Quality of intrapartum care at Mulago national referral hospital, Uganda: clients’ perspective

Abstract

BackgroundQuality of intrapartum care is an important intervention towards increasing clients’ utilization of skilled attendance at birth and accelerating improvements in newborn’s and maternal survival and wellbeing. Ensuring quality of care is one of the key challenges facing maternal and neonatal services in Uganda. The study assessed quality of intrapartum care services in the general labor ward of the Mulago national referral and teaching hospital in Uganda from clients’ perspective.MethodsA cross sectional study was conducted using face to face interviews at discharge with 384 systematically selected clients, who delivered in general labor ward at Mulago hospital during May, 2012. Data analysis was done using STATA Version (10) software. Means and median general index scores for quality of intrapartum care services were calculated. Linear regression models were used to determine factors associated with quality of care.ResultsOverall, quality of intrapartum care mean index score was 49.4 (standard deviation (sd) 15.46, and the median (interquartile range (IQR)) was 49.1 (37.5–58.9). Median index scores (IQR) per selected quality of care indicators were; dignity and respect 75 (50–87.5); relief of pain and suffering 71.4 (42.8-85.7); information 42.1 (31.6-55.3); privacy and confidentiality 33.3 (1–66.7); and involvement in decision making 16.7 (1–33.3). On average, higher educational level (college/university) (β: 6.81, 95% CI: 0.85-15.46) and rural residence of clients (β: 5.67, 95% CI: 0.95-10.3) were statistically associated with higher quality scores.ConclusionThis study has revealed that quality of intrapartum care services from clients’ perspective was low. Improvements should be focused on involving clients in decision making, provision of information about their conditions and care, and provision of privacy and confidentiality. There is also need to improve the number and availability of health care providers in the labor ward.

Quality of the delivery services in health facilities in Northern Ethiopia

“…In this study only 31.25% of the facilities fulfilled the quality standards for delivery services according to the national guidelines, which comparable to reports from other Sub-Saharan Africa countries [12, 13, 21]. The poor performance of health facilities on process quality has serious implications on the efficiency of the care provided in the health facilities, leading to delayed treatment that in turn negatively affect the outcome of birth leading to either fetal/newborn or maternal death [20].…”

Expectations and needs of Ugandan women for improved quality of childbirth care in health facilities: A qualitative study

“…Our findings also parallel other research conducted in Uganda, for example, regarding the noninvolvement of women in decision‐making during labor and childbirth. Kigenyi et al . quantitatively measured the quality of intrapartum care at a national referral hospital in Uganda through exit interviews and found that women perceived the quality to be low (overall mean index score 49.4%), with just 10% of clients in their study having been given the opportunity to ask questions, and 9% being asked about their care preferences.…”

Evaluating the Privacy Perceived by Mothers in the Labor

“…25 Kigenyi ve ark., yaptıkları çalışmada, bakım alanın bakış açısıyla intrapartum bakım hizmetlerinin kalitesinin düşük olduğunu ortaya koymuş ve kişinin durumu, bakımı hakkında karar ve bilgi verirken hasta odaklı olunması, mahremiyet ve gizliliğin sağlanması gerektiğini belirtmişlerdir. 26 Mohammad ve ark., lohusaların %75,6'sının doğumda aldıkları bakımdan memnun olmadıklarını, nedeninin ise doğumlarına istemedikleri ve tanı-madıkları kişilerin katılması, doğum eyleminin tahmin ettiklerinden daha ağrılı olması ve bakım verenlerin doğum ağrısının yönetiminde yetersiz yardım etmesi olduğunu saptamışlardır. 27 Bu sonuçlar doğrultusunda; doğumhane ortamlarının iyileştirilmesi, hizmet içi eğitim programları ile ebelerin bilinçlendirilerek doğuma desteğin artırıl-ması, doğum ağrılarına yönelik kullanılan yöntem-lerin ve doğum öncesi hazırlık sınıflarının yaygınlaştırılması sonucu kadının mahremiyeti, bakımın kalitesi ve doğum memnuniyetine katkı sağlanabileceği düşünülmektedir.…”