Maternal and neonatal services in Ethiopia: measuring and improving quality

Abstract

ProblemMaternal and neonatal mortality remains high in low- and middle-income countries, with poor quality of intrapartum care as a barrier to further progress.ApproachWe developed and tested a method of measuring the quality of maternal and neonatal care that could be embedded in a larger national performance management initiative. The tool used direct observations and medical record reviews to score quality in nine domains of intrapartum care. We piloted and evaluated the tool in visits to the 18 lead hospitals that have responsibility to promote and coordinate quality improvement efforts within a hospital cluster in Ethiopia. Between baseline and follow-up assessments, staff from a national quality collaborative alliance provided hospital-based training on labour and delivery services.Local settingEthiopia has invested in hospital quality improvement for more than a decade and this tool was integrated into existing quality improvement mechanisms within lead hospitals, with the potential for scale-up to all government hospitals.Relevant changesSignificant improvements in quality of intrapartum care were detected from baseline (June–July 2015) to follow-up (February–March 2016) in targeted hospitals. The overall mean quality score rose from 65.6 (standard deviation, SD: 10.5) to 91.2 (SD: 12.4) out of 110 items (P < 0.001).Lessons learntThe method was feasible, requiring a total of 3 days and two to three trained data collectors per hospital visit. It produced data that detected substantial changes made during 8 months of national hospital quality improvement efforts. With additional replication studies, this tool may be useful in other low- and middle-income countries.

Quality of youth friendly sexual and reproductive health Services in West Gojjam Zone, north West Ethiopia: with special reference to the application of the Donabedian model

“…The highest score in the input component in this study may not be associated with the implementation of YFS program; instead it reflects the general requirement to functions as a health care facility as a whole. Furthermore, this is an essential component for maternal health care services -which is the top priority of the country [42]. Related to issues specific to adolescent services, this finding implies that provision of quality of YFSRH is still a significant problem, and the health system has been inefficient in fully adhering to YFS standards.…”

<p>Reducing Disrespect and Abuse of Women During Antenatal Care and Delivery Services at Injibara General Hospital, Northwest Ethiopia: A Pre–Post Interventional Study</p>

“…6 Although much has been done to ensure access to health services, in Ethiopia a lack of quality services and low utilization of maternal health service continues to be achallenge. [14][15][16][17] Every year. One of 52 mothers has a chance to die from pregnancy and childbirth related problems.…”

Institutional Delivery Service Utilization and Associated Factors in Rural Communities of Central Gondar zone, Northwest Ethiopia

“…Nonetheless this proportion was better as compared to the national and regional estimates of Ethiopia [11].The current proportion was also better as compared to a community based study done in Kersa district, Eastern Ethiopia [29] and a systematic review conducted in Ethiopia [30].The performance was still below the Health Sector Transformation Plan (HSTP) of Ethiopia in which the plan set to increase institutional deliveries attended by skilled health personnel to 90% [31]. The reason for these differences might be due to the current study was conducted after introducing strong follow-up and supportive supervision strategies on maternal healthcare services in Ethiopia [32]. Conversely, the ndings of the current study are lower than studies conducted in other parts of Ethiopia: Mana district, Bench Maji, and Debre Berhan in Ethiopia in which the institutional delivery utilization was 86.4%, 78.3% and 80.2%…”