done. An adapted health facility assessment tool was employed in data collection. Data were double-entered into Epi Data version 4.2 and analyzed using STATA version 13 and presented using descriptive statistics. Results Facility readiness for the provision of postpartum care was low (median score 24% (IQR: 18.7, 26.7). Availability, and use of up-to-date, policies, guidelines and written clinical protocols for identifying, monitoring, and managing postpartum care were inconsistent across all levels of care. Lack of or non-functional equipment poses challenges for screening, diagnosing, and treating postnatal emergencies. Frequent stock-outs of essential drugs and supplies, particularly, hydralazine, antibiotics, oxygen, and blood products for transfusions were more common at health centers compared to hospitals. Inadequate human resources and sub-optimal supplies inhibit the proper functioning of health facilities and impact the quality of postpartum care. Overall, private not-for-profit health facilities had higher facility readiness scores. Conclusions Our findings suggest sub-optimal rural health facility readiness to assess, monitor, and manage postpartum emergencies to reduce the risk of preventable maternal/newborn morbidity and mortality. Strengthening health system inputs and supply side factors could improve facility capacity to provide quality postpartum care.https://doi.org/10.1186/s12913-023-09031-4Facility readinessPostpartum careFacility assessment
spellingShingle Mariam Namutebi
Gorrette K. Nalwadda
Simon Kasasa
Patience A. Muwanguzi
Cynthia Kuteesa Ndikuno
Dan K. Kaye
Readiness of rural health facilities to provide immediate postpartum care in Uganda
BMC Health Services Research
Facility readiness
Postpartum care
Facility assessment
title Readiness of rural health facilities to provide immediate postpartum care in Uganda
title_full Readiness of rural health facilities to provide immediate postpartum care in Uganda
title_fullStr Readiness of rural health facilities to provide immediate postpartum care in Uganda
title_full_unstemmed Readiness of rural health facilities to provide immediate postpartum care in Uganda
title_short Readiness of rural health facilities to provide immediate postpartum care in Uganda
title_sort readiness of rural health facilities to provide immediate postpartum care in uganda
topic Facility readiness
Postpartum care
Facility assessment
url https://doi.org/10.1186/s12913-023-09031-4
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