Intrapartum care intervention fidelity and factors associated with it in South Wollo Administrative Zone, Northeast Ethiopia.

Abstract

Background: Implementation of recommended intrapartum care intervention varies across places due to contextual socio-cultural and behavioral determinants. Previous research has utilized several operationalizations to measure intrapartum intervention content and has failed to analyze provider and facility-related factors that influence intrapartum intervention content. So yet, no study has used intervention fidelity metrics to assess intrapartum care. Therefore, this study aimed at assessing institutional intrapartum care intervention fidelity & factors associated with it. Methods: On randomly selected keabeles (study sites), a cross-sectional study design was used. All health posts and health extension workers within the specified area were included, as were 898 postnatal mothers within six months of delivery. Data was collected via an interview, self-administered questionnaires, and an observation checklist. To calculate the institutional delivery coverage and intrapartum care intervention fidelity, descriptive statistics were used. The weighted sum of all intrapartum care components and institutional delivery coverage were used to calculate intrapartum care intervention fidelity. The researchers utilized a multilevel linear regression analysis model to find characteristics linked to intrapartum care intervention fidelity. Results: In this study, institutional delivery coverage was 60.9% (95% CI: 57.7 – 64.1) with intrapartum care intervention fidelity of 35.6% (95% CI: 31.3-35.9). Moreover, only 21 (2.3%) of mothers received all of the contents of intrapartum care intervention. Health posts’ distance from mothers’ home, unskilled birth attendant, poor relationship between HEWs and HC staffs and low HEWs knowledge of danger signs were statistically significant barriers while HEWs as birth attendant were facilitators for Intrapartum care intervention fidelity. Conclusion: This study investigated that intrapartum care intervention fidelity was low. This finding indicated that distance from health institution inhibit mothers to receive skilled intrapartum care interventions as recommended.