Exploring Areas of Improvement in Postnatal Care Services in a Tertiary Care Hospital in Pakistan

Abstract

Objective:To assess current quality of postnatal care in tertiary hospital in Lahore to identify areas for further improvement.Design:It was descriptive cross-sectional study which employed quantitative method to collect and analyze data.Setting:Lady Aitchison Hospital-a tertiary hospital in Lahore.Population:Ninety-six maternities admitted in wards of Lady Aitchison hospital during December 2021 to January 2022.Method:After IRB approval, consent was taken from mothers selected by random sampling and interviewed using Donabedian framework performa.Outcome Measures:Satisfaction with structure,process and outcome of delivery in postpartum mothers were assessed.Results:Among 96 mothers,56% were below 25 years of age,39% had secondary education,with more than one child(71%) and 57% visited for the first time.Majority of mothers,were given medicine timely(82%) and found attitude(85%) and information(83%) provided by healthcare workers helpful.Their subjective satisfaction rate with staff was 90%.However,there was lack of proper guidelines and facilities for examination,limited counselling of mothers regarding neonatal care and substandard interior of hospitals.Vital steps such as neonatal and maternal abdominopelvic,general and wound examination were left out in upto 30%. Information regarding danger signs of mothers and neonates was not given to 69% and information on family planning was given in only 28%.Contentment with infrastructure of hospital was subpar and it was suggested that sanitary conditions of washrooms and paraphernalia i.e.heaters and beds needed improvement.Conclusions:This study suggests that although patients were satisfied by services of healthcare workers,the infra-structure of hospital can be upgraded to provide better quality facilities in terms of air-conditioning,washrooms and well-designed areas for extensive examination of breast,pelvis,abdomen and neonates with introduction of WHO guidelines for postnatal care.