Implementing quality-of-care during labour, childbirth, and early postnatal care, northeast Namibia: a quasi-experimental study
# Background Attention to quality-of-care is increasing in low- and-middle-income countries. Nevertheless, few studies exist on the impact of these approaches to caregiving. This paper presents results on the quality-of-care mothers and neonates receive during labour, childbirth, and early postnata...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Inishmore Laser Scientific Publishing Ltd
2023-12-01
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| Series: | Journal of Global Health Reports |
| Online Access: | https://doi.org/10.29392/001c.90725 |
| _version_ | 1797371611608776704 |
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| author | Gloria Mutimbwa Siseho Thubelihle Mathole Debra Jackson |
| author_facet | Gloria Mutimbwa Siseho Thubelihle Mathole Debra Jackson |
| author_sort | Gloria Mutimbwa Siseho |
| collection | DOAJ |
| description | # Background
Attention to quality-of-care is increasing in low- and-middle-income countries. Nevertheless, few studies exist on the impact of these approaches to caregiving. This paper presents results on the quality-of-care mothers and neonates receive during labour, childbirth, and early postnatal care, pre-and-post-implementation of the World Health Organization/United Nations Children's Fund/United Population Fund (WHO/UNICEF/UNFPA) quality improvement interventions.
# Methods
A quasi-experimental study design was used to assess the quality-of-care measures/interventions around childbirth and the immediate postnatal care period; we purposively sampled a high-volume hospital, northeast Namibia. Using the Every Mother Every Newborn (EMEN) childbirth quantitative survey questionnaire, we interviewed (pre=100; post=102) women who delivered prior to their discharge home and observed (pre=53; post=60) different women at admission, of which 19 of 53 and 50 of 60, respectively, progressed to deliver on the same day of data collection. Twenty (pre) and 24 (post) staff, and one facility manager (pre-and-post) were also interviewed. Descriptive statistics were used to present results.
# Results
Postintervention, we found improvements in most assessed quality-of-care measures/interventions, e.g., thorough drying (94.7-100%), babies placed skin-to-skin with their mothers (89.5-98%) and assessed for resuscitation (69.8-98%) needs. Monitoring labour using partograph remained low (11.3-19.3%). During admission, women's history taking (75.5-95%), blood pressure (98.1%-100%), urine testing (77.4-93.3%), foetal heart rate (94.3-100%), abdominal (86.8-100%) and vaginal examinations (96.2-100%) all improved. Yet, quality-of-care gaps were identified for labour monitoring, and routine postnatal care. Less 50% of women received counselling on family planning (5.3-42%), postnatal care (5.3-40%), maternal (0-38%) and newborn (0-40%) danger signs. Women's satisfaction with information on breastfeeding and post-partum care and hygiene was 48-56.9% and 41-43.0% respectively.
# Conclusions
This is the first study in Namibia to assess pre-and-post implementation of quality-of-care practices around childbirth, and postnatal period. Inconsistency and noteworthy quality-of-care gaps exist in the early postnatal care period. Postnatal care management and interpersonal communication skills trainings are likely to improve and sustain high evidence-based care beyond labour and delivery. The poor quality-of-care practices for labour and postnatal care requires further investigation. |
| first_indexed | 2024-03-08T18:22:20Z |
| format | Article |
| id | doaj.art-34a1a1d4c9064333b5c727838b207b23 |
| institution | Directory Open Access Journal |
| issn | 2399-1623 |
| language | English |
| last_indexed | 2024-03-08T18:22:20Z |
| publishDate | 2023-12-01 |
| publisher | Inishmore Laser Scientific Publishing Ltd |
| record_format | Article |
| series | Journal of Global Health Reports |
| spelling | doaj.art-34a1a1d4c9064333b5c727838b207b232023-12-30T17:13:19ZengInishmore Laser Scientific Publishing LtdJournal of Global Health Reports2399-16232023-12-017Implementing quality-of-care during labour, childbirth, and early postnatal care, northeast Namibia: a quasi-experimental studyGloria Mutimbwa SisehoThubelihle MatholeDebra Jackson# Background Attention to quality-of-care is increasing in low- and-middle-income countries. Nevertheless, few studies exist on the impact of these approaches to caregiving. This paper presents results on the quality-of-care mothers and neonates receive during labour, childbirth, and early postnatal care, pre-and-post-implementation of the World Health Organization/United Nations Children's Fund/United Population Fund (WHO/UNICEF/UNFPA) quality improvement interventions. # Methods A quasi-experimental study design was used to assess the quality-of-care measures/interventions around childbirth and the immediate postnatal care period; we purposively sampled a high-volume hospital, northeast Namibia. Using the Every Mother Every Newborn (EMEN) childbirth quantitative survey questionnaire, we interviewed (pre=100; post=102) women who delivered prior to their discharge home and observed (pre=53; post=60) different women at admission, of which 19 of 53 and 50 of 60, respectively, progressed to deliver on the same day of data collection. Twenty (pre) and 24 (post) staff, and one facility manager (pre-and-post) were also interviewed. Descriptive statistics were used to present results. # Results Postintervention, we found improvements in most assessed quality-of-care measures/interventions, e.g., thorough drying (94.7-100%), babies placed skin-to-skin with their mothers (89.5-98%) and assessed for resuscitation (69.8-98%) needs. Monitoring labour using partograph remained low (11.3-19.3%). During admission, women's history taking (75.5-95%), blood pressure (98.1%-100%), urine testing (77.4-93.3%), foetal heart rate (94.3-100%), abdominal (86.8-100%) and vaginal examinations (96.2-100%) all improved. Yet, quality-of-care gaps were identified for labour monitoring, and routine postnatal care. Less 50% of women received counselling on family planning (5.3-42%), postnatal care (5.3-40%), maternal (0-38%) and newborn (0-40%) danger signs. Women's satisfaction with information on breastfeeding and post-partum care and hygiene was 48-56.9% and 41-43.0% respectively. # Conclusions This is the first study in Namibia to assess pre-and-post implementation of quality-of-care practices around childbirth, and postnatal period. Inconsistency and noteworthy quality-of-care gaps exist in the early postnatal care period. Postnatal care management and interpersonal communication skills trainings are likely to improve and sustain high evidence-based care beyond labour and delivery. The poor quality-of-care practices for labour and postnatal care requires further investigation.https://doi.org/10.29392/001c.90725 |
| spellingShingle | Gloria Mutimbwa Siseho Thubelihle Mathole Debra Jackson Implementing quality-of-care during labour, childbirth, and early postnatal care, northeast Namibia: a quasi-experimental study Journal of Global Health Reports |
| title | Implementing quality-of-care during labour, childbirth, and early postnatal care, northeast Namibia: a quasi-experimental study |
| title_full | Implementing quality-of-care during labour, childbirth, and early postnatal care, northeast Namibia: a quasi-experimental study |
| title_fullStr | Implementing quality-of-care during labour, childbirth, and early postnatal care, northeast Namibia: a quasi-experimental study |
| title_full_unstemmed | Implementing quality-of-care during labour, childbirth, and early postnatal care, northeast Namibia: a quasi-experimental study |
| title_short | Implementing quality-of-care during labour, childbirth, and early postnatal care, northeast Namibia: a quasi-experimental study |
| title_sort | implementing quality of care during labour childbirth and early postnatal care northeast namibia a quasi experimental study |
| url | https://doi.org/10.29392/001c.90725 |
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