Assessing the competence of midwives to provide care during labor, childbirth and the immediate postpartum period – A cross sectional study in Tigray region, Ethiopia

Goshu, Miruts; Godefay, Hagos; Bihonegn, Fantaw; Ayalew, Firew; Haileselassie, Daniel; Kebede, Ayantu; Temam, Girma

doi:10.1371/journal.pone.0206414

Cited by 13 publications

(7 citation statements)

References 22 publications

(20 reference statements)

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“…The Ethiopian government made various efforts towards making safe-motherhood a priority. Launching a number of midwifery training programs, 29 health extension programs (HEP), 8 and scaling-up MWHs, 9 which were initially concentrated at the hospital level but have more recently been implemented at health centers, are some of the initiatives illustrating these efforts. Proper implementation of MWHs at the health centre level improved access to the basic emergency obstetric and newborn care (BEmONC), 30,31 which constitutes the seven signal functions: administering parenteral antibiotics, oxytocic drugs, and anticonvulsants; manual removal of the placenta and retained products; and perform assisted vaginal birth and, basic neonatal resuscitation.…”

Section: Discussionmentioning

confidence: 99%

<p>A Culturally Sensitive and Supportive Maternity Care Service Increases the Uptake of Maternity Waiting Homes in Ethiopia</p>

Selbana¹,

Derese²,

Endalew³

et al. 2020

IJWH

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Background: Maternal delays in utilization of emergency obstetric care are impacting on a high maternal mortality, especially in the poor resource countries including Ethiopia. Different strategies are designed and employed to reduce those maternal delays, and one of such strategies employed to overcome the geographic barriers and improve maternal and neonatal health outcomes is utilization of maternity waiting homes (MWHs). Studies related to the utilization of MWHs and associated factors are limited in Ethiopia and there were none in the study area. Objective: The aim of this study was to assess the utilization of maternity waiting homes and associated factors. Methods and Materials: A community-based cross-sectional study design was conducted, using multistage sampling technique. Logistic regression analysis with 95% CI for odds ratio (OR) was used to identify significant factors. Results: A total of 379 women participated in this study, making a response rate of 85%. Of the total participants, 42.5% (95% CI=38-48) of women utilized MWHs. After controlling for potential confounders, women's decision-making capacity (AOR=12.74; 95% CI=6.18-26.26), women having someone who can care for their children and/or husband at home (AOR=2.71; 95% CI=1.44-5.09), MWHs offering food service (AOR=4.03; 95% CI=2.07-7.85), offering and/or allowing women to practice their own cultural ceremony (allowing to cook their own food type, porridge, coffee, etc) (AOR=9.55; 95% CI=4.45-20.47), and women's attitude towards MWHs (AOR=0.09; 95% CI=0.03-0.23) were factors significantly associated with the utilization of MWHs. Conclusion: Compared to its contribution in reducing maternal and perinatal mortality, the utilization of MWHs was low in this study area. The integration of culturally sensitive and supportive maternity services, along with community participatory approach, would increase utilization of MWHs and consequently contribute in achieving the SDGs related to maternal and neonatal health.

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Section: Discussionmentioning

confidence: 99%

<p>A Culturally Sensitive and Supportive Maternity Care Service Increases the Uptake of Maternity Waiting Homes in Ethiopia</p>

Selbana¹,

Derese²,

Endalew³

et al. 2020

IJWH

View full text Add to dashboard Cite

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“…The Lancet Commission on High Quality Health Systems revealed that the quality of obstetric and newborn health services remains poor and variable across low-and middleincome countries (LMICs) [1][2][3][4]. Inadequate healthcare provider competence has been identified as a contributing factor to the widespread poor quality care found in many LMICs [5][6][7][8]. Increasing care competence is one of the key strategy to improve health outcomes [4].…”

Section: Introductionmentioning

confidence: 99%

Determinants of healthcare providers’ confidence in their clinical skills to deliver quality obstetric and newborn care in Uganda and Zambia

Kim

Arsenault

Atuyambe

et al. 2020

BMC Health Serv Res

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Background Poor quality obstetric and newborn care persists in sub-Saharan Africa and weak provider competence is an important contributor. To be competent, providers need to be both knowledgeable and confident in their ability to perform necessary clinical actions. Confidence or self-efficacy has not been extensively studied but may be related to individuals’ knowledge, ability to practice their skills, and other modifiable factors. In this study, we investigated how knowledge and scope of practice are associated with provider confidence in delivering obstetric and newborn health services in Uganda and Zambia. Methods This study was a secondary analysis of data from an obstetric and newborn care program implementation evaluation. Provider knowledge, scope of practice (completion of a series of obstetric tasks in the past 3 months) and confidence in delivering obstetric and newborn care were measured post intervention in intervention and comparison districts in Uganda and Zambia. We used multiple linear regression models to investigate the extent to which exposure to a wider range of clinical tasks associated with confidence, adjusting for facility and provider characteristics. Results Of the 574 providers included in the study, 69% were female, 24% were nurses, and 6% were doctors. The mean confidence score was 71%. Providers’ mean knowledge score was 56% and they reported performing 57% of basic obstetric tasks in the past 3 months. In the adjusted model, providers who completed more than 69% of the obstetric tasks reported a 13-percentage point (95% CI 0.08, 0.17) higher confidence than providers who performed less than 50% of the tasks. Female providers and nurses were considerably less confident than males and doctors. Provider knowledge was moderately associated with provider confidence. Conclusions Our study showed that scope of practice (the range of clinical tasks routinely performed by providers) is an important determinant of confidence. Ensuring that providers are exposed to a variety of services is crucial to support improvement in provider confidence and competence. Policies to improve provider confidence and pre-service training should also address differences by gender and by cadres.

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“…As data on the competence of NPAs is so scarce globally, comparison with similar studies was not possible. However, competence studies involving nurses [ 38 , 39 ], midwives [ 40 , 41 ], and other allied healthcare providers [ 42 ] across the LMICs have shown that acquiring sufficient competency levels is a global educational challenge.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the effect of interventions for strengthening non-physician anesthetists’ education in Ethiopia: a pre- and post-evaluation study

et al. 2021

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Background Access to safe surgery has been recognized as an indispensable component of universal health coverage. A competent anesthesia workforce is a prerequisite for safe surgical care. In Ethiopia, non-physician anesthetists are the main anesthesia service providers. The Government of Ethiopia implemented a program intervention to improve the quality of non-physician anesthetists’ education, which included faculty development, curricula strengthening, student support, educational resources, improved infrastructure and upgraded regulations. This study aimed to assess changes following the implementation of this program. Methods A pre-and post-evaluation design was employed to evaluate improvement in the quality of non-physician anesthetists’ education. A 10-station objective structured clinical examination (OSCE) was administered to graduating class anesthetists of 2016 (n = 104) to assess changes in competence from a baseline study performed in 2013 (n = 122). Moreover, a self-administered questionnaire was used to collect data on students’ perceptions of the learning environment. Results The overall competence score of 2016 graduates was significantly higher than the 2013 class (65.7% vs. 61.5%, mean score difference = 4.2, 95% CI = 1.24–7.22, p < 0.05). Although we found increases in competence scores for 6 out of 10 stations, the improvement was statistically significant for three tasks only (pre-operative assessment, postoperative complication, and anesthesia machine check). Moreover, the competence score in neonatal resuscitation declined significantly from baseline (from 74.4 to 68.9%, mean score difference = − 5.5, 95% CI = -10.5 to − 0.5, p < 0.05). Initial gender-based performance differences disappeared (66.3% vs. 65.3%, mean score difference = − 1.0, 95% CI = − 6.11-3.9, p > 0.05 in favor of females), and female students scored better in some stations. Student perceptions of the learning environment improved significantly for almost all items, with the largest percentage point increase in the availability of instructors from 38.5 to 70.2% (OR = 3.76, 95% CI = 2.15–6.55, p < 0.05). Conclusion The results suggest that the quality of non-physician anesthetists’ education has improved. Stagnation in competence scores of some stations and student perceptions of the simulated learning environment require specific attention.

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Assessing the competence of midwives to provide care during labor, childbirth and the immediate postpartum period – A cross sectional study in Tigray region, Ethiopia

Cited by 13 publications

References 22 publications

<p>A Culturally Sensitive and Supportive Maternity Care Service Increases the Uptake of Maternity Waiting Homes in Ethiopia</p>

<p>A Culturally Sensitive and Supportive Maternity Care Service Increases the Uptake of Maternity Waiting Homes in Ethiopia</p>

Determinants of healthcare providers’ confidence in their clinical skills to deliver quality obstetric and newborn care in Uganda and Zambia

Evaluating the effect of interventions for strengthening non-physician anesthetists’ education in Ethiopia: a pre- and post-evaluation study

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