Quality of the delivery services in health facilities in Northern Ethiopia

Abstract

BackgroundSubstantial improvements have been observed in the coverage of and access to maternal health service, especially in skilled birth attendants, in Ethiopia. However, the quality of care has been lagging behind. Therefore, this study investigated the status of the quality of delivery services in Northern Ethiopia.MethodsA facility based survey was conducted from December 2014 to February 2015 in Northern Ethiopia. The quality of delivery service was assessed in 32 health facilities using a facility audit checklist, by reviewing delivery, by conducting in-depth interview and observation, and by conducting exit interviews with eligible mothers. Facilities were considered as ‘good quality’ if they scored positively on 75% of the quality indicators set in the national guidelines for all the three components; input (materials, infrastructure, and human resource), process (adherence to standard care procedures during intrapartum and immediate postpartum periods) and output (the mothers’ satisfaction and utilization of lifesaving procedures).ResultsOverall 2 of 32 (6.3%) of the study facilities fulfilled all the three quality components; input, process and output. Two of the three components were assessed as good in 11 of the 32 (34.4%) health facilities. The input quality was the better of the other quality components; which was good in 21 out of the 32 (65.6%) health facilities. The process and output quality was good in only 10 of the 32 (31.3%) facilities.ConclusionsOnly 6.3% of the studied health facilities had good quality in all three dimensions of quality measures that was done in accordance to the national delivery service guidelines. The most compromised quality component was the process. Systematic and sustained efforts need to be strengthened to improve all dimensions of quality in order to achieve the desired quality of delivery services and increase the proportion of births occurring in health facilities.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2125-3) contains supplementary material, which is available to authorized users.

Level of Quality of Option B+PMTCT Service Provision in Public Health Facilities in Mekelle Zone, Northern Ethiopia: Cross-sectional study

“…Over all, only 25% of the health facilities were rated as good in all the three components; that is input, process and output. Quality service delivery in any of the three quality components was low when compared with the nation target in 2020 [10,20] and a report from similar study conducted in northern Ethiopia; Input (65.62%), Process (31.25%), and Output (31.25%) respectively [13]. The reason for such discrepancy might be variation in national targets used in two findings.…”

“…On the other hand the report complies with similar evidence from [14] public hospitals of Hadiya zone of southern Ethiopia. However, with low availability coverage as reported from [13,22] of Northern Ethiopia, and Zimbabwe respectively.…”

“…In line with process quality component, only 25% of study health facilities fulfilled quality service deliver based on the standards according to the national technical guide line. Quality item full filled were WHO clinical staging, discussing the benefit of Option B+,reviewing issues of opportunistic infections appointment of clients for the next visit, taking infant history, physical examination, and providing ARV prophylaxis for exposed infants The report was comparable with an evidence from [ 13,16] of northern Ethiopia,and South West Ethiopia. But lower when compared with evidence from [23] of Malawi.…”

“…Mothers were still faced a challenge to retain in the service. For instance, 16% over all LTF was reported in North East Ethiopia with (11.9%) at 6 months, (15.7%) at 12 months and (22.6%) at 24 months respectively [11], 14.8% in Eastern Ethiopia [12],and northern Ethiopia 9.8% Axum saint marry hospital [13]. As reported from different facility based 4 studies [14,15,16], poor service quality was the main challenge.…”

Evidence-based intrapartum practice and its associated factors at a tertiary teaching hospital in the Philippines, a descriptive mixed-methods study.

“…However, studies have identified gaps between recommended and actual practices [2]. Essential routine monitoring and assessment during labour as well as key practices are not sufficiently conducted, compounded by inappropriate infrastructures and supplies [3][4][5]. Mistreatment and abusive actions, including unnecessary interventions, are also common in health facility deliveries [4,6].…”